ChemInform Research Articles

CAR-based cell therapies for systemic lupus erythematosus.

The remarkable efficacy of chimeric antigen receptor (CAR) T cell therapy in hematological malignancies has provided a solid basis for the therapeutic concept, wherein specific pathogenic cell populations can be eradicated by means of targeted recognition. During the past few years, CAR-based cell therapies have been extensively investigated in preclinical and clinical research across various non-tumor diseases, with particular emphasis in the treatment of autoimmune diseases (ADs), yielding significant advancements. The recent deployment of CD19-directed CAR T cells has induced long-lasting, drug-free remission in patients with systemic lupus erythematosus (SLE) and other systemic AD, alongside a more profound immune reconstruction of B cell repertoire compared with conventional immunosuppressive agents and B cell-targeting biologics. Despite the initial success achieved by CAR T cell therapy, it is critical to acknowledge the divergences in its application between cancer and AD. Through examining recent clinical studies and ongoing research, we highlight the transformative potential of this therapeutic approach in the treatment of SLE, while also addressing the challenges and future directions necessary to enhance the long-term efficacy and safety of CAR-based cell therapies in clinical practice.

Evidence-Based Practice in Pediatric Critical Care Nursing.

Evidence-Based Practice in Pediatric Critical Care Nursing.

Preface: 5th International Conference on Artificial Intelligence and Engineering Applications (AIEA 2024)

2024 the 5th International Conference on Artificial Intelligence and Engineering Applications (AIEA 2024) was held in Guilin, China during November 16-17, 2024. AIEA 2024 is a platform for presenting excellent results and new challenges facing the field of the artificial intelligence and engineering applications, especially in the field of unmanned vehicles and aircraft, infrared identification, radar detection and so on. It brings together experts from industry, governments and academia, experienced in engineering, design and research. We appreciate that if you disseminate this flyer to your friends, colleagues, disciples and others who might interests to AIEA Conference Series. The conference received 91 manuscripts, by submitting a paper to AIEA, the authors agree to the review process and understand that papers undergo a peer-review process. Manuscripts will be reviewed by appropriately qualified experts in the field selected by the Conference Committee, who will give detailed comments and-if the submission gets accepted-the authors submit a revised version that takes into account this feedback. All papers are reviewed using a double-blind review process: authors declare their names and affiliations in the manuscript for the reviewers to see, but reviewers do not know each other's identities, nor do the authors receive information about who has reviewed their manuscript. The Committees of AIEA 2024 invest great efforts in reviewing the papers submitted to the conference and organizing the sessions to enable the participants to gain maximum benefit. With our warmest regards, Kaisen Li, Truman Pan Conference Organizing Committees

IFlpMosaics enable the multispectral barcoding and high-throughput comparative analysis of mutant and wild-type cells.

To understand gene function, it is necessary to compare cells carrying the mutated target gene with normal cells. In most biomedical studies, the cells being compared are in different mutant and control animals and, therefore, do not experience the same epigenetic changes and tissue microenvironment. The experimental induction of genetic mosaics is essential to determine a gene cell-autonomous function and to model the etiology of diseases caused by somatic mutations. Current technologies used to induce genetic mosaics in mice lack either accuracy, throughput or barcoding diversity. Here we present the iFlpMosaics toolkit comprising a large set of new genetic tools and mouse lines that enable recombinase-dependent ratiometric induction and single-cell clonal tracking of multiple fluorescently labeled wild-type and Cre-mutant cells within the same time window and tissue microenvironment. The labeled cells can be profiled by multispectral imaging or by fluorescence-activated flow cytometry and single-cell RNA sequencing. iFlpMosaics facilitate the induction and analysis of genetic mosaics in any quiescent or progenitor cell, and for any given single or combination of floxed genes, thus enabling a more accurate understanding of how induced genetic mutations affect the biology of single cells during tissue development, homeostasis and disease.

Association of DNA methylation of RASSF1A and SHOX2 with lung cancer risk: A systematic review and meta-analysis.

