Mastitis PostpartumOPTIMISTNCT05794945
Optimizing Mastitis Identification and Treatment
An observational study of Mastitis Postpartum, run by University of Tromso at 2 sites in Norway.
Trial summary
The goal of this observational study is to gain more information about the aetiology and progression of mastitis and breast inflammation, in order to develop evidence-based clinical guidelines and treatment plans, especially concerning judicious use of antibiotics. Read more about this study
- Who is it for?
- Ages 18 to 50 years, women only
- Conditions the study is for
- Mastitis Postpartum
- How many people
- 300 participants
- Where
- 2 sitesNorway
- Study dates
- 1 Oct 2023to 1 Oct 2028
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 50 years
- Women only
- No healthy volunteers
- Adult
Study population: Pregnant mothers aged > 18 years planning to give birth at University Hospital Noth Norway (UNN), with the intention to breastfeed and with an address in Tromsø municipality.
Who may be able to join
- Pregnant mothers aged > 18
- mothers must understand information given in Norwegian or English
- participants must be willing to complete study questionnaires
- participants must be willing to and provide biological samples
Who cannot join
- No exclusion criteria
Trial locations and contacts
2 sites in 1 country. Contact the study team or a site near you to ask about taking part.
Norway2 sites, 2 recruiting
- Recruiting
Tromsø municipality, health centre
Tromsø, Troms, 9019
- Recruiting
UiT-The Arctic University of Norway
Tromsø, 9019
Pauline Cavanagh, PhD, pauline.cavanagh@uit.no
Beate Fossum Løland, MD,PhD
About this study
Official title: OPTIMISTOptimizing Mastitis Identification and Treatment
The goal of this observational study is to gain more information about the aetiology and progression of mastitis and breast inflammation, in order to develop evidence-based clinical guidelines and treatment plans, especially concerning judicious use of antibiotics.
The main questions it aims to answer are:
Read more
- Do clinical symptoms differ between inflammatory and infectious mastitis?
- What is the microbial composition in human milk, and does it change before, during, and after episodes of mastitis?
- Does the bacterial composition change due to antibiotic treatment?
- Are all mastitis episodes treated with antibiotics bacterial mastitis?
- Do mothers with recurrent mastitis have a distinct microbial composition?
- Are there immunological markers that can differentiate between bacterial and inflammatory mastitis?
Researchers will compare breastfeeding women with and without mastitis to see if the microbiological composition in milk and on the skin of the breast and breast nipple differs.
Read the detailed description
Mastitis (breast inflammation) is experienced by up to one-fifth of all breastfeeding mothers. Mastitis is a painful condition and a leading cause of early weaning, an undesired outcome with potentially negative implications for both mother and baby. Empirical evidence explaining the aetiology of mastitis is lacking; thus the definitions and treatment of mastitis is conflicting. The recent mechanobiological model proposes that the mechanical forces of lactation, especially at the onset of milk production, can cause damage to the mammary tissue, which induces an inflammatory response. Concurrently a growing amount of evidence shows that bacteria previously written off as contaminants have a role in mastitis which has been overlooked. The dynamics between the mechanobiological model and bacterial colonization have not yet been investigated. To fill this knowledge gap, researchers will conduct a longitudinal study collecting milk samples and questionnaires during the breastfeeding period with a particular emphasis on mastitis. Milk and skin swab samples will be used for culture dependent and culture independent assessment of the microbial composition in mastitis, and will be compared to the composition found in mothers without mastitis.
The main objective of this clinical study is to gather empirical data to provide an evidence-based update to the clinical guidelines for mastitis diagnosis and care. This will provide a foundation for improving the treatment and prevention of mastitis, with better outcomes for mothers and newborns.
- Conditions
- Mastitis Postpartum
- Keywords
- Breast inflammation, Clinical mastitis, Sub-clinical mastitis
- Medical subject headings
- Mastitis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| Breastfeeding mothers | In this study breastfeeding mothers will be included. Samples will be collected from breast-feeding mothers experiencing mastitis Samples will be collected from breast-feeding mothers after the mastitis episode is resolved Breastfeeding mothers will be sampled at each mastitis episode, and with the final sample collected after a maximum of 12 months |
What is being measured
The primary outcome is the main question the study is designed to answer.
Determination of the microbial composition in human milk from mothers without mastitis by MALDTI-TOF and Illumina sequencing
In order to investigate if there is a particular microbial composition of the human milk that leads to mastitis, the microbial composition in human milk from mothers without mastitis will be assessed. The investigators will collect milk samples from all enrolled mothers at day 6-7 after birth. Milk samples will be stored at -20 until further processing.
Mothers who develop mastitis will be further sampled as described in outcome 2. Samples will be analyzed using culture dependent and culture independent methods. Following culturing of the milk samples, colonies will be analysed by Matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) to identify bacterial species. DNA will be isolated from the same milk sample.16S rRNA amplicon sequencing of DNA from milk samples will be performed using the Illumina technology, in order to get an overview of the total bacterial composition.
