DRC Membership Application

DIABETES RESEARCH CENTER (DRC)

(Clay F. Semenkovich, MD - DRC Director)

Washington University Faculty

Membership Application

Instructions:

1. Read the Washington University DRC Membership Guidelines
2. Complete this application form

3. Submit your NIH Biosketch and Other Support to: kenney.m@wustl.edu

Today's Date (mm/dd/yyyy)

Name

First Name

Middle Initial

Last Name

Academic Information

Academic Title

Institution

Department

Division

Work Address

Email

Work Phone

Cell Phone

Admin Assistant Name

Grant Assistant Name

Research Interests

(Select at least one and as many that apply)

AREA:

Metabolic Regulation
Islet Biology / Immunology
Prevention / Control
Complications

Research Interests

(Select at least one and as many that apply)

CATEGORY:

Basic
Translational
Clinical
Population / Community Based

Other Memberships That You Currently Belong to at Washington University:

Digestive Diseases Research Core Center (DDRCC)
Nutrition Obesity Research Center (NORC)
Institute of Clinical and Translational Sciences (ICTS)
Center for Diabetes Translational Research (WU-CDTR)
Other (if more than one, separate each by a comma)

In Which of the Following DRC Programs Do You Plan to Participate?

Please Provide a One-Paragraph Description of Your Diabetes / Metabolism-Related Research (less than 250 words):

Indicate Your ORCID Number Below.

ORCID is a unique research identifier that helps you track your research and professional activities. It is free, is required for submitting publications to most journals and increases recognition for your work.

If you do not have one, you may get one easily at this link and keep it for your entire career: https://orcid.org/register

The DRC has Five Biomedical Cores. Please Select Each Service Within Each Core That You Plan to Use.

4. Metabolomics Core Services

Targeted metabolomic analyses (GC/MS or LC-MS/MS)
Structural analysis and identification
Validated assay development
Qualitative flux analyses
Training/education in mass spectrometry, sample preparation, or interpretation of spectra

5. Translational Diagnostics Core Services

Core diabetes hormones human (c-peptide, insulin, pancreatic polypeptide, glucagon)
Core diabetes hormones, mouse/rat (insulin)
Core diabetes metabolites (glucose, glycated hemoglobin)
Adipokines (leptin, adiponectin, IL-6, MCP-1, TNFalpha)
Lipids (apolipoprotein A1 [apoA1], apolipoprotein B [apoB], total cholesterol, low density lipoprotein cholesterol [LDL], high density lipoprotein cholesterol [HDL], lipoprotein (a) [Lp(a)], triglycerides, free fatty acid [FFA])
Blood chemistry (BMP, CMP CBC, lactate, beta-hydroxybutyrate)
Urine chemistry (BUN, creatinine, microalbumin)
Custom service (RIA, ELISA)
Special pricing for specialized test send out

This is the End of the Application. Please Leave Any Additional Information That You Would Like Us to Know.