This study estimates the research upon the potential worth of Ras association domain family member 1 A (RASSF1A) and short stature homeobox 2 (SHOX2) DNA methylation in lung cancer (LC) diagnosis. Open-published research was searched through PubMed, EMBASE, the Cochrane Library, Web of Science, China National Knowledge Infrastructure, and Chinese Biology Medicine Literature Database. Data on true positives, false positives, false negatives, and true negatives were extracted. This meta-analysis included 22 studies encompassing 4109 subjects (2427 LC patients and 1682 controls). The combined sensitivity, specificity, and area under the curve for RASSF1A and SHOX2 DNA methylation were 0.77 (95% CI: 0.71-0.81), 0.90 (95% CI: 0.87-0.92), and 0.92 (95% CI: 0.87-0.92), respectively. The pooled positive likelihood ratio and negative likelihood ratio were 7.5 (5.9-9.7) and 0.26 (0.21-0.32). The combined diagnostic odds ratio was 29 (95% CI: 20-41). RASSF1A and SHOX2 DNA methylation may emerge as potential diagnostic biomarkers for early-stage LC.

TERT promoter mutations in gliomas: Molecular roles in tumorigenesis, metastasis, diagnosis, prognosis, therapeutic targeting, and drug resistance.

Telomerase reverse transcriptase (TERT), a critical player in cellular immortalization, has emerged as a focal point of investigation due to its frequent promoter mutations in various human malignancies. TERT promoter mutations exhibit a significant role in tumorigenesis, fostering unbridled cellular proliferation and survival. This comprehensive review delves into the landscape of TERT promoter mutations and their profound implications in cancer, particularly within the context of gliomas. This article meticulously examines the intricate interplay between TERT promoter mutations and the metastatic cascade, shedding light on their capacity to orchestrate invasive behavior in gliomas. Moreover, this review describes the recent trends in therapeutic targeting of the TERT and dissects the evolving landscape of drug resistance associated with TERT mutations, providing insights into potential therapeutic challenges. In addition, the diagnostic and prognostic implications of TERT promoter mutations in gliomas are scrutinized, unraveling their potential as robust biomarkers. It also discusses the recent advancements in molecular diagnostics, illustrating the promise of TERT mutations as diagnostic tools and prognostic indicators. This review collectively aims to contribute to a deeper understanding of TERT promoter mutations in gliomas, offering a foundation for future research endeavors and paving the way for innovative strategies in glioma management.

The Use of POCUS to Identify Subgaleal Fluid Collections and Intracranial Infections.

Point-of-care ultrasound (POCUS) has been useful in describing soft tissue infections, such as cellulitis and abscesses. There has been limited use of ultrasound to describe findings of intracranial infections, such as Pott's puffy tumor, in cases of forehead prominence and signs of infection. In this case series we present POCUS findings in 2 cases of intracranial infections and one case of soft tissue edema without intracranial involvement from a single pediatric tertiary care center. Ultrasound findings revealed subgaleal fluid collections with associated periosteal lifting of the frontal bone in cases of Pott's Puffy tumor and intracranial infection, but no bony disruption or periosteal lifting in the patient with traumatic soft tissue edema. As pediatric intracranial infections may continue to have uncharacteristic seasonal peaks, POCUS may be considered as a first-line imaging technique for patients presenting with forehead swelling for differentiating infectious and traumatic etiologies as well as judging the need for further imaging techniques such as computed tomography and magnetic resonance imaging.

State of the art-pharyngeal reconstruction

Reconstruction of the pharynx after ablative cancer surgery is challenging. Restoration of function and esthetics is at the forefront. There is currently no gold standard for reconstruction. The workhorses for free flap reconstruction are the radial free forearm flap or the anterolateral thigh flap. For medium size defects the free lateral arm flap is an excellent alternative. The current article discusses the advantages and disadvantages of the different free flap options from the perspective of two experiences head and neck surgeons and describes the usual steps in pharyngeal reconstruction. The ideal choice of reconstruction depends on the size and volume of the defect, the availability of donor vessels, and also on the experience and preference of the surgeon.

Oncoplastic breast reconstruction with single-port laparoscopically harvested omental flap: insights from a ten-year tertiary center experience.

