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Article ; Online: Knee acoustic emissions as a noninvasive biomarker of articular health in patients with juvenile idiopathic arthritis: a clinical validation in an extended study population.

Goossens, Quentin / Locsin, Miguel / Gharehbaghi, Sevda / Brito, Priya / Moise, Emily / Ponder, Lori A / Inan, Omer T / Prahalad, Sampath

Pediatric rheumatology online journal

2023 Volume 21, Issue 1, Page(s) 59

Abstract: Background: Joint acoustic emissions from knees have been evaluated as a convenient, non-invasive digital biomarker of inflammatory knee involvement in a small cohort of children with Juvenile Idiopathic Arthritis (JIA). The objective of the present ... ...

Abstract	Background: Joint acoustic emissions from knees have been evaluated as a convenient, non-invasive digital biomarker of inflammatory knee involvement in a small cohort of children with Juvenile Idiopathic Arthritis (JIA). The objective of the present study was to validate this in a larger cohort. Findings: A total of 116 subjects (86 JIA and 30 healthy controls) participated in this study. Of the 86 subjects with JIA, 43 subjects had active knee involvement at the time of study. Joint acoustic emissions were bilaterally recorded, and corresponding signal features were used to train a machine learning algorithm (XGBoost) to classify JIA and healthy knees. All active JIA knees and 80% of the controls were used as training data set, while the remaining knees were used as testing data set. Leave-one-leg-out cross-validation was used for validation on the training data set. Validation on the training and testing set of the classifier resulted in an accuracy of 81.1% and 87.7% respectively. Sensitivity / specificity for the training and testing validation was 88.6% / 72.3% and 88.1% / 83.3%, respectively. The area under the curve of the receiver operating characteristic curve was 0.81 for the developed classifier. The distributions of the joint scores of the active and inactive knees were significantly different. Conclusion: Joint acoustic emissions can serve as an inexpensive and easy-to-use digital biomarker to distinguish JIA from healthy controls. Utilizing serial joint acoustic emission recordings can potentially help monitor disease activity in JIA affected joints to enable timely changes in therapy.
MeSH term(s)	Child ; Humans ; Arthritis, Juvenile/diagnosis ; Biomarkers ; Knee Joint ; ROC Curve ; Sensitivity and Specificity ; Machine Learning
Chemical Substances	Biomarkers
Language	English
Publishing date	2023-06-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2279468-2
ISSN	1546-0096 ; 1546-0096
ISSN (online)	1546-0096
ISSN	1546-0096
DOI	10.1186/s12969-023-00842-7
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Article ; Online: Acoustic Emissions From Loaded and Unloaded Knees to Assess Joint Health in Patients With Juvenile Idiopathic Arthritis.

Gharehbaghi, Sevda / Whittingslow, Daniel C / Ponder, Lori A / Prahalad, Sampath / Inan, Omer T

IEEE journal of biomedical and health informatics

2021 Volume 25, Issue 9, Page(s) 3618–3626

Abstract: Objective: We studied and compared joint acoustical emissions (JAEs) in loaded and unloaded knees as digital biomarkers for evaluating knee health status during the course of treatment in patients with juvenile idiopathic arthritis (JIA).: Methods: ... ...

Abstract	Objective: We studied and compared joint acoustical emissions (JAEs) in loaded and unloaded knees as digital biomarkers for evaluating knee health status during the course of treatment in patients with juvenile idiopathic arthritis (JIA). Methods: JAEs were recorded from 38 participants, performing 10 repetitions of unloaded flexion/extension (FE) and loaded squat exercises. A novel algorithm was developed to detect and exclude rubbing noise and loose microphone artifacts from the signals, and then 72 features were extracted. These features were down-selected based on different criteria to train three logistic regression classifiers. The classifiers were trained with healthy and pre-treatment data and were used to predict the knee health scores of post-treatment data for the same patients with JIA who had a follow-up recording. This knee health score represents the probability of having JIA in a subject (0 for healthy and 1 for arthritis). Results: Post-treatment knee health scores were lower than pre-treatment scores, agreeing with the clinical records of successful treatment. Regarding loaded versus unloaded knee scores, the squats achieved a higher score on average compared to FEs. Conclusion: In healthy subjects with smooth cartilage, the knee scores of squats and FEs were similar indicating that vibrations from the friction of articulating surfaces do not significantly change by the joint load. However, in subjects with JIA, the scores of squats were higher than the scores of FEs, revealing that these two exercises contain different, possibly clinically relevant, information that could be used to further improve this novel assessment modality in JIA.
MeSH term(s)	Acoustics ; Arthritis, Juvenile ; Exercise Therapy ; Humans ; Knee Joint/diagnostic imaging ; Posture
Language	English
Publishing date	2021-09-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2695320-1
ISSN	2168-2208 ; 2168-2194
ISSN (online)	2168-2208
ISSN	2168-2194
DOI	10.1109/JBHI.2021.3081429
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Article ; Online: Quality of life measures and physical activity in childhood systemic lupus erythematosus.

