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{"sheet":"Application form (Form 1-1)","index":0,"n_rows":93,"n_cols":28,"rows_kept":93,"cut":false,"hidden":false,"merged":[[27,5,27,17],[27,18,27,22],[28,5,28,22],[86,1,86,8],[90,1,90,8],[54,1,54,9],[54,10,54,22],[16,9,17,11],[18,9,18,11],[18,12,18,22],[16,12,17,22],[29,5,29,22],[43,1,43,22],[47,1,47,22],[30,5,30,22],[31,21,32,22],[39,11,39,12],[39,13,39,16],[39,17,39,20],[40,9,40,10],[40,11,40,12],[40,13,40,16],[46,5,46,8],[44,21,44,22],[93,1,93,22],[89,1,89,21],[56,1,56,3],[59,1,59,3],[63,1,63,8],[63,9,63,21],[65,1,65,8],[67,1,67,8],[69,1,69,8],[71,1,71,8],[73,1,73,8],[27,0,28,0],[27,1,28,4],[36,13,36,16],[36,17,36,20],[37,9,37,10],[37,11,37,12],[37,13,37,16],[37,17,37,20],[33,5,33,8],[34,5,34,8],[31,5,32,8],[33,11,33,12],[33,13,33,16],[33,17,33,20],[34,9,34,10],[34,11,34,12],[34,13,34,16],[34,17,34,20],[31,9,32,10],[31,11,32,12],[31,13,32,16],[31,17,32,20],[29,1,29,4],[30,1,30,4],[1,20,1,22],[4,0,4,22],[19,9,20,11],[21,9,21,11],[22,9,22,11],[23,9,23,11],[7,16,7,21],[21,12,21,22],[22,12,22,22],[23,12,23,22],[19,12,19,14],[2,21,2,22],[6,11,6,16],[6,17,6,22],[20,12,20,22],[2,17,2,18],[14,9,15,11],[14,12,15,22],[13,12,13,22],[12,9,12,11],[12,12,12,22],[13,9,13,11],[31,0,32,0],[31,1,32,4],[35,5,35,8],[52,1,52,22],[55,1,55,22],[61,1,61,22],[46,1,46,4],[49,0,49,22],[40,17,40,20],[44,9,44,10],[44,11,44,12],[44,13,44,16],[44,17,44,20],[45,9,45,10],[45,11,45,12],[45,13,45,16],[45,17,45,20],[35,9,35,10],[35,11,35,12],[35,13,35,16],[35,17,35,20],[36,9,36,10],[36,11,36,12],[39,9,39,10],[45,21,45,22],[44,5,44,8],[48,0,48,22],[46,9,46,10],[46,11,46,12],[46,13,46,16],[46,17,46,20],[45,5,45,8],[35,1,35,4],[41,5,41,8],[41,9,41,10],[41,11,41,12],[41,13,41,16],[41,17,41,20],[41,21,41,22],[42,5,42,8],[42,9,42,10],[42,11,42,12],[42,13,42,16],[42,17,42,20],[42,21,42,22],[33,1,33,4],[34,1,34,4],[45,1,45,4],[44,1,44,4],[36,1,36,4],[37,1,37,4],[39,1,39,4],[40,1,40,4],[38,1,38,4],[41,1,41,4],[42,1,42,4],[33,9,33,10],[35,21,35,22],[36,21,36,22],[37,21,37,22],[38,21,38,22],[38,13,38,16],[38,17,38,20],[81,1,81,22],[62,1,62,22],[64,1,64,22],[33,21,33,22],[34,21,34,22],[39,21,39,22],[40,21,40,22],[38,9,38,10],[38,11,38,12],[36,5,36,8],[37,5,37,8],[38,5,38,8],[39,5,39,8],[40,5,40,8],[58,1,58,22],[46,21,46,22],[51,1,51,22],[53,1,53,3],[82,1,82,22],[72,1,72,22],[74,1,74,22],[76,1,76,22],[78,1,78,22],[80,1,80,22],[66,1,66,22],[68,1,68,22],[70,1,70,22],[75,1,75,8],[77,1,77,8],[79,1,79,8]]}
[]
["（Form 1-1)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"＊ Receipt Number　",null,null,null,2023,null,null,"-"]
[]
["Application Form for Joint Usage/Research Center for Raditation Disaster Medical Science"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"Date of submission:",null,null,null,null,null,"/          /"]
[]
["To:Director of Research Center for Radiation Disaster Medical Science"]
[]
[null,null,null,null,null,null,null,null,"Applicant"]
[null,null,null,null,null,null,null,null,null,null,null,null,"AA"]
[null,null,null,null,null,null,null,null,null,"Representative's \nName:"]
[null,null,null,null,null,null,null,null,null,null,null,null,"(Please enter your name the way you would in submitting your paper.)"]