To evaluate the 10-year functional and oncological outcomes of single-port laparoscopically harvested omental flap (SLOF) for immediate breast reconstruction after breast cancer surgery. The technical feasibility and oncologic safety of breast reconstruction using a laparoscopically harvested omental flap remain controversial. We examined 236 patients with breast cancer (including 2 patients with malignant phyllodes tumors) who underwent nipple-sparing mastectomy or breast-conserving surgery followed by immediate SLOF reconstruction between February 2015 and March 2024 at our institution. Short- and long-term outcomes were assessed. Cosmetic outcomes were evaluated using a three-panel assessment and the Seoul Breast Esthetic Scoring Tool and compared with those of a matched cohort of patients who underwent deep inferior epigastric perforator (DIEP) flap breast reconstruction. The rate of clinically significant complications of Clavien-Dindo grade IIIa or greater was 3.8% (9/236). Two patients with flap failure required flap removal and conversion to other reconstruction procedures. The cosmetic satisfaction rates were 82.5% and 76.4% in the SLOF and DIEP groups, respectively (P = 0.467). Over a median 59-month follow-up, the local, regional, and systemic recurrence rates were 3%, 2.1%, and 3%, respectively. All patients underwent annual screening for gastric cancer via esophagogastroduodenoscopy, and there were no cases of delayed flap removal due to gastrectomy. Oncoplastic breast reconstruction using SLOF is safe and feasible. The natural contour and texture of the reconstructed breast and the nearly invisible scar at the abdominal single-port incision provide excellent cosmetic outcomes that are superior to those of other reconstruction methods.

Systematic review of the feasibility of sparing the rectoprostatic fascia in male patients undergoing total mesorectal excision for rectal cancer.

The main purpose of this study was to determine the feasibility of sparing the rectoprostatic fascia (RPF) in adult male cadavers and in adult male patients who underwent total mesorectal excision (TME) for rectal cancer. A secondary objective was to evaluate urogenital function following rectal cancer surgery, pathologic, and oncologic outcomes. In accordance with PRISMA guidelines, we performed a systematic review with an a priori design to identify relevant studies via MESH terms and keywords. Research was conducted from March 1stto July31st 2023andwas updated betweenSeptember 30thtoOctober 10th 2024 in MEDLINE, SCOPUS, the Web of Science, Google Scholar, and reference lists. Disagreements between individual judgments were resolved by referral to a third researcher. In total, 3693 studies were identified, 22 of which were relevant to the main research question. Overall, 785 living individuals and 25 cadavers were included in whom RPF was identified and spared (498/785 patients or 63.44%). The quality of the surgical specimen was considered good in all cases. Urogenital integrity at 6months after RPF-TME and the classic TME were compromised in 27.9% and 41% of patients, respectively. One study revealed that at 3years, local/systemic recurrence was similar between the two groups. Despite the fact that the current practice of rectal cancer surgery requires the TME to extend anteriorly to the RPF, RPF-sparing TME is not only a feasible and safe option but also important for preserving fair male urogenital function, especially for young patients whose erectile function is a priority. CRD42020171188.

The Predictive Role of Preoperative Malnutrition Assessment in Postoperative Outcomes of Patients Undergoing Surgery Due to Gastrointestinal Cancer: A Cross-Sectional Observational Study.

Background: Malnutrition affects patients undergoing surgery for gastrointestinal cancers and contributes to poor postoperative outcomes, including increased complication rates, longer hospital stays, and higher mortality. Despite the availability of several malnutrition screening tools and prognostic scores, their effectiveness in predicting postoperative outcomes remains unclear. This study aimed to compare the predictive accuracy of Patient-Generated Subjective Global Assessment (PG-SGA), Global Leadership Initiative on Malnutrition (GLIM), Geriatric Nutritional Risk Index (GNRI), and Controlling Nutritional Status (CONUT) score for postoperative outcomes in patients undergoing surgery for colorectal, hepato-pancreato-biliary and upper gastrointestinal cancers. Methods: A cross-sectional observational study from March 2022 to October 2023 was conducted in two university surgical departments, after registration on ClinicalTrials database (NCT05795374). Patient characteristics, preoperative nutritional status and postoperative outcomes were analyzed. Results: In total, 480 patients were enrolled. CONUT and GNRI demonstrated high specificity (over 90% and 80%, respectively) for predicting overall complications, major complications, prolonged hospital stay, mortality, and advanced disease stage across all cancer types. Notably, CONUT showed a specificity over 97% and GNRI over 89.7% for colorectal and upper gastrointestinal cancer patients, respectively, despite their lower sensitivity. On the contrary, PG-SGA and GLIM presented better sensitivity (up to 50%), but slightly lower specificity (up to 86.4%). Conclusions: CONUT and GNRI are valuable for ruling out non-at-risk patients for adverse postoperative outcomes, while PG-SGA and GLIM provide better sensitivity. A step-up approach-initial screening with PG-SGA and GLIM, followed by detailed evaluation with CONUT or GNRI- should be validated in future studies across diverse clinical settings.

A prospective study on the enhancement of surgical safety in robotic surgery: The BirdView camera system.