Nelson, Meghan Corrigan / Gibson, Sinclair / Villacis-Nunez, D Sofia / Kimi Chan, Lai Hin / Ponder, Lori / Prahalad, Sampath / Moorthy, L Nandini

Lupus

2022 Volume 31, Issue 9, Page(s) 1114–1120

Abstract: Childhood systemic lupus erythematosus (cSLE) is a life-long disease with significant morbidity and mortality, and with associated significant impact on health-related quality of life (HRQOL). Previous literature supports that physical activity has ... ...

Abstract	Childhood systemic lupus erythematosus (cSLE) is a life-long disease with significant morbidity and mortality, and with associated significant impact on health-related quality of life (HRQOL). Previous literature supports that physical activity has positive impact on HRQOL in patients with chronic diseases, including cSLE. We sought to describe the physical activity of our patients with cSLE and determine the relationship between physical activity, SLE activity, treatment modalities and HRQOL in cSLE. Children ≤18 years of age with cSLE and their parents were enrolled and completed corresponding child and parent Simple Measure of Impact of Lupus Erythematosus in Youngsters
MeSH term(s)	Adolescent ; Age of Onset ; Child ; Exercise ; Humans ; Lupus Erythematosus, Systemic/drug therapy ; Quality of Life ; Retrospective Studies ; Severity of Illness Index
Language	English
Publishing date	2022-06-06
Publishing country	England
Document type	Journal Article
ZDB-ID	1154407-7
ISSN	1477-0962 ; 0961-2033
ISSN (online)	1477-0962
ISSN	0961-2033
DOI	10.1177/09612033221106154
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Zs.A 3717: Show issues

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Article: Clinical Determinants of Childhood Onset Systemic Lupus Erythematosus among Early and Peri-Adolescent Age Groups.

Nelson, Meghan Corrigan / Chandrakasan, Shanmuganathan / Ponder, Lori / Sanz, Ignacio / Goldberg, Baruch / Ogbu, Ekemini A / Rouster-Stevens, Kelly / Prahalad, Sampath

Children (Basel, Switzerland)

2022 Volume 9, Issue 12

Abstract: Introduction: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that is associated with significant morbidity and mortality. SLE disproportionately affects women and minorities. Childhood-onset SLE (cSLE) in particular tends to be ... ...

