We report on a measurement of the parity violating asymmetry in the elastic scattering of polarized electrons off unpolarized protons with the A4 apparatus at MAMI in Mainz at a four momentum transfer value of Q 2 = 0.108 (GeV/c) 2 and at a forward electron scattering angle of 30 • < θe < 40 • . The measured asymmetry is ALR( ep) = (-1.36 ± 0.29stat ± 0.13syst) × 10 −6 . The expectation from the Standard Model assuming no strangeness contribution to the vector current is A0 = (-2.06± 0.14) × 10 −6 . We have improved the statistical accuracy by a factor of 3 as compared to our previous measurements at a higher Q 2 . We have extracted the strangeness contribution to the electromagnetic form factors from our data to be G s E + 0.106 G s M = 0.071 ± 0.036 at Q 2 = 0.108 (GeV/c) 2 . As in our previous measurement at higher momentum transfer for G s E + 0.230 G s M , we again find the value for G s E + 0.106 G s M to be positive, this time at an improved significance level of 2 σ.
We report on a measurement of the asymmetry in the scattering of transversely polarized electrons off unpolarized protons, A ⊥ , at two Q 2 values of 0.106 (GeV/c) 2 and 0.230 (GeV/c) 2 and a scattering angle of 30−6 . The first errors denotes the statistical error and the second the systematic uncertainties. A ⊥ arises from the imaginary part of the two-photon exchange amplitude and is zero in the one-photon exchange approximation. From comparison with theoretical estimates of A ⊥ we conclude that πN-intermediate states give a substantial contribution to the imaginary part of the two-photon amplitude. The contribution from the ground state proton to the imaginary part of the two-photon exchange can be neglected. There is no obvious reason why this should be different for the real part of the two-photon amplitude, which enters into the radiative corrections for the Rosenbluth separation measurements of the electric form factor of the proton.
Background
Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a severe adverse event of SARS-CoV-2 vaccination. We describe the characteristics of patients reported in Germany based on the Brighton Collaboration (BC) case definition criteria for Thrombosis and Thrombocytopenia Syndrome (TTS) and focus on patients with complete anti-platelet factor 4 (PF4)-antibody laboratory work up.
Methods
The adverse drug reaction database of the Paul-Ehrlich Institute was queried for TTS cases following ChAdOx1 nCoV-19 vaccination from February 1, until May 21, 2021. Cases with reports from the Greifswald laboratory were analysed in detail.
Findings
PF4 antibody tests were available for 69 suspected TTS cases reported to the Paul-Ehrlich Institute, of whom 52 patients fulfilled the BC case definition; 37 (71%) women, 15 (29%) men, median age 46·0 years (interquartile range 31·0-60·3 years). Cerebral venous sinus thrombosis was confirmed in 37 (71%), (additional) multiple thromboses in 19 (37%) patients. Twelve patients died. Non-survivors showed lower platelet counts compared to survivors (median nadir 15,000/µL vs 49,000/µL; p<0·0001). Combined anti-PF4/heparin IgG ELISA and PF4-dependent platelet activation testing yielded sensitivity of 96% (95% confidence interval 87-100%) and specificity of 77% (50-93%) for TTS. Four patients with thrombocytopenia but without thrombosis presented with severe headache or cerebral bleeding, explaining the lower specificity.
Interpretation
VITT has high mortality and can present with isolated thrombocytopenia, severe headache, and bleeding. Demonstration of platelet activating anti-PF4 IgG has high sensitivity for TTS and captures a wider spectrum of clinically relevant VITT than the current BC case definition.
Funding
Deutsche Forschungsgemeinschaft: 374031971-TRR240; Domagk-Programm Universitätsmedizin Greifswald
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