[null,null,null,null,null,null,null,null,null,"Affiliated \nOrganization:"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Fukushima①Research on low-dose and low-dose rate radiation effects"]
[null,null,null,null,null,null,null,null,null,"Department \nName:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Fukushima②Development of diagnostic and treatment methods for internal radiation exposure"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Fukushima③Research and development of radiation-protective drugs"]
[null,null,null,null,null,null,null,null,null,"Job title",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Fukushima④Research on risk communication regarding radiation disasters"]
[null,null,null,null,null,null,null,null,null,"Address:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Other①Research on the molecular mechanisms of genomic damage and repair"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Other②Research on mechanisms of radiation carcinogenesis and development of cancer treatment"]
[null,null,null,null,null,null,null,null,null,"TEL:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Other③Basic research on development of medical care for radiation disasters"]
[null,null,null,null,null,null,null,null,null,"FAX:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Other④Basic research on regenerative medicine approaches to improve radiation treatment"]
[null,null,null,null,null,null,null,null,null,"e-mail:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Other⑤Evaluative research on health effects and health risks associated with radiation disasters"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Other⑥Application of radioisotopes to medical diagnosis and treatment"]
[null,"We hereby apply as follows:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Other⑦Medical radiation research"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Open-topic/Joint research based on original ideas of the applicant(s) that utilizes the facilities, equipment and materials of the center and is aimed at the comprehensive development of radiation disaster medical science."]
["1.","Joint Research Title",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(Please check one.)"]
[null,null,null,null,null,"※If you are applying for a continuation, please check the proposal title on the list of proposals adopted in the previous fiscal year and enter the name of the proposal.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"https://housai.hiroshima-u.ac.jp/wp/wp-content/uploads/2022/09/b8cc297046b7df6f6b99291a249e2d05-1.pdf"]
["2.","Joint Research Topic",null,null,null,"※Please be sure to select one of the following."]
["3.","Joint Research Period",null,null,null,"April, 1 2023 (or adopted day if after April 2nd) to March 31, 2024"]
["4.","Research Organization",null,null,null,"Name",null,null,null,"※Age (as of \nApril 1, 2023)",null,"※Gender",null,"Affiliated Organization",null,null,null,"Department\nName",null,null,null,"Job title"]
[]
[null,"Joint Researcher Name\n (Representative)"]
[null,"Joint Researcher2"]
[null,"Joint Researcher3"]
[null,"Joint Researcher4"]
[null,"Joint Researcher5"]
[null,"Joint Researcher6"]
[null,"Joint Researcher7"]
[null,"Joint Researcher8"]
[null,"Joint Researcher9"]
[null,"Joint Researcher10"]
[]
[null,"Resident Researcher \n(Representative)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Hiroshima University","Research Institute for Radiation Biology and Medicine"]
[null,"Resident Researcher2",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Nagasaki University","Atomic Bomb Disease Institute"]
[null,"Resident Researcher3",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Fukushima Medical University","Fukushima Global Medical Science Center"]
[]
["※This is for the purpose of alloting the number of \"Female Researchers\" and \"Age (as of April 1, 2023)\" to be accepted when submitting to the Ministry of Education, "]
["　Culture, Sports, Science and Technology. It is also for reviewing the allocation of joint research funds."]
[]
["5. ","Purpose of Joint Research (Within 100 to 200 words)"]
[]
[null,"Words：",null,null,0]
["6.","Joint Research Plan (Within 100 to 200 words)",null,null,null,null,null,null,null,null,"(In the case of continuous research project, please describe your research result or self-assessment.)"]
[]
[null,"Words：",null,null,0]
["7.","Expected Results (Within 100 to 200 words)"]
[]
[null,"Words：",null,null,0]
[]
["8.","Facilities and Equipments Desired to be Used (Check the box(es) for any equipment you intend to use."]
[null,"1. Will you use equipments? (Be sure to complete Form 1-2 if you plan to use it.)"]
[]
[null,"2. Will you use radioactive isotpoes?"]
[]
[null,"3. Will you conduct expriments with genetically modified organisms (including experiments that create or use organisms with genome editing)"]
[]
[null,"4. Will you conduct animal experiments?"]
[]
[null,"5. Will you enter the animal rooms?"]
[]
[null,"6. Will your research be subject to the Ethical Guidelines for Human Genome/Genetic Analysis Research?"]
