ࡱ>  bjbj 4{{"""""6666l6+~ooo6+8+8+8+8+8+8+$-K0\+"ooooo\+""q+o""*o6+r&'@^B'*+0+P'0O\0''T0"B(ooooooo\+\+\ooo+oooo0ooooooooo : SPMIC Study Details Submission Form Please fill out all sections on the form that are applicable and give reasons for any blanks, e.g. N/A or in progress. Submit via email to  HYPERLINK "mailto:spmic_scanning@nottingham.ac.uk" spmic_scanning@nottingham.ac.uk. TitleCategory Select one or more. Class teaching should be booked directly with Facility Manager.ScienceCommercial StudyPhD. TeachingMSc. TeachingShort name (8 char max)Brief Description (up to 200 char)PI NameResponsible SchoolMain ContactOther people involved Name, involvement & responsibility. e.g. Dr XXXX, paradigm design & writing paper Indicate MRI or MEG competent people and MR assistantsNames and usernames of those able to book on CalpendoNumber of hours and funding for each facility required Split hours requested into development and full study hours if it helps explain the application. For MEG also indicate MRI hours required for anatomical imagesFacilityExpected price per hourNumber of hoursPrice per hour if less than fully funded1.5T3003T4007T650MEG400OtherTotal Income (Also give % of fully funded cost if less than 100%)Justification for any deviation from full funding. Priority is given to fully funded projects. Development time will be scrutinized by ExCo. Highlight cross cutting factors e.g. sequence development or validation, development of cohorts.Funding Source Give date of grant submitted and exact funding requestedAccount Code Activity Code Cost Centre Contact Name(s)/email for invoicing and financial queriesSplit of funding across financial years e.g. project from Jun16-Aug17. 14k might split Jun16-Jul16 = 2k Aug16-Jul17 12k. Aug15-Jul16 : Aug16-Jul17 : Aug17-Jul18 :Details of funding constraints e.g. deadlines within the financial year that money should be spentStart/End Date of scanning End date cannot exceed 3 years. May be renewed but cost cannot be guaranteedVolunteer/Booking details e.g. 20 volunteers scanned twice. 5 hr sessions scanning 4 subjects in each. Total hours required = 50Ethics code(s) Please confirm that safety form and information about incidental findings is taken from information on SPMIC website. Data sharing arrangement What does ethics approval say?Other approvals/agreements obtained e.g. R&D, contract with industrial partner etc.Indicate any project-specific safety issues that you foresee. Additional risk assessments may be required before the project startsIndicate which facilities you want to use. Ring your preferred choice(s) and cross through any you definitely cannot use.0.5 T Paramed (upright)1.5 T GE3T GE7T PhilipsMEG1.5 T Philips (until 31/03/17)3T Philips Achieva3T Philips Ingenia (widebore)Justify request if very specific:Equipment required e.g. RF coils / button response kit / EEG etc.Project Details can be attached separately e.g. sequences to be developed, full details of fMRI paradigms. MEG analysis approaches anticipated. Include references.Data analysis plans Do you require analysis support? [This may incur costs] Post Project Aims (PhD thesis, papers, further funding etc)Relevant prior work particularly using SPMIC or predecessor facilities e.g. Previous project 2012-2013 XXX on 3T,XX hours, funding 10k. Published inSelect the user group most appropriate to review your project: Acquisition and data analysis (sequence development and areas not covered below) Clinical and commercial trials (including multicentre trials) Molecular Imaging (including cancer imaging) Neuroimaging (clinical neurology and basic neuroscience) For MEG we recommend contacting Matt Brookes before applying MSK Imaging Obesity, GI and liver imaging Lung Imaging SPMIC use only: Do not complete this page. For scientific and commercial projects SPMIC project numberWhat is your usergroups opinion of the proposed science, in particular the imaging aspects? Please justify.Acceptable/Unacceptable Is this externally peer reviewed? What the expertise of the usergroup to judge this?How does this project interact with others going on in the UoN?Do the project team propose to provide appropriate staffing for the level of complexity of the study?Do you think the project team will require particular support from SPMIC (consider both imaging and other aspects)?Is this study fully funded ? Y/NDo you support the funding level (please justify your response)?Do you have any other concerns about this study? Are there any particular SPMIC risks? (e.g. Does the study require lots of early morning slots? Does the study require an exceptionally large amount of scanner time?)15% of scanner time is allocated to unfunded development work (strategic innovation, maintaining imaging and associated protocols at the state of the art, some validation or normative data). Please explain whether or not you believe this project falls into this category, and highlight potential benefits to other teams and usergroups. 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