Abstract	Introduction: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that is associated with significant morbidity and mortality. SLE disproportionately affects women and minorities. Childhood-onset SLE (cSLE) in particular tends to be more aggressive than adult-onset SLE. Despite substantial improvements in the treatment of cSLE, there is significant variability in treatment responses and long-term outcomes. Furthermore, there is a paucity of studies involving cSLE, and in particular, cSLE among different age groups. The aim of this study was to test the hypothesis that an early-onset cSLE cohort would demonstrate unique characteristics with distinctive clinical and laboratory features at disease onset. We specifically investigated whether clinical, epidemiological, or serological factors are differentially associated with early- and late-onset cSLE. This could have direct impact on clinical management with the goal of improving outcomes and quality of life for children with SLE. Methods: Our study was conducted at a large tertiary center. We included 213 subjects seen at our pediatric rheumatology clinic aged 4−17 years. Epidemiologic, clinical phenotype, disease severity, serology, treatment, and outcome data were compared between subjects with cSLE onset prior to 10 years of age (early-onset disease, n = 43) and those with cSLE onset greater than 10 years of age (peri-adolescent disease, n = 170). We compared clinical features between early- and peri-adolescent onset cSLE in order to investigate the association between age at disease onset of cSLE and clinical disease expression and outcomes. Results: Of the 213 subjects with cSLE in our study, 43 subjects had early-onset disease (age 2 to ≤9 years) and 170 patients had peri-adolescent onset disease. We found that early-onset cSLE was associated with a higher prevalence of positive anti-dsDNA antibody at cSLE diagnosis, higher anti-dsDNA antibody titer at cSLE diagnosis, rash, and azathioprine use (p < 0.001, p = 0.004, p = 0.011, and p = 0.008, respectively). In contrast, we found that peri-adolescent onset cSLE (≥10 years of age) was associated with worse disease activity (SLEDAI range 0−24) (p < 0.001), higher SLICC at diagnosis (p < 0.001), as well as a higher rate of mycophenolate mofetil and hydroxychloroquine use (p = 0.003 and p < 0.001, respectively). There were no significant differences in the prevalence of neuropsychiatric symptoms or the development of Class IV/Class V lupus nephritis between the early-onset and peri-adolescent groups.
Language	English
Publishing date	2022-11-30
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2732685-8
ISSN	2227-9067
ISSN	2227-9067
DOI	10.3390/children9121865
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Article ; Online: Prevalence of tissue transglutaminase antibodies and IgA deficiency are not increased in juvenile idiopathic arthritis: a case-control study.

Kohli, Angela Taneja / Hersh, Aimee O / Ponder, Lori / Chan, Lai Hin Kimi / Rouster-Stevens, Kelly A / Tebo, Anne E / Kugathasan, Subra / Guthery, Stephen L / Bohnsack, John F / Prahalad, Sampath

Pediatric rheumatology online journal

2023 Volume 21, Issue 1, Page(s) 110

Abstract: Background: The prevalence of Celiac Disease (CD) in Juvenile Idiopathic Arthritis (JIA) has been reported to be 0.1-7% in various small studies. As a result of the limited number of research and their inconclusive results there are no clear ... ...

Abstract	Background: The prevalence of Celiac Disease (CD) in Juvenile Idiopathic Arthritis (JIA) has been reported to be 0.1-7% in various small studies. As a result of the limited number of research and their inconclusive results there are no clear recommendations for routine CD screening in asymptomatic patients with JIA. Our aim is to estimate the prevalence of IgA deficiency and tissue transglutaminase (tTG) IgA in a cohort of JIA followed in two large academic medical centers. Methods: Serum was collected and stored from all subjects and analyzed in a reference laboratory for total IgA (Quantitative Nephelometry) and tTG IgA antibody levels (Semi-Quantitative Enzyme-Linked Immunosorbent Assay). Fisher's exact tests were performed for statistical significance. Risk estimates (odds ratios) with 95% confidence intervals were calculated. Results: 808 JIA cases and 140 controls were analyzed. Majority were non-Hispanic whites (72% vs. 68% p = 0.309). A total of 1.2% of cases were IgA deficient compared to none of the controls (p = 0.373). After excluding IgA deficient subjects, 2% of cases had tTG IgA ≥ 4u/mL compared to 3.6% of controls (p = 0.216) (OR = 0.5; 95% C.I = 0.1-1.4); and 0.8% of cases had tTG IgA > 10u/mL compared to 1.4% of controls (p = 0.627) (OR = 0.5; 95%C.I = 0.1-2.9). Conclusions: Using the largest JIA cohort to date to investigate prevalence of celiac antibodies, the prevalence of positive tTG IgA was 0.8% and of IgA deficiency was 1.2%. The results did not demonstrate a higher prevalence of abnormal tTG IgA in JIA. The study did not support the routine screening of asymptomatic JIA patients for CD.
MeSH term(s)	Humans ; Protein Glutamine gamma Glutamyltransferase 2 ; Arthritis, Juvenile/epidemiology ; Case-Control Studies ; Transglutaminases ; Prevalence ; IgA Deficiency/diagnosis ; IgA Deficiency/epidemiology ; Immunoglobulin A ; Autoantibodies ; Celiac Disease/diagnosis ; Celiac Disease/epidemiology
Chemical Substances	Protein Glutamine gamma Glutamyltransferase 2 (EC 2.3.2.13) ; Transglutaminases (EC 2.3.2.13) ; Immunoglobulin A ; Autoantibodies
Language	English
Publishing date	2023-10-05
Publishing country	England
Document type	Journal Article
ZDB-ID	2279468-2
ISSN	1546-0096 ; 1546-0096
ISSN (online)	1546-0096
ISSN	1546-0096
DOI	10.1186/s12969-023-00890-z
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Article ; Online: Profiling the peripheral immune response to ex vivo TNF stimulation in untreated juvenile idiopathic arthritis using single cell RNA sequencing.