To investigate the surgical safety and benefits of using the BirdView camera system with a wide field of view in robotic surgery for rectal cancer in a prospective clinical study. This study included 20 consecutive patients who underwent robotic surgery at our institution between the years 2022 and 2023. The primary endpoint was perioperative safety, which was defined as the occurrence of adverse events, including other organ injuries and malfunctions, caused by the BirdView camera system. There were no injuries to any other organs caused by the console surgeon or assistant forceps during surgery. Surgical adverse events occurred in five cases (atelectasis, paralytic ileus, and anastomotic leakage) during the postoperative course. There were no cases of device failure or damage to the surrounding organs, including peritoneal heat damage. We believe that the BirdView system could be valuable in improving the safety of robotic surgery by enabling the observation of blind spots, thus preventing harm to other organs.

Long-term results of the ORATOR-study: radiotherapy versus transoral robotic surgery for oropharyngeal cancer

Long-term results of the ORATOR-study: radiotherapy versus transoral robotic surgery for oropharyngeal cancer

Incidence of adverse events related to intravenous immunoglobulin therapy in children.

Intravenous immunoglobulin (IVIG) therapy is used in the treatment of pediatric diseases, although data about IVIG-related adverse events (IVIG-AEs) are limited. Objectives of this study were to document the incidence of IVIG-AEs in pediatric hospitalized patients and to identify risk factors for IVIG-AEs. This retrospective cohort study included patients <18 years old who received IVIG therapy while admitted at a Canadian pediatric tertiary care center between 2016 and 2020. Patients and IVIG-perfusions characteristics were collected, as well as IVIG-AEs. Bivariate and multivariable logistic regressions were used to explore predictors of IVIG-AEs. We included 228 children, totaling 478 IVIG perfusions. Indications included treatment for inflammatory (52.6%), autoimmune disorders (35.5%), and immunoglobulin replacement (11.8%). A total of 213 IVIG-AEs were reported. Fever (13.6%) and headache (6.7%) were the most frequent IVIG-AEs. Most IVIG-AEs were mild (57%) or moderate (31%) in severity, but 12% were severe reactions. The following factors were predictive of IVIG-AEs in univariate analyses: older age (OR 1.14 [95% CI: 1.07-1.21]), dehydration (OR 2.55 [95% CI: 1.43-4.55]), concurrent allergies (OR 2.87 [95% CI: 1.26-6.56]), first perfusion (OR 1.53 [95% CI: 1.02-2.30]), and higher dosage (OR 2.14 [95% CI: 1.39-3.33]). Concurrent steroids decreased the risk of IVIG-AEs (OR 0.43 [95% CI: 0.19-0.96]). Older age and higher IVIG dose remained independent predictors of IVIG-AEs in multivariable analyses. Mild IVIG-AEs are frequent in children, and serious reactions may occur. Prospective studies are needed to confirm risk factors for IVIG-AEs and to evaluate how to best prevent them.

Use of Emergency Telemedicine Physicians for Telephone Triage Disposition of Pediatric Patients.

Telemedicine is a growing field, with limited data around its utility supporting pediatric emergency care telephone triage. We instituted telemedicine physician support for nurse telephone triage decisions. When the nursing protocols recommended urgent or emergent care, a telemedicine physician reviewed and modified care urgency if appropriate. Our primary study objectives were to evaluate the proportion of patients who were downgraded to less urgent care and assess for potential harm related to the downgrade in care urgency. We conducted a retrospective observational cohort study of pediatric telephone calls to the Mayo Clinic Health System nurse triage line that were directed to the emergency department telemedicine physician from January 1, 2019, to December 31, 2019. Electronic medical records of patients whose care urgency was downgraded and presented to medical care within 72 hours of the triage call were reviewed. There were 8559 nurse line calls regarding pediatric patients, 882 of which were referred to the telemedicine physician. Among these, 396/882 (44.9%, 95% confidence interval 41.6-48.3) were downgraded. Of downgraded cases, 198 (50.0%) patients sought care within 72 hours of the original call, of which 193 (97.5%) patients were discharged home from that medical visit and 5 (2.5%) patients required admission. No patients were determined to have suffered harm due to the downgrade of visit urgency. Our data suggests that telemedicine physicians can safely downgrade nurse triage care recommendations for pediatric patients. Most downgraded patients sought outpatient care, avoiding unnecessary utilization of the emergency department without evidence of associated harm.