[]
[null,"7. Will your research be subject to the Guidelines for Distribution and Use of Human ES cells?"]
[]
[null,"8. Will your research be subject to the Guidelines for gene therapy Clinical Research?"]
[]
[null,"9. Will your research be subject to the Ethical Guidelines for Medical Research on Human Subjects?"]
[]
[null,"10. Other"]
[]
[null,"※ For research activities with \"Plan to use,\" \"Plan to enter,\" and \"Applicable,\" appropriate procedures  are required prior to the start of the experiments.      (applications to office managing equipment, attendance at training sessions, various other applications, etc.)"]
[]
[null,"★Submission of Letter of Approval"]
[null,"Affiliation: Hiroshima University, Nagasaki University, or Fukushima Medical University."]
[]
[null,"A letter of approval is not required."]
[null," ※Applicants affiliated with other than the three universities are required to submit a letter of approval."]
[null,"If you are submitting the proposal after submitting the proposal application, please indicate in the memo section when you plan to submit the proposal."]
[]
[null,"Upload the approval letter."]
[null,"Regarding the expected date of submission."]

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["（Form 1-2）"]
[]
["Desired equipments"]
["* Please check the box(es) for the equipments you intend to use (required)"]
["Code #","Check","Location",null,null,"Sytem names","Components, etc."]
["H-1",true,"Hiroshima University","Radiation Research Center for Frontier Science","Radiation Experiments","Gamma cell room","Gammacell 40 Exactor"]
["H-2",null,null,null,null,"Low-dose rate irradiation room1","Low dose or low dose-rate irradiatior"]
["H-3",null,null,null,null,"Low-dose rate irradiation room2","Low dose or low dose-rate irradiatior"]
["H-4",null,null,null,null,"Low-dose rate irradiation rearing room1 (For animal)","Low dose or low dose-rate irradiatior"]
["H-5",null,null,null,null,"Low-dose rate irradiation rearing room2 (For animal)","Low dose or low dose-rate irradiatior"]
["H-6",null,null,null,"Animal Experiments","transgenic mice"]
["H-7",null,null,null,null,"knock out mice"]
["H-8",null,null,null,null,"conventional animal rooms"]
["H-9",null,null,null,null,"special animal rooms"]
["H-10",null,null,null,"Molecular and Cellular experiments","next generation sequencer system","(32) High-throughput long-read sequencer"]
[null,null,null,null,null,null,"(31-2) microchip automatic electrophoresis system"]
["H-11",null,null,null,null,"cell information analysis system","(2) confocal microscopy scanning microscope / 3-D time-lapse imaging system"]
[null,null,null,null,null,null,"(35-1) imaging cytometer"]
[null,null,null,null,null,null,"(35-2) high-content imaging system"]
[null,null,null,null,null,null,"(27) fluorescence microscopy"]
["H-12",null,null,null,null,"live cell imaging system","(41) incubator fluorescence  microscopy for time-laps analysis"]
[null,null,null,null,null,null,"(41) incubator microscopy for time-laps analysis"]
["H-13",null,null,null,null,"chromosome analysis system","(40) chromosome analysis system"]
["H-14",null,null,null,null,"single cell analysis system","(1-3) advanced flow cytometer"]
[null,null,null,null,null,null,"(1-4) cell sorting system"]
[null,null,null,null,null,null,"(41) digital mRNA quantitation system"]
["H-15",null,null,null,null,"preparation system for pathological speciemen","(33) system for preparing pathological speciemens"]
[null,null,null,null,null,null,"(13-2) laser microdissection system"]
["H-16",null,null,null,null,"other　（　　　　　　　　　　　）"]
["H-17",null,null,"Division of Radiaiton Information Registry","Documents on Atomic Bomb disaster","data from Atomic-bomb victims"]
["H-18",null,null,null,"Archive documents","Atomic-bomb related books"]
["H-19",null,null,null,null,"Armed Forces Institute of Pathology (AFIP) samples and records"]
["H-20",null,null,"Research materials",null,"human radiosensitive cells"]
["H-21",null,null,null,null,"other　（　　　　　　　　　　　）"]
["N-1",null,"Nagasaki University","Experimental equipments","Radiation experiments","X-ray irradiation device"]
