Abstract Submission Page

First Author Name

Member Classification※

Member

non-member

First Author Name※

First Name

Middle Name

Last/Surname

First Author Affiliation Agency Information

Affiliation Name※

(e.g.) The Third Department of Internal Medicine, University of East-Tokyo, Tokyo, Japan

Country※

First Author Affiliation Address Information

Affiliation Address※

Address + Postal/Zip Code (e.g.) 1-4-2, Kasumigaseki, Chiyoda-ku, Tokyo 123-4567

Phone Number※

Please include "-" (hyphen)

Phone Number Extension

Fax Number

Please include "-" (hyphen)

First Author Email Address ※

First Author Email Address(For confirmation)※

Affiliation Information

Affiliation No.2

Affiliation Name※

Country※

Affiliation No.3

Affiliation Name※

Country※

Affiliation No.4

Affiliation Name※

Country※

Co-Author Information

First Author Affiliation Number	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

Co-Author Order		Name	Affiliation Number
Sample	Member Classification※ Member non-member	First Name※ Middle Name Last/Surname	1　If you belong to the same affiliation as the first one, select 「1」. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Co-Author 1	Member Classification※ Member non-member	First Name※ Middle Name Last/Surname	1　If you belong to the same affiliation as the first one, select 「1」. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Co-Author 2	Member Classification※ Member non-member	First Name※ Middle Name Last/Surname	1　If you belong to the same affiliation as the first one, select 「1」. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Co-Author 3	Member Classification※ Member non-member	First Name※ Middle Name Last/Surname	1　If you belong to the same affiliation as the first one, select 「1」. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Co-Author 4	Member Classification※ Member non-member	First Name※ Middle Name Last/Surname	1　If you belong to the same affiliation as the first one, select 「1」. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Co-Author 5	Member Classification※ Member non-member	First Name※ Middle Name Last/Surname	1　If you belong to the same affiliation as the first one, select 「1」. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Co-Author 6	Member Classification※ Member non-member	First Name※ Middle Name Last/Surname	1　If you belong to the same affiliation as the first one, select 「1」. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Co-Author 7	Member Classification※ Member non-member	First Name※ Middle Name Last/Surname	1　If you belong to the same affiliation as the first one, select 「1」. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Co-Author 8	Member Classification※ Member non-member	First Name※ Middle Name Last/Surname	1　If you belong to the same affiliation as the first one, select 「1」. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Co-Author 9	Member Classification※ Member non-member	First Name※ Middle Name Last/Surname	1　If you belong to the same affiliation as the first one, select 「1」. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Co-Author 10	Member Classification※ Member non-member	First Name※ Middle Name Last/Surname	1　If you belong to the same affiliation as the first one, select 「1」. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Co-Author 11	Member Classification※ Member non-member	First Name※ Middle Name Last/Surname	1　If you belong to the same affiliation as the first one, select 「1」. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Co-Author 12	Member Classification※ Member non-member	First Name※ Middle Name Last/Surname	1　If you belong to the same affiliation as the first one, select 「1」. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Co-Author 13	Member Classification※ Member non-member	First Name※ Middle Name Last/Surname	1　If you belong to the same affiliation as the first one, select 「1」. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Co-Author 14	Member Classification※ Member non-member	First Name※ Middle Name Last/Surname	1　If you belong to the same affiliation as the first one, select 「1」. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Co-Author 15	Member Classification※ Member non-member	First Name※ Middle Name Last/Surname	1　If you belong to the same affiliation as the first one, select 「1」. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

Application for English Presentation Award ※

Yes, I apply for English Presentation Award

No, I apply for General topics (Oral or Digital Poster)

If EPA not accepted ※

If not accepted for EPA, I would like to be considered for a General Topic (Oral or Digital Poster).

If not accepted for EPA, I would like to withdraw my abstract.

Title ※

Enter within 140 characters including spaces (approximately 20-25 words).

* Drug Names in Titles: Authors are required to use the generic name when referring to drugs in the title of the abstract. The use of brand names is not permitted as a general rule.

* Brand Names in Titles (Exception): In cases where the use of a brand name is unavoidable, the name must be followed immediately by the appropriate symbol—trademark (™) or registered trademark (®)—in superscript.

