ࡱ> RTQ nbjbjaa FV  8(,TT:#8WWW""""""",r$$':"W5"WWW""WR"W"r5!T5"^!" #0:#!^(^(5"5"I"TWWW""WWW:#^(WWWWWWWWW  :    ΢Ȧ Institutional Animal Care and Use Committee (IACUC) Protocol Closeout Form Date: ___________________ Principal Investigator/Instructor: _______________________________________ Title: ____________________________________________________________ ________________________________________________________________ Project Year : __________________ 3 yr review due date:_______________ Project type: ( Research ( Teaching PROJECT STATUS (please check) ( Project never initiated: Please terminate and remove from committee files. ( Withdrawn (Stop here. Sign last page and return.) ( Project not funded (Stop here. Sign last page and return.) ( Project complete (complete report stating reason for termination in Section E) ( Terminate on anniversary date. ( Terminate on ___/___/___ RECORD OF ANIMAL USAGE: Species# Approved for 3 year period# Purchased each year# Bred each yearTotal # used each yearRemaining each yearYear 1 Year 2 Year 3Total remaining at CloseThe Record of Animal Usage is complete and correct: ( Yes ( No if No, please explain. TYPES OF PROCEDURES (check all that apply) ( survival ( prolonged restraint ( cause disease state ( terminal ( neuromuscular blockers ( cause behavioral stress ( multiple surgery ( transgenic breeding ( blood/tissue collection ( antibody production USDA PAIN CATEGORY ( B Animals used only for breeding purposes ( C no pain or distress nor use of pain relieving drugs or anesthesia. ( D pain or distress for which appropriate anesthetic, analgesic or tranquilizing drugs are used. ( E pain or distress for which the use of appropriate anesthetic, analgesic, or tranquilizing drugs has been scientifically justified to adversely affect the procedures, results or interpretation. PROJECT PERSONNEL Have there been any personnel/staff changes since the last IACUC approval was granted? ( Yes ( No Please list all personnel who are currently working on this project: Name: Responsibility in Project: reason for TERMINATION (if closing a protocol): If this is an active (on-going) project, please provide a brief update on the progress made in achieving the specific aims of the protocol. If the number of animals used is different from the original expectation please explain. F. PROBLEMS ENCOUNTERED WITH PROTOCOL: ( Yes ( No If yes, describe any unanticipated adverse events, morbidity or mortality, the cause(s) if known, and how the problems were resolved. ALTERNATIVES TO ANIMAL USE: Since the last IACUC approval, have alternatives to the use of animals become available that could be substituted to achieve your specific project aims? ( Yes ( No (If yes, please explain below) ALTERNATIVES TO POTENTIALLY PAINFUL PROCEDURES: (Only address the following if your protocol is USDA category D or E). Since the last IACUC approval have alternatives which are potentially less painful or distressful become available that could be used to achieve your specific project aims? ( Yes ( No (If yes, please explain below) I. CHANGES TO PROTOCOL ( No changes have been made and the project will continue as previously approved by the IACUC. (Skip to item K) ( Changes have been made since the last continuing review. Attach a copy of each change that was submitted to the IACUC for approval. (Complete rest of item J below) Do one or more of these changes significantly altered the nature of the protocol? ( Yes ( No If no, skip to item K If yes, check all that apply ( added an AWA covered species ( added survival surgical procedures ( changed procedures to test hypotheses that are unrelated to the original scientific intent and justification of the protocol. ( performed a procedure that may cause more than momentary pain or distress that cannot be alleviated with analgesics or anesthesia. J. CERTIFICATION OF THE PRINCIPAL INVESTIGATOR: Signature certifies that this project is not unnecessarily duplicative and that the principal investigator understands the requirements of the PHS Policy on Humane Care and Use of Laboratory Animals, applicable USDA regulations and ΢Ȧ policies governing the use of vertebrate animals for research or teaching. Signature further certifies the investigator will continue to conduct this project in full compliance with the aforementioned requirements. ------------------------------------------------------------- ------------------------- Signature of principal investigator Date BEFORE RETURNING THIS PROGRESS REPORT HAVE YOU DONE THE FOLLOWING? ( Attached copies of changes enacted during this project year? ( Completed item F justifying the need to continue or terminate this project? ( Signed the report? ( Included copies of the progress report and attachments?     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