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Investigator Application for the LungMAP BioRepository

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Although a pdf can be printed, please complete this survey electronically in order to avoid missing or misconstruing portions. Thank you!

Lung Molecular Atlas Program (LungMAP) BioRepository - New Project Request for Resources

The Human Tissue Core (HTC) of the NHLBI-funded LungMAP consortium provides de-identified, quality cell and tissue samples to qualified investigators. We welcome your interest and contributions to understanding Human Lung Development, Injury and Repair in order to improve lung health of infants, children and adults.

The LungMAP manages the use of the repository resources and reviews all applications. Approvals and repository access are based on the content of this application. When a project application is to be approved, the HTC will arrange a short, virtual, one-one tutorial to introduce use of the Repository and to help with selection of biospecimens.

If your scope of work changes significantly, you must complete a revised application.

Donor tissue is supplied by the University of Rochester Medical Center Biorepository for Investigation of Neonatal Diseases of the Lung (BRINDL) with research authorization through the United Network for Organ Sharing and the Neonatal and Pediatric Organ Donor Program and LungMAP Collaborating Investigators. We are extremely grateful to the patients and families who have generously given such precious gifts.

Date of Request:

* must provide value

Provide your contact information

Last Name

* must provide value

First name

* must provide value

Your role in the project

* must provide value

Are you or your Principal Investigator a member of the LungMAP consortium?

* must provide value

Provide contact information for the Principal Investigator supervising this project.

PI Last Name

* must provide value

PI First Name

* must provide value

PI Email Address

* must provide value

PI Phone

* must provide value

PI Institution

* must provide value

PI Address

* must provide value

PI City

* must provide value

PI State

* must provide value

PI Zip Code

* must provide value

PI Country

* must provide value

Upload PI NIH Bio sketch or CV

Co-Investigator Contact Information

Are there Co-Investigators for the project?

If Yes, please give contact information below.

Co-Investigator (1) Last Name

Co-Investigator (1) First Name

Co-Investigator (1) Degree

Co-Investigator (1) Email Address

Co-Investigator (2) Last Name

Co-Investigator (2) First Name

Co-Investigator (2) Degree

Co-Investigator (2) Email Address

Specific Objectives of the Project

Experimental Plan
In the next sections, provide an Experimental Plan, in summary or outline form, sufficient to determine the suitability of the LungMAP Resource for the Project.

If you receive samples from the repository, this Summary Abstract will be published on the LungMAP.net website. Your Project Summary will help us understand your work, facilitate collaborations, and inform the public of the important work and discoveries our Investigators are accomplishing with this valuable resource. (Maximum 300 words).

Project Specific Aims

Project Experimental Design

Summary of experimental protocol(s) or assays to be applied to tissues or cells

References (Optional)

Current and Pending Funding Supporting the Proposed Studies of LungMAP Samples

1) Local / Departmental Funding

2) Grant Title, Agency and Award ID

3) Additional Grant Title, Agency and Award ID

Summary of Donor Demographics To Be Requested

List Specific Ages if known

Specific Case Features Desired

(example: control/normal, specifics of disease, anatomic structures, cell types, etc.)

Describe Any Anticipated Specific Features of Cases to be Requested

Sample Types Available

Cases vary in tissue types and preservation states available.

Tissue types: Lung, Trachea, Pulmonary Artery/Vein, Aorta, Spleen, Thymus, Blood (PBMC, Diluted Plasma), Thoracic Lymph nodes, Nerve, Heart, Esophagus, Kidney

Preservation Methods:
- Formalin-Fixed Paraffin Embedded Tissue
- OCT Embedded Fresh Frozen Tissue
- CMC Embedded Fresh Frozen Tissue
- Paraformaldehyde-fixed, Sucrose Cryoprotected, OCT Embedded Frozen Tissue
- Dissociated Cells (or Blood PBMC)
- PCLS (precision cut lung slices)
- Fresh Frozen Tissue - unfixed, not embedded
- Plasma or Serum

Any Special Requests Regarding Tissue or Preservation Types

Agreements Required:

1) Institutional Human Subjects Research Review

2) Data Sharing Agreement

3) Publication Policy Agreement

4) Material Transfer Agreement

5) LungMAP Utilization Committee Review

1) Institutional Review Board (IRB), full, expedited, exemption, or non-human subject research approval for your project must be obtained. Conditional approval to receive Repository biospecimens can be obtained pending IRB review. However, specimens/data will not be distributed until documentation of your IRB's action is received.

URMC BRINDL Repository Institutional Review Board Exemption Letter provided to facilitate review

Please indicate the nature of your IRB/Ethical Board Review:

Upload IRB approval documentation

2) Data Sharing Agreement

Investigators approved to study BRINDL tissues will perform independent studies. We expect that Investigators will allow their Project Title and Summary Abstract to be posted on the LungMAP.net website. We highly encourage expeditious sharing of BRINDL facilitated research data and methods. We encourage data sharing on LungMAP.net. Presentations and publications should acknowledge the LungMAP Consortium and Biorepository for source material. Sharing and collaboration will be implemented in ways that preserve publication and intellectual rights of Investigators. Copyright to data and images displayed on the LungMAP site is held by the individual Investigators and Research Centers that contribute them.

3) Publication Policy Agreement

In publications and public presentations of work resulting from the use of the LungMAP BRINDL biospecimens or support of the biorepository staff, we strongly encourage users to cite the LungMAP Consortium (DCC: U24-HL148865), LungMAP Human Tissue Core (U01-HL122700 and U01-HL144861), relevant LungMAP protocols and publications. Please also cite BRINDL Donor Ids for cases used.

Example citation: "The reported Results are in whole or part based upon resources generated by the LungMAP Consortium. Data was downloaded from www.lungmap.net, on ______. BRINDL cases DXXX ... DXXY are reported. The LungMAP Consortium, the Human Tissue Core (U01-HL144861) and the LungMAP Data Coordinating Center (U24-HL148865) are funded by the National Heart, Lung, and Blood Institute (NHLBI)."

Your acknowledgment will help NHLBI track and continue to support community use of this resource.

See also: Citing LungMAP and the Human Tissue Core Repository (https://www.lungmap.net/about-lungmap/citing-lungmap/)

Publication Policy Agreement

4) Material Transfer Agreement

A Material Transfer Agreement (MTA), referencing use of both materials and generated data, is needed before BRINDL specimens/data can be distributed. The MTA template to be used is attached for reference.

With acceptance of this application, the MTA will be initiated by the LungMAP HTC. Providing your institutional Office of Research & Project Administration signing official name and email will facilitate execution of the initiated MTA form.

Signing Official contact name

Signing Official contact email

Lab Contact and Shipping Information

FedEx Acct

The recipient will cover the costs of shipping the requested materials. This acct number can be provided at a later date prior to shipment.

FedEx Shipping Address

Shipping Instructions

Thank you! Your completed application should be reviewed within 2-4 weeks of submission. Contact below if response appears delayed.

Questions and followup: gloria_pryhuber@urmc.rochester.edu

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