Assessment of Bioactivity of Homalomena aromatica Essential Oil From Northeast India Through Combinative In Vitro and In Silico Approaches.

Homalomena aromatica Schott is a valuable medicinal aromatic plant having wide range of applications in ethnobotany, pharmacology, perfumery and flavor industry. Traditionally, various part of H. aromatica such as leaves and rhizomes were applied to treat joint pain, skin diseases, colds, asthma, diarrhea, and jaundice. Whole herbs extracts are used to address muscle weakness, rheumatism, and allergies, purify the blood, treat deafness, and promote wound healing, especially in postpartum women. The present study is subjected to assess anti-inflammatory, anti-diabetic, tyrosinase inhibitory, acetylcholinesterase (AChE), antimicrobial, and genotoxic efficacies of H. aromatica rhizome essential oil (HAEO). To validate the findings of biological assays, in silico methods including Prediction of Activity Spectra for Substances (PASS) tool, target prediction, and molecular docking were employed. Using Clevenger apparatus dry rhizome of HAEO was extracted. The chemical profiling was performed using gas chromatography/mass spectrometry (GC/MS) where HAEO yield was 1.09%±0.641% (v/w) with 12 compounds where linalool was identified as major compound (76.29%). Anti-inflammatory activity showed IC50 value for protease inhibitory assay 19.59µL/mL and albumin denaturation assay 32.16µL/mL. The IC50 value for α-amylase inhibitory activity showed 29.84µL/mL, whereas tyrosinase inhibitory activity showed 73.62µL/mL. Acetylcholinesterase inhibitory (AChEase) activity revealed an IC50 value of 38.13µL/mL. Antimicrobial activity showed minimal inhibitory concentration (MIC) values of 10±0.47 and 45±0.47µg/mL against Staphylococcus aureus and Candida albicans. Genotoxicity analysis showed HAEO has moderate toxic effect. In silico results identified six potential targets via Swiss target prediction: (AChE, CYP51, peroxisome proliferator-activated receptor [PPAR], cyclooxygenase-2 [COX-2], and tyrosinase-related protein 1 [TYRP1]). Additionally, molecular docking studies revealed Linalool -7.4kcal/mol, Spathulenol -8.5kcal/mol, aromadendrene oxide-(2) -8.3kcal/mol better docking scores. For the first time, this study reports on anti-diabetic, anti-tyrosinase, acetylcholinesterase inhibitory activities and genotoxicity of HAEO. In silico investigation supports these activities by evaluating binding affinities and interactions between compounds and their respective targets through molecular docking. From the current reports, HAEO can be used for development of natural drugs in near future.

Electroacupuncture promotes gastrointestinal functional recovery after radical colorectal cancer surgery: a protocol of multicenter randomized controlled trial (CORRECT trial)

IntroductionThe incidence of postoperative gastrointestinal dysfunction (POGD) is notably high among patients following colorectal cancer surgery, highlighting the urgency for the prompt development of efficacious preventive and therapeutic approaches. Electroacupuncture (EA) represents an intervention modality that holds promise for the management of POGD. However, the existing empirical evidence substantiating its efficacy remains scarce. The aim of this study is to evaluate the efficacy and safety of EA as a treatment for POGD in patients undergoing colorectal cancer surgery.MethodsThis study is a multicenter, parallel-group, randomized controlled trial, named as CORRECT. CORRECT trial will recruit 300 participants diagnosed with colorectal cancer and about to undergo radical surgery across four sub-centers. The participants will be randomly assigned to one of three groups: the EA group, sham-electroacupuncture group, or control group, with a randomization ratio of 2:2:1. All groups will follow a standardized Enhanced Recovery After Surgery (ERAS) protocol. The EA group will receive EA at acupoints LI4, SJ6, ST36, and ST37, while the SA group will undergo sham-electroacupuncture. The treatments will be administered twice daily from the day of surgery until the fourth day after the operation. The primary endpoint is the time to first flatus, while secondary endpoints encompass time to first defecation, bowel sound emergence, initial water intake, duration of postoperative hospitalization, nausea and vomiting, pain levels, and blinded evaluations. Additional outcomes include medication usage and complication rates, et al.DiscussionThe CORRECT trial aims to provide high-quality evidence for the role of EA in the treatment of POGD following colorectal cancer surgery. It will contribute data towards the integration of acupuncture into ERAS protocols. Insights from the trial could help in tailoring treatment plans based on individual patient responses to EA, optimizing care on a case-by-case basis.Trial registrationClinical Trial Registry registration was approved by the ClinicalTrials.gov committee on November 2023 with the ClinicalTrials.gov Identifier: NCT06128785. URL: https://clinicaltrials.gov/study/NCT06128785?tab=history&a=1#study-details-card.