Imbach, Kathleen J / Treadway, Nicole J / Prahalad, Vaishali / Kosters, Astrid / Arafat, Dalia / Duan, Meixue / Gergely, Talia / Ponder, Lori A / Chandrakasan, Shanmuganathan / Ghosn, Eliver E B / Prahalad, Sampath / Gibson, Greg

Pediatric rheumatology online journal

2023 Volume 21, Issue 1, Page(s) 17

Abstract: Background: Juvenile Idiopathic Arthritis (JIA) is an autoimmune disease with a heterogenous clinical presentation and unpredictable response to available therapies. This personalized transcriptomics study sought proof-of-concept for single-cell RNA ... ...

Abstract	Background: Juvenile Idiopathic Arthritis (JIA) is an autoimmune disease with a heterogenous clinical presentation and unpredictable response to available therapies. This personalized transcriptomics study sought proof-of-concept for single-cell RNA sequencing to characterize patient-specific immune profiles. Methods: Whole blood samples from six untreated children, newly diagnosed with JIA, and two healthy controls were cultured for 24 h with or without ex vivo TNF stimulation and subjected to scRNAseq to examine cellular populations and transcript expression in PBMCs. A novel analytical pipeline, scPool, was developed wherein cells are first pooled into pseudocells prior to expression analysis, facilitating variance partitioning of the effects of TNF stimulus, JIA disease status, and individual donor. Results: Seventeen robust immune cell-types were identified, the abundance of which was significantly affected by TNF stimulus, which resulted in notable elevation of memory CD8 + T-cells and NK56 cells, but down-regulation of naïve B-cell proportions. Memory CD8 + and CD4 + T-cells were also both reduced in the JIA cases relative to two controls. Significant differential expression responses to TNF stimulus were also characterized, with monocytes showing more transcriptional shifts than T-lymphocyte subsets, while the B-cell response was more limited. We also show that donor variability exceeds the small degree of possible intrinsic differentiation between JIA and control profiles. An incidental finding of interest was association of HLA-DQA2 and HLA-DRB5 expression with JIA status. Conclusions: These results support the development of personalized immune-profiling combined with ex-vivo immune stimulation for evaluation of patient-specific modes of immune cell activity in autoimmune rheumatic disease.
MeSH term(s)	Child ; Humans ; Arthritis, Juvenile/drug therapy ; Immunity ; Gene Expression Profiling ; Sequence Analysis, RNA
Language	English
Publishing date	2023-02-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2279468-2
ISSN	1546-0096 ; 1546-0096
ISSN (online)	1546-0096
ISSN	1546-0096
DOI	10.1186/s12969-023-00787-x
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Article ; Online: The Simple prEservatioN of Single cElls method for cryopreservation enables the generation of single-cell immune profiles from whole blood.

Satpathy, Sarthak / Thomas, Beena E / Pilcher, William J / Bakhtiari, Mojtaba / Ponder, Lori A / Pacholczyk, Rafal / Prahalad, Sampath / Bhasin, Swati S / Munn, David H / Bhasin, Manoj K

Frontiers in immunology

2023 Volume 14, Page(s) 1271800

Abstract: Introduction: Current multistep methods utilized for preparing and cryopreserving single-cell suspensions from blood samples for single-cell RNA sequencing (scRNA-seq) are time-consuming, requiring trained personnel and special equipment, so limiting ... ...

