Examining sex differences in knee pain: the Multicenter Osteoarthritis Study

SummaryObjectiveTo determine whether women experience greater knee pain severity than men at equivalent levels of radiographic knee osteoarthritis (OA).Design and methodsA cross-sectional analysis of 2712 individuals (60% women) without knee replacement or a recent steroid injection. Sex differences in pain severity at each Kellgren–Lawrence (KL) grade were assessed by knee using visual analog scale (VAS) scale and Western Ontario and McMaster Universities Arthritis Index (WOMAC) with and without adjustment for age, analgesic use, Body mass index (BMI), clinic site, comorbid conditions, depression score, education, race, and widespread pain (WSP) using generalized estimating equations. Effect sizes (Cohen's d) were also calculated. Analyses were repeated in those with and without patellofemoral OA (PFOA).ResultsWomen reported higher VAS pain at all KL grades in unadjusted analyses (d = 0.21–0.31, P < 0.0001–0.0038) and in analyses adjusted for all covariates except WSP (d = 0.16–0.22, P < 0.0001–0.0472). Pain severity differences further decreased with adjustment for WSP (d = 0.10–0.18) and were significant for KL grade ≤2 (P = 0.0015) and 2 (P = 0.0200). Presence compared with absence of WSP was associated with significantly greater knee pain at all KL grades (d = 0.32–0.52, P < 0.0001–0.0008). In knees with PFOA, VAS pain severity sex differences were greater at each KL grade (d = 0.45–0.62, P = 0.0006–0.0030) and remained significant for all KL grades in adjusted analyses (d = 0.31–0.57, P = 0.0013–0.0361). Results using WOMAC were similar.ConclusionsWomen reported greater knee pain than men regardless of KL grade, though effect sizes were generally small. These differences increased in the presence of PFOA. The strong contribution of WSP to sex differences in knee pain suggests that central sensitivity plays a role in these differences

Contractions, deformations and curvature

The role of curvature in relation with Lie algebra contractions of the pseudo-ortogonal algebras so(p,q) is fully described by considering some associated symmetrical homogeneous spaces of constant curvature within a Cayley-Klein framework. We show that a given Lie algebra contraction can be interpreted geometrically as the zero-curvature limit of some underlying homogeneous space with constant curvature. In particular, we study in detail the contraction process for the three classical Riemannian spaces (spherical, Euclidean, hyperbolic), three non-relativistic (Newtonian) spacetimes and three relativistic ((anti-)de Sitter and Minkowskian) spacetimes. Next, from a different perspective, we make use of quantum deformations of Lie algebras in order to construct a family of spaces of non-constant curvature that can be interpreted as deformations of the above nine spaces. In this framework, the quantum deformation parameter is identified as the parameter that controls the curvature of such "quantum" spaces.Comment: 17 pages. Based on the talk given in the Oberwolfach workshop: Deformations and Contractions in Mathematics and Physics (Germany, january 2006) organized by M. de Montigny, A. Fialowski, S. Novikov and M. Schlichenmaie

Irrational Conformal Field Theory

This is a review of irrational conformal field theory, which includes rational conformal field theory as a small subspace. Central topics of the review include the Virasoro master equation, its solutions and the dynamics of irrational conformal field theory. Discussion of the dynamics includes the generalized Knizhnik-Zamolodchikov equations on the sphere, the corresponding heat-like systems on the torus and the generic world- sheet action of irrational conformal field theory.Comment: 195 pages, Latex, 12 figures, to appear in Physics Reports. Typos corrected in Sections 13 and 14, and a footnote added in Section 1