* Institutional Information in Titles: Authors must not include the presenter’s institutional affiliation, nor any description that could identify the institution, in the title.

Abstract Body

Enter within 1,600 characters including spaces (approximately 300-350 words).
*Please note that the abstract will be published as submitted. We kindly ask you to carefully check for any typographical or grammatical errors before submission.

*Drug Names: Authors are required to use the generic name when referring to drugs in the body of the abstract. The use of brand names is not permitted as a general rule.

*Brand Names (Exception): In cases where the use of a brand name is unavoidable, the name must be followed immediately by the appropriate symbol—trademark (™) or registered trademark (®)—in superscript.

*Institutional Information: Authors must not include the presenter’s institutional affiliation, nor any description that could identify the institution, within the abstract text.

Type your abstract in the box below. You may also paste text processed offline into the box.

Follow the instructions below for special characters.
If you want to include symbols or Greek letters, type the respective code indicated in the tables at the position where you want to place it, or copy the code and paste it in the position.

If you want to use superscripts, subscripts, italics, bold, or underlines, follow the instructions below.

Characters
Please copy and paste these characters if you would like to use them to complete your abstract registration.

! " # $ % & ' ( ) * + , - . / : ; = ? @ [ \ ] ^ _ ` { | } ~

Symbols

When using the following symbols, please copy this field and paste it into the necessary place in the body of the abstract.

What to enter	Na<SUP>+</SUP>	H<SUB>2</SUB>O	<I>c-fos</I>	<B>Bold</B>	<U>Underline</U>	>	<
What to appear	Na⁺	H₂O	c-fos	Bold	Underline	>	<

Superscript

Enclose the text before and after with and .

Example: Na+ for Na⁺

Subscript

Enclose the characters before and after with and .

Example: H2O for H₂O

Italic

Enclose the text before and after with and .

Example: c-fos for c-fos

Bold

Enclose and before and after the text.

Example: Bold for Bold

Underline

Enclose and before and after the characters.

Example: Underline for Underline

"<" or ">" (greater than and less than signs)

Type "<" for < and ">" for > instead.

Example: p<0.05

If you wish to use symbols, please refer to the character code table here and copy and paste the input code.

Diagram※

Yes

Character Count
Affiliation name (co-author) is counted when the first author or the target institution number of the co-author is selected.

Subject Information

:0Count

Title

:0Count

Abstract Body

:0Count

Total

:0Count

Abstract Body※

*Drug Names: Authors are required to use the generic name when referring to drugs in the body of the abstract. The use of brand names is not permitted as a general rule.

*Institutional Information: Authors must not include the presenter’s institutional affiliation, nor any description that could identify the institution, within the abstract text.

Keyword1 ※

Keyword2

Keyword3

COI

For the first author and all co-authors, please disclose any Conflict of Interest (COI) status related to companies, organizations, or entities associated with the presentation topic within the past three (3) years from the time of submission, by self-declaration for each author.

First Author

Item		Conflict?※
1	① Honoraria ($10,000 or more per year from one company or organization）	Author Yes None
2	② Stock or stock options （$10,000 or more per year or holding 5% or more of shares in one private company）	Author Yes None
3	③ Royalties or licenses （$10,000 or more per year for one patent）	Author Yes None
4	④ Lecture fees ($5,000 or more per year from one company or organization）	Author Yes None
5	⑤ Manuscript fees ($5,000 or more per year from one company or organization）	Author Yes None
6	⑥ Research funding ($10,000 or more per year of research funding including funding for collaborative research, funded research, and drug trials paid by one company or organization）	Author Yes None
7	⑦ Scholarship fund ($10,000 or more per year provided by one company or organization to a disclosing party, his/her course/class, or laboratory）	Author Yes None
8	⑧ Endowed chair sponsored by a company (to be filled in if you belong to a corporate-sponsored endowed course)	Author Yes None
9	⑨ Travel fees, gifts, and others ($500 or more per year from one company or organization）	Author Yes None

Password ※

Password must contain at least 6 characters, including at least one lowercase alphabet and one number.

You will need your reception number and password to check and correct your abstract, so make a note of these two displayed on the registration completion screen. Please be sure to fill in the question items displayed with *. Registration cannot be completed if there is no input. Please fill in the required questions and then click the "Next" button.

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