Abstract	Introduction: Current multistep methods utilized for preparing and cryopreserving single-cell suspensions from blood samples for single-cell RNA sequencing (scRNA-seq) are time-consuming, requiring trained personnel and special equipment, so limiting their clinical adoption. We developed a method, Simple prEservatioN of Single cElls (SENSE), for single-step cryopreservation of whole blood (WB) along with granulocyte depletion during single-cell assay, to generate high quality single-cell profiles (SCP). Methods: WB was cryopreserved using the SENSE method and peripheral blood mononuclear cells (PBMCs) were isolated and cryopreserved using the traditional density-gradient method (PBMC method) from the same blood sample (n=6). The SCPs obtained from both methods were processed using a similar pipeline and quality control parameters. Further, entropy calculation, differential gene expression, and cellular communication analysis were performed to compare cell types and subtypes from both methods. Results: Highly viable (86.3 ± 1.51%) single-cell suspensions (22,353 cells) were obtained from the six WB samples cryopreserved using the SENSE method. In-depth characterization of the scRNA-seq datasets from the samples processed with the SENSE method yielded high-quality profiles of lymphoid and myeloid cell types which were in concordance with the profiles obtained with classical multistep PBMC method processed samples. Additionally, the SENSE method cryopreserved samples exhibited significantly higher T-cell enrichment, enabling deeper characterization of T-cell subtypes. Overall, the SENSE and PBMC methods processed samples exhibited transcriptional, and cellular communication network level similarities across cell types with no batch effect except in myeloid lineage cells. Discussion: Comparative analysis of scRNA-seq datasets obtained with the two cryopreservation methods i.e., SENSE and PBMC methods, yielded similar cellular and molecular profiles, confirming the suitability of the former method's incorporation in clinics/labs for cryopreserving and obtaining high-quality single-cells for conducting critical translational research.
MeSH term(s)	Leukocytes, Mononuclear ; Cryopreservation/methods ; Quality Control
Language	English
Publishing date	2023-11-28
Publishing country	Switzerland
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2023.1271800
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Article: Impact of the Season of Birth on the Development of Juvenile Idiopathic Arthritis in the United States: A Nationwide Registry-based Study.

Dave, Ishaan / Estroff, Brandon / Gergely, Talia / Rostad, Christina A / Ponder, Lori A / McCracken, Courtney / Prahalad, Sampath

The Journal of rheumatology

2021 Volume 48, Issue 12, Page(s) 1856–1862

Abstract: Objective: Autoimmune disorders result from the interplay of genetic and environmental factors. Many autoimmune disorders are associated with specific seasons of birth, implicating a role for environmental determinants in their etiopathology. We ... ...

Abstract	Objective: Autoimmune disorders result from the interplay of genetic and environmental factors. Many autoimmune disorders are associated with specific seasons of birth, implicating a role for environmental determinants in their etiopathology. We investigated if there is an association between the season of birth and the development of juvenile idiopathic arthritis (JIA). Methods: Birth data from 10,913 children with JIA enrolled at 62 Childhood Arthritis and Rheumatology Research Alliance Registry sites was compared with 109,066,226 US births from the same period using a chi-square goodness-of-fit test. Season of birth of the JIA cohort was compared to the US population estimate using a 2-sided 1-sample test for a binomial proportion and corrected for multiple comparisons. Secondary analysis was performed for JIA categories, age of onset, and month of birth. Results: A greater proportion of children with JIA were born in winter (January-March) compared to the US general population (25.72% vs 24.08%; corrected Conclusion: Relative to the general population, children with JIA are more often born in the winter, and specifically in the month of January. These observations support the hypothesis that seasonal variations in exposures during the gestational and/or early postnatal periods may contribute to development of JIA.
MeSH term(s)	Arthritis, Juvenile/epidemiology ; Child ; Cohort Studies ; Humans ; Registries ; Rheumatology ; Seasons ; United States/epidemiology
Language	English
Publishing date	2021-06-15
Publishing country	Canada
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	194928-7
ISSN	1499-2752 ; 0315-162X
ISSN (online)	1499-2752
ISSN	0315-162X
DOI	10.3899/jrheum.201238
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Article ; Online: Knee Acoustic Emissions as a Digital Biomarker of Disease Status in Juvenile Idiopathic Arthritis.

