Header
Abstract Submission
Please use ONLY English alphanumeric characters (Single-byte character).
Information with (*) must be completed.
First author’s information
Title*                
Name* First Name:     Middle Name:     Last Name:
Affiliation*
E-mail address*
  (for confirmation)
Country*
Co-authors
  First Name Middle Name Last Name Affiliation
e.g. John A. Smith The Univ. of Tokyo
Co-authors 1
Co-authors 2
Co-authors 3
Co-authors 4
Co-authors 5
Co-authors 6
Co-authors 7
Co-authors 8
Co-authors 9
Co-authors 10
Co-authors 11
Co-authors 12
Co-authors 13
Co-authors 14
Co-authors 15
Corresponding author’s information
If the corresponding author is the first author, you don’t need to fill in this information.
Title                
Name First Name:     Middle Name:     Last Name:
Affiliation
E-mail address
Country
Presentation Category
Presentation Type Select a presentation type
 *Only for the people who have been selected and received an email from the program secretariat can choose “symposia”

Symposium title / Category ·For Symposia
  Select the symposium title in the email from the secretariat
·For oral presentation and poster presentation
  Select a category

Title and Abstract
Title*
(30 word limit)
Abstract
(200 word limit)
Disclosure of Conflict of Interest
[Q1]*
Has the speaker received funding* or property** (tangible or intangible benefit or convenience in research) from a profit-oriented organization (such as a business enterprise or investor)?
   
Note:
*Public research funds and donations that do not designate purpose of use do not apply.
**Contribution of pharmaceutical products and physical measurements constitute convenience in research.
[Q2]
If the answer to [Q1] is Yes, please briefly describe the relationship between the speaker and the profit-oriented organization.
Examples:
1. The research is (a joint research project) funded by Company XX.
2. The speaker is the owner (shareholder***) of the company.
3. The research project has received XX measurement from Company XX.
4. The research project has received a donation of material XX from Company XX.
[Q2] If the answer to [Q1] is Yes, please describe here
Note:
***Stock ownership of roughly 5% of total shares is the benchmark.
Ethics for medical research involving human subjects or animal experiments
[Human subjects]*


[Animal experiments]*