["N-2",null,null,null,null,"whole-body counter"]
["N-3",null,null,null,null,"germanium semiconductor radiation detector"]
["N-4",null,null,null,null,"gamma-ray irradiation device"]
["N-5",null,null,null,null,"other　（　　　　　　　　　　　）"]
["N-6",null,null,null,"Animal experiments","PET/SPECT/CT in vivo imaging system for small animals"]
["N-7",null,null,null,null,"other　（　　　　　　　　　　　）"]
["N-8",null,null,null,"Genetic experiments","next generation sequencer system","HiSeq2500 system"]
[null,null,null,null,null,null,"MiSeq system"]
["N-9",null,null,null,null,"other　（　　　　　　　　　　　）"]
["N-10",null,null,"Documents on radiation disaster","Documents on Atomic Bomb disaster","database for solid cancers in Atomic Bomb victims "]
["N-11",null,null,null,null,"database for documents on Atomic Bomb disaster"]
["N-12",null,null,null,"Documents on radiation exposures","database for whole body counter in  Chernobyl"]
["N-13",null,null,null,null,"other　（　　　　　　　　　　　）"]
["N-14",null,null,"Field","Nagasaki University Office","Representative Office for Molecular Epidemiology studies around Chernobyl"]
["N-15",null,null,null,null,"Nagasaki University-Kawauchi Village Reconstruction Promotion Base"]
["N-16",null,null,null,null,"Nagasaki University-Tomioka Town Reconstruction Promotion Base"]
["N-17",null,null,null,null,"Nagasaki University-Okuma Town Reconstruction Promotion Base"]
["N-18",null,null,null,null,"Nagasaki University-Futaba Town Reconstruction Promotion Base"]
["N-19",null,null,null,null,"other　（　　　　　　　　　　　）"]
["F-1",null,"Fukushima Medical University","Radiation Medical Science Center for the Fukushima Health Management Survey",null,"Fukushima Health Management Survey Database"]
["F-2",null,null,null,null,"imaging Flow Cytometry","ImageStream .A N.X Mark II Imaging Flow Cytometer"]
["F-3",null,null,"Advanced Clinical Resrarch Center\n（http://www.fmu.ac.jp/home/acrc/research/index）",null,"PET/MRI","Siemens Helthcare Biograph mMR"]
["F-4",null,null,null,null,"PET/MR scanner","Siemens Helthcare Biograph mMR"]
["F-5",null,null,null,null,"PET/SPECT/CT in vivo imaging system for small animals","Siemens Helthcare Biograph Inveon PET/SPECT/CT"]

{"sheet":"WRITTEN OATH (Form 2)","index":2,"n_rows":24,"n_cols":5,"rows_kept":24,"cut":false,"hidden":false,"merged":[[23,4,23,5],[5,1,5,2],[6,1,6,2],[5,3,5,5],[6,3,6,5],[7,3,7,5],[13,2,13,5],[14,2,14,5],[15,2,15,5],[19,4,19,5],[10,2,10,5],[11,2,11,5],[4,1,4,5],[7,1,7,2],[12,2,12,5],[21,4,21,5],[22,4,22,5]]}
[null," (Form 2)"]
[]
[null,"To: Director of Research Center for Radiation Disaster Medical Science"]
[]
[null,"WRITTEN OATH"]
[null,"Joint Research Title"]
[null," Name of the Resident Representative Researcher"]
[null,"Name of the Affiliated Organization and Job Title",null,"\r\n"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,"Date (year/month/date):",null,"/            /"]
[null,null,"Joint Representative Researcher"]
[null,null,null,"Affiliated Organization:                               "]
[null,null,null,"Department:                                        "]
[null,null,null,"Name signature:                                     "]

{"sheet":"LETTER OF APPROVAL (Form 3)","index":3,"n_rows":25,"n_cols":5,"rows_kept":25,"cut":false,"hidden":false,"merged":[[4,0,4,4],[17,0,17,4],[25,2,25,4],[24,2,24,4],[22,3,22,4],[21,3,21,4],[20,3,20,4],[9,3,9,4],[11,3,11,4],[13,3,13,4],[15,0,15,4],[19,3,19,4]]}
["(Form 3)"]
[]
[null,null,null,"Date (year/month/date):","/           /"]
[]
["LETTER OF APPROVAL"]
[]
["To: Director of Research Center for Radiation Disaster Medical Science"]
[]
[null,null,null,"Address:"]
[]
[null,null,null,"Name of Affiliated Organization:"]
[]
[null,null,null,"Name of the Head of Affiliated Organization:"]
[null,null,null,"(sealed)"]
[]
["I approve the implementation of joint research according to the following items:"]
[]
["Items"]
[]
["1.　Research Representative"]
[null,"Official Job Title:"]
[null,"Name:"]
["2.  Joint Research Title:"]
[]
["3.Joint Research Period:",null,"From April 1, 2023 (or adopted day if after April 2nd) to March 31, 2024"]

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