Whittingslow, Daniel C / Zia, Jonathan / Gharehbaghi, Sevda / Gergely, Talia / Ponder, Lori A / Prahalad, Sampath / Inan, Omer T

Frontiers in digital health

2020 Volume 2, Page(s) 571839

Abstract: In this paper, we quantify the joint acoustic emissions (JAEs) from the knees of children with juvenile idiopathic arthritis (JIA) and support their use as a novel biomarker of the disease. JIA is the most common rheumatic disease of childhood; it has a ... ...

Abstract	In this paper, we quantify the joint acoustic emissions (JAEs) from the knees of children with juvenile idiopathic arthritis (JIA) and support their use as a novel biomarker of the disease. JIA is the most common rheumatic disease of childhood; it has a highly variable presentation, and few reliable biomarkers which makes diagnosis and personalization of care difficult. The knee is the most commonly affected joint with hallmark synovitis and inflammation that can extend to damage the underlying cartilage and bone. During movement of the knee, internal friction creates JAEs that can be non-invasively measured. We hypothesize that these JAEs contain clinically relevant information that could be used for the diagnosis and personalization of treatment of JIA. In this study, we record and compare the JAEs from 25 patients with JIA-10 of whom were recorded a second time 3-6 months later-and 18 healthy age- and sex-matched controls. We compute signal features from each of those record cycles of flexion/extension and train a logistic regression classification model. The model classified each cycle as having JIA or being healthy with 84.4% accuracy using leave-one-subject-out cross validation (LOSO-CV). When assessing the full JAE recording of a subject (which contained at least 8 cycles of flexion/extension), a majority vote of the cycle labels accurately classified the subjects as having JIA or being healthy 100% of the time. Using the output probabilities of a JIA class as a basis for a joint health score and test it on the follow-up patient recordings. In all 10 of our 6-week follow-up recordings, the score accurately tracked with successful treatment of the condition. Our proposed JAE-based classification model of JIA presents a compelling case for incorporating this novel joint health assessment technique into the clinical work-up and monitoring of JIA.
Language	English
Publishing date	2020-11-19
Publishing country	Switzerland
Document type	Journal Article
ISSN	2673-253X
ISSN (online)	2673-253X
DOI	10.3389/fdgth.2020.571839
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Article: Using Knee Acoustical Emissions for Sensing Joint Health in Patients with Juvenile Idiopathic Arthritis: A Pilot Study.

Semiz, Beren / Hersek, Sinan / Whittingslow, Daniel C / Ponder, Lori / Prahalad, Sampath / Inan, Omer T

IEEE sensors journal

2018 Volume 18, Issue 22, Page(s) 9128–9136

Abstract: In this paper, we present a pilot study evaluating novel methods for assessing joint health in patients with Juvenile Idiopathic Arthritis (JIA) using wearable acoustical emission measurements from the knees. Measurements were taken from four control ... ...

Abstract	In this paper, we present a pilot study evaluating novel methods for assessing joint health in patients with Juvenile Idiopathic Arthritis (JIA) using wearable acoustical emission measurements from the knees. Measurements were taken from four control subjects with no known knee injuries, and from four subjects with JIA, before and after treatment. Time and frequency domain features were extracted from the acoustical emission signals and used to compute a knee audio score. The score was used to separate out the two groups of subjects based solely on the sounds their joints produce. It was created using a soft classifier based on gradient boosting trees. The knee audio scores ranged from 0-1 with 0 being a healthy knee and 1 being an involved joint with arthritis. Leave-one-subject-out cross-validation (LOSO-CV) was used to validate the algorithm. The average of the right and left knee audio scores was 0.085±0.099 and 0.89±0.012 for the control group and group with JIA, respectively (p<0.05). The average knee audio score for the subjects with JIA decreased from 0.89±0.012 to 0.25±0.20 following successful treatment (p<0.05). The knee audio score metric successfully distinguished between the control subjects and subjects with JIA. The scores calculated before and after treatment accurately reflected the observed clinical course of the subjects with JIA. After successful treatment, the subjects with JIA were classified as healthy by the algorithm. Knee acoustical emissions provide a novel and cost-effective method for monitoring JIA, and can be used as an objective guide for assessing treatment efficacy.
Language	English
Publishing date	2018-09-24
Publishing country	United States
Document type	Journal Article
ISSN	1530-437X
ISSN	1530-437X
DOI	10.1109/JSEN.2018.2869990
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