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Major physiological challenge Sultan Qaboos University ETHICS COMMITTEE FOR ANIMAL USE IN RESEARCH  ,'E9) 'D3D7'F B'(H3 D,F) #.D'BJ'* '3*./'E 'D-JH'F'* AJ 'D*,'1( 'D9DEJ) APPLICATION FORM FOR THE USE OF ANIMAL IN RESEARCH Use the appendices attached to this form to assist you in completing the form G. PERIOD OF WHICH ACTIVITIES REQUIRE ETHICAL APPROVAL End date: Commencement date:H. ANIMALS REQUIRMENTS (add more columns if necessary)Animal group 4Animal group 3Animal group 2Animal group 1SpeciesStrain (inbred, outbred, knockout, etc)Age/weightSexNumberI. SOURCE OF ANIMALSAnimal group 4Animal group 3Animal group 2Animal group 1agIJ small animal houseagIJ Agricultural Experimental StationImported (state the source) *Animals re-used from a previous trial WildOtherJ. INVASIVE PROCEDURE(S)Experience ExperimenterType of Procedure (s)Where procedure(s) will be performedK. USE OF HAZARDOUS AGENTSHazardous chemicals or drugs or biological agents:Approval of the University/College Biosafety Office/Committee: L. METHOD OF DISPOSAL (Fate of animals at the end of the activity)Animal group 4Animal group 3Animal group 2Animal group 1Released to natural habitatScheduled death on trial (lethality tests only) Scheduled euthanasia on trialScheduled euthanasia post-trialTransferred immediately to another projectKept at the institution for later use or saleOther  M. DESCRIPTION OF DESIGN AND ANIMAL PROCEDURES: Briefly explain the experimental design and specify all animal procedures. This description should allow the committee to understand the experimental course of an animal from its entry into the experiment to the endpoint of the study. Specifically address the points stated in Appendix 3 (Use additional sheets if necessary.) DECLARATION OF PRINCIPAL INVESTIGATOR OR STUDENT SUPERVISOR (Student project) I declare that the statements made in this form are correct: Name: Signature and date: FOR OFFICIAL USE ONLY Decision date: Submission date:Proposal # RejectedReturn for revisionApprovedDate:Chairman signature GUIDELINES FOR COMPLETING THE FORM APPENDIX 1 (SECTION E: RATIONALE FOR USE OF ANIMALS) Please indicate the primary purpose of animal usage in the study. 1. Understanding of animal biology: Using animals for activities that aim to increase the basic understanding of the structure, function and behavior of animals and humans. 2. Maintenance and improvement of human or animal health and welfare: Activities that aim to produce improvements in the health and welfare of animals, including humans 3. Achievement of educational objectives: Activities carried out for the achievement of educational objectives. The purpose of the activity is not to acquire new knowledge, rather to pass on established knowledge to others. This would include interactive or demonstration classes in methods of animal husbandry, management, examination or treatment 4. Environmental study: Activities that aim to increase the understanding of the animals environment or its role in it, or aim to manage wild or feral populations. These will include studies to determine population levels and diversity and may involve techniques such as collection of voucher specimens, radio tracking or capture and release. APPENDIX 2 (SECTION F: CATEGORY OF PROCEDURE) Please assess your methodology in relation to what you think best categorizes the procedures. 1. Observation studies with minor interference: Animals are not interacted with or, where there is interaction, it would not be expected to compromise the animals welfare any more than normal handling, feeding etc. There is no pain or suffering involved. 2. Animal unconscious without recovery: Animal is rendered unconscious under controlled circumstances (i.e. not in a field situation) with as little pain or distress as possible. Capture methods are not required. Any pain is minor and brief and does not require analgesia. Procedures are carried out on the unconscious animal that is then killed without regaining consciousness. 3. Minor conscious intervention without anesthesia: Animal is subjected to minor procedures that would normally not require anesthesia or analgesia. Any pain is minor and analgesia usually unnecessary, although some distress may occur as a result of trapping or handling. 4. Minor operative procedures with recovery: Animal may be rendered unconscious with as little pain or distress as possible. A minor procedure such as cannulation or skin biopsy is carried out and the animal allowed to recover. Depending on the procedure, pain may be minor or moderate and post-operative analgesia may be appropriate. Field capture using chemical restraint methods is also included here. 5. Surgery with recovery: Animal may be rendered unconscious with as little pain or distress as possible. A major procedure such as abdominal or orthopedic surgery is carried out and the animal allowed to recover. Postoperative pain is usually considerable and at a level requiring analgesia. 6. Minor physiological challenge: Animal remains conscious for some or all of the procedure. There is interference with the animals physiological or psychological processes. The challenge may cause only a small degree of pain/distress or any pain/distress is quickly and effectively alleviated. 7. Major physiological challenge: Animal remains conscious for some or all of the procedure. There is interference with the animals physiological or psychological processes. The challenge causes a moderate or large degree of pain/distress that is not quickly or effectively alleviated. 8. Death as an endpoint: This category only applies in those rare cases where the death of the animal is a planned part of the procedures. Death as an end point does NOT include, death by natural causes; animals which are euthanized on completion of the project; animals which are killed if something goes wrong; animals killed for dissection or for use as voucher specimens or accidental deaths. APPENDIX 3 (SECTION M: DESCRIPTION OF EXPERIMENTAL DESIGN AND ANIMAL PROCEDURES) Please include the following when applicable: Rationale of choice of type and number of animals. Experimental injections or inoculations: Include substances, e.g., infectious agents, adjuvants, etc. Include dose, sites, volume, route, and timing). Blood withdrawals: State volume, frequency, withdrawal sites, and methodology. Surgical procedures: Identify and describe the surgical procedure(s) to be performed. Include 1; preoperative procedures e.g., fasting, analgesic loading, and monitoring and supportive care during surgery. State dosage, route, and schedule of administration for anesthesia, analgesia, and tranquilizers. If survivalsurgery, describe postoperative care required, frequency of observation include detection and management of postoperative complications. Radiation: Type, dosage and schedule. Other potential stressors (e.g., food or water deprivation, noxious stimuli, environmental stress) Procedures to monitor and minimize distress. Such as amending the protocol, using medication, moving animals to different cages etc. Experimental endpoint criteria (e.g., tumor size, percentage body weight gain or loss, inability to eat or drink, behavioral abnormalities, clinical symptomatology, or signs of toxicity, etc). Death as an endpoint must always be scientifically justified. Method of euthanasia or disposition of animals at the end of the study. Indicate the proposed method of euthanasia (e.g. decapitation, cervical dislocation, exsanguination, etc.). If a chemical agent is used specify the dosage and route of administration. 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