Project Information Form for the Waisman Center CMN Core Lab
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The Waisman Center’s Cellular and Molecular Neuroscience (CMN) Core is a multi-user facility available
to WC IDDRC investigators and all non-WC investigators. New projects must be approved by CMN Core
staff prior to use. We ask new investigators to provide background information about the proposed
project (p. 1) and indicate their planned usage of the CMN Core (p. 2). Finally, as the safety of the CMN
Core staff and users of the facility is of ultimate concern, we must evaluate if the project may be safely
performed in our facility. Information about the sample sources and potentially infectious agents is
critical for effective biosafety measures. This Project Information form MUST BE COMPLETED and
SIGNED by the laboratory director before experiments or projects begin. Appropriate biosafety approval
of experiments prior to sample submission to the core laboratory is required. This questionnaire will be
kept on file during the duration of the project.
Directions: Please return the completed form to CMN Core Manager, Karla Knobel cmn@waisman.wisc.edu
PROJECT INFORMATION
Date:
Are you a Waisman IDDRC (Core Grant) Investigator
Y or
N
Principal Investigator
(Laboratory Director):
Phone number:
Fax number:
E-mail:
Project Lead Investigator:
Phone Number:
Fax Number:
E-mail:
Laboratory Location
(Building and Room):
Project title (if any):
Summary or description of Overall Project objectives. Provide an abstract describing project (may come from original grant).
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Project Information Form for the Waisman Center CMN Core Lab
CMN CORE EQUIPMENT/SERVICES
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Please Indicate what services/equipment you plan to use
for this project (Y or N)
Microscopy and Confocal Imaging
Epifluorescence and Brightfield Microscopy (Zeiss
Axioplan2 with AxioVision)
Stereology
(Zeiss Axioplan2 with MBF StereoInvestigator)
Nikon C1 Laser Scanning Confocal
Upright Microscope
Nikon A1R-Si High Speed Spectral Laser Scanning
Confocal-Inverted Microscope
Leica TCS-LSI ‘Macroconfocal’ stereo microscope
Perkin Elmer Operetta High Content Screening
System
Imaging Analysis Software (Nikon NIS-Elements)
Quantitative Fluorescence Analysis
LiCore Odyssey Near-Infrared Phosphorimager
GloMax Fluorescence/Luminescence Platereader
ABI 7500 Real Time PCR (96 well)
ViiA7 Real Time PCR (96, 384 well, TLDA card)
FACSCalibur Flow Cytometer
CMN Core Laboratory Equipment
SpeedVac
REVCO -80
Microm HM505 Cryostat
Beckman L70 UltraCentrifuge
NanoDrop
CMN Core Laboratory Services
Induced Pluripotent Stem (iPS) Cell production
Tissue Culture Service Support
Bioinformatic and Biostatistic Support:
Whole genome (NexGen) sequencing?
Genotype/phenotype or trait mapping analysis:
eg Exome mapping, SNP analysis, Copy number
variation (CNV)?
Microarray Analysis?
Tissure Preparation Services
Are there any services, equipment, educational programs that you think the CMN Core could provide that would
benefit members of your laboratory?
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Project Information Form for the Waisman Center CMN Core Lab
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BIOSAFETY INFORMATION
Briefly explain how the cells you are studying are prepared. Ie, list type of sample and source (eg. mouse spleen cells, human
peripheral blood mononuclear cells, cells from an animal en-grafted with human cells, etc.); for cell lines, describe cell origin.
What is the solution that your cells are suspended in (eg. 1x PBS or fixative)?
Describe how you intend to analyze these preparations.
Does the sample contain any known infectious agent(s)? Yes or No
IF YES list agent(s) and provide agent biosafety level using classifications as listed in “Biosafety in Microbiological and
Biomedical Laboratories”, US Department of Health and Human Services, 4 th edition.
Has the infectious agent been inactivated? Yes or No
IF YES, describe method of inactivation. IF NO please contact CMN Core manager for permission to use core.
.
Were blood cell donors screened for blood-borne pathogens, e.g., HIV, HBV, HCV? Yes or No
IF YES, list test results, positive and negative. IF NO please contact CMN Core manager for permission to use core.
Could the sample contain other known human pathogens? Yes or No
IF YES, list agent(s). IF NO please contact CMN Core manager for permission to use core.
Were the cells transformed using a virus such as EBV, SIV, HIV-1, herpes virus, adenovirus or another virus not mentioned?
Yes or No
IF YES, list virus. IF NO please contact CMN Core manager for permission to use core.
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Project Information Form for the Waisman Center CMN Core Lab
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BIOSAFETY iNFORMATION continued
Were cells genetically engineered? How were they genetically engineered? Was a gene therapy virus (adenovirus,
retrovirus, lentivirus, herpesvirus, etc.) used to transfer genetic information to the cells? Yes or No
IF YES, describe method in detail, attach vector map and show packaging cell line.
Have the cells been tested for mycoplasma infection and/or viral infection (HIV, HBV, SIV, etc.)? Yes or No If yes, give date
of last test(s) and test(s) result. Tests must have been performed just prior to sample submission to the flow cytometry
laboratory.
Will the samples be fixed prior to submission to core flow cytometry laboratory? Describe the fixation protocol in detail,
e.g., list concentration and exposure time.
CMN CORE POLICIES
1.
All problems and equipment related issues must be communicated immediately to the core manager
(cmn@waisman.wisc.edu).
2. New users must be approved prior to the start of their projects (complete CMN Project Information form
and submit to core manager). Users must provide funding information PRIOR to the start of experiments
AND when grants change (complete CMN Funding information form and submit to core manager).
Failure to do so will delay the start of your experiment.
3. Cryostat users must obtain pre-approval from the core manager before starting experiments.
4. Users must provide grant number EACH TIME they sign in to use a piece of equipment.
5. Users must be trained to use equipment independently (microscope training MUST be obtained from core
manager). Failure to complete training may result in suspension of use.
6. Failure to report problems or inappropriate usage of CMN Core equipment will immediately result in
suspension of use.
7. Usage priority is ALWAYS given to Waisman Center IDDRC investigators. Conflicts will be resolved by the
core manager (cmn@waisman.wisc.edu).
8. Users can sign up IN ADVANCE for a maximum of three -4 hour- segments per week.
9. Users can sign up for a maximum of -4 hours- if that time is available within 24 hours.
10. There are no time restrictions for off-hours usage (between 6pm -7am on nights and weekends).
11. Cancellations must occur 48 hours prior to assigned time or you will be billed for your time.
12. Billing occurs in 15 minute increments.
13. Preapproval must be obtained from core manager for longer experiments and if grant deadlines must be
considered.
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Project Information Form for the Waisman Center CMN Core Lab
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14. All users must acknowledge CMN Core support in publications resulting from use of the CMN Core facility.
For example: "This study was supported in part by a core grant to the Waisman Center from the National
Institute of Child Health and Human Development (P30 HD03352)."
INVESTIGATOR ACKNOWLEDGEMENT OF RESPONSIBILITY
I certify that the information provided herein is correct. I ensure that my researchers are aware of
and will conform to the listed CMN Core policies.
____________________________________Signature (Principal Investigator)
_______________Date
I will acknowledge the CMN Core laboratory if any future publications result from projects performed
within the CMN Core laboratory or with the assistance of CMN Core personnel.
____________________Initials (Principal Investigator)
____________________Initials (Project Leader)
_______________Date
_______________Date
"This study was supported in part by a core grant to the Waisman Center from the National Institute
of Child Health and Human Development (P30 HD03352)."
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