High Spatiotemporal Near-Infrared II Fluorescence Lifetime Imaging for Quantitative Detection of Clinical Tumor Margins.

Accurate detection of tumor margins is essential for successful cancer surgery. While indocyanine green (ICG)-based near-infrared (NIR) fluorescence (FL) surgical navigation enhances the visual identification of tumor margins, its accuracy remains subjective, underscoring the need for quantitative approaches. In this study, a high spatiotemporal fluorescence lifetime (FLT) imaging technology is developed in the second near-infrared window (NIR-II, 1000-1700nm) for quantitative tumor margin detection, utilizing folate receptor-targeted ICG nanoprobes (FPH-ICG). FPH-ICG exhibits a significantly prolonged NIR-II FLT (750 ±7ps vs 260 ±3ps) and increased NIR-II FL brightness (FPH-ICG/ICG=3.8). In vitro and in vivo studies confirm that FPH-ICG specifically targets folate receptor-α (FRα) on SK-OV-3 ovarian cancer cells, achieving high-contrast NIR-II FL imaging with a signal-to-background ratio of 10.8. Notably, NIR-II FLT imaging demonstrates superior accuracy (90%) and consistency in defining tumor margins compared to NIR-II FL imaging (58%) in both SK-OV-3 tumor-bearing mice and clinical tumor samples. These findings underscore the potential of NIR-II FLT imaging as a quantitative tool for guiding surgical tumor margin detection.

Research progress of breast cancer surgery during 2010–2024: a bibliometric analysis

PurposeThis study seeks to systematically analyze the research literature pertaining to breast cancer surgery from 2010 to 2024, as indexed in the PubMed database, employing bibliometric methodologies.MethodsEmploying the “bibliometrix” package in the R programming language, alongside VOSviewer and CiteSpace software, this research conducted a comprehensive visual analysis of 1,195 publications. The analysis encompassed publication trends, collaborative networks, journal evaluation, author and institutional assessments, country-specific analyses, keyword exploration, and the identification of research hotspots.ResultsThe study observed a rising trend in the number of publications related to breast cancer surgery. However, there was a concomitant decline in citation rates, potentially indicating either a saturation of the research field or a diminution in research quality. The United States, China, and Japan are the leading contributors to research output, with the United States showing the most extensive international collaboration. The University of California, University of Toronto, and University of Texas MD Anderson Cancer Center were the top institutions for the number of published papers. Through a comprehensive analysis of keywords, we have identified “breast cancer” “pain” “anxiety” “lymphedema” “mastectomy” and “surgery” as central research themes within this domain, the corresponding clusters were subjected to analysis.ConclusionThis study provides a comprehensive review of breast cancer surgery research, emphasizing major research areas and proposing future research directions. This study provides a significant resource for researchers and clinicians in the field.

A bibliometric analysis of Indonesian stem education research (2019–2023): Trends, contributors, and future directions

Science, technology, engineering, and mathematics (STEM) education is a global priority, but effective implementation faces challenges. This bibliometric study analyzed the results of Indonesian STEM education research to elucidate publication and contributor patterns. The Scopus database was searched for Indonesian STEM education publications from 2019–2023 and produced 52 documents from 23 sources. The analysis found a negative average growth rate of −5.43%, with a peak of 14 releases in 2020, possibly related to the COVID-19 pandemic. Although the output was relatively limited, the diversity of sources suggests wide-ranging interest. The leading authors were identified based on their productivity and impact on citation, with Wahono. emerging as the most influential worldwide. Universitas Pendidikan Indonesia was an institutional leader. The Journal of Physics Conference series dominated the contributions and emphasized the role of conference proceedings. Examination of the citations and text frequencies revealed key themes that include technology, engineering, pedagogy, and skills of the 21st century. Several widely cited works ensured international visibility. In general, this bibliometric analysis quantitatively mapped the landscape of Indonesian STEM education research, finding a decline in performance but a strong foundation of committed institutions and authors. The sustainability of production and impact requires targeted policies based on insight into existing strengths, productive scholars, and influential publications. The results provide an empirical basis for practices and policies for the effective development of STEM education in Indonesian schools.