Measured: 18 months
Determination of the microbial composition in human milk from mothers at onset of mastitis by MALDTI-TOF and Illumina sequencing
The investigators will investigate if the microbial composition in human milk changes at onset of mastitis. By analysing possible changes in microbial composition the investigators will assess if the mastitis symptoms are caused by microorganisms, or if the symptoms of mastitis are inflammatory. Milk samples will be collected by the mother at onset of mastitis, 24 hours after onset of symptoms and after resolution of symptoms. If the mastitis episode is treated with antibiotics, a new sample will be taken 24 hours after cessation of antibiotic treatment. Milk samples will be stored at -20 until further processing. Samples will be analyzed using culture dependent, and culture independent methods. Following culturing of the samples, colonies will be analysed by MALDI-TOF to identify bacterial species. 16S rRNA amplicon sequencing of DNA from milk samples will be performed using the Illumina technology, in order to get an overview of the total bacterial composition.
Measured: 18 months
Assessment of the microbial composition on nipples of mothers without mastitis
It is no agreement on if mastitis causing bacteria originate from the breast nipple, or if they are part of the milk microbiome. We will sample the breast nipples in order to investigate if microorganisms colonizing the breast skin enter the mammary glands, and potentially cause mastitis. A skin swab of the nipple (both breasts) will be taken at day 6-7 after birth. Following culturing of the swab, bacterial colonies will be analysed by MALDI-TOF to identify bacterial species. The skin swabs will be collected at the same timepoints as collection of milk samples.
Measured: 18 months
Assessment of the microbial composition on nipples of mothers with mastitis
It is no agreement on if mastitis causing bacteria originate from breast nipple, or if they are part of the milk microbiome. We will sample the breast nipples in order to investigate if microorganisms colonizing the breast skin enter the mammary glands, and potentially cause mastitis.
When the mother experiences symptoms of mastitis the mother will collect a skin swab sample. Following culturing of the swab, bacterial colonies will be analysed by MALDI-TOF to identify bacterial species. The skin swabs will be collected at the same timepoints as collection of milk samples.The microbial composition on nipples of mothers with mastitis will also be compared to the nipple microflora of mothers without mastitis in order to see if there is a correlation between particular skin colonizing bacteria that cause mastitis.
Measured: 18 months
The concentration of immunological markers in milk from mothers without mastitis
A milk sample will be collected at day 6-7 after birth, and the concentration of immunological markers will be assessed in the milk of mothers without mastitis. The concentration (pg/ml) of 8 immune factors, including innate immune factors (IL6, IFNγ, TNFα), acquired immune factors (IL2, IL4, IL10), chemokines (IL8), and growth factor (GMCSF), will be determined by magnetic bead-based multi- plex immunoassays, using a Bioplex 200 instrument (Bio-Rad, Hercules, CA, USA).
Measured: 18 months
The concentration of immunological markers in milk from mothers with mastitis
In order to determine if there is an increase in the immunological markers present in milk from mothers with mastitis, milk samples will be collected at onset of mastitis symptoms and 24 hours after cessation of symptoms. If the mother requires antibiotic treatment , samples will be collected at onset of treatment and 24 hours after cessation of antibiotic treatment. The concentration (pg/ml) of 8 immune factors, including innate immune factors (IL6, IFNγ, TNFα), acquired immune factors (IL2, IL4, IL10), chemokines (IL8), and growth factor (GMCSF), will be determined by magnetic bead-based multi- plex immunoassays, using a Bioplex 200 instrument (Bio-Rad, Hercules, CA, USA).The investigators will assess if the concentration of immunological markers differs in bacterial mastitis and inflammatory mastitis.
Measured: 18 months
Mapping of mastitis symptoms by detailed Questionnaires
The mothers will be asked to fill in a detailed questionnaire regarding breastfeeding practice and symptoms of mastitis.
The questionnaire will accompany the collection of milk samples as described in outcome 1and 2.
Measured: 18 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted3 Apr 2023
- Study start1 Oct 2023
- Primary completion1 Oct 2027 (estimated)
- Study completion1 Oct 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Mastitis PostpartumStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 300 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Tromso
- Sponsor type
- University, hospital or other
- Collaborators
- Norwegian Institute of Public Health, The University of Western Australia, Helse Nord
- Responsible party
- Sponsor
- Investigators
- Jorunn Pauline Cavanagh, PhD, Principal investigator, The Arctic university of Norway-UiT
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05794945
- Sponsor's protocol ID
- 2023/578416 (REK)
- Other IDs
- 2023
- Acronym
- OPTIMIST
- Status last verified
- Mar 2026
- First submitted
- 24 Feb 2023
- Last updated
- 12 Mar 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Researchers will share questionnaires, Informed consent forms and protocol, after data is published.
Publications
Wilson E, Woodd SL, Benova L. Incidence of and Risk Factors for Lactational Mastitis: A Systematic Review. J Hum Lact. 2020 Nov;36(4):673-686. doi: 10.1177/0890334420907898. Epub 2020 Apr 14.
PubMed 32286139Mitchell KB, Johnson HM, Rodriguez JM, Eglash A, Scherzinger C, Zakarija-Grkovic I, Cash KW, Berens P, Miller B; Academy of Breastfeeding Medicine. Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum, Revised 2022. Breastfeed Med. 2022 May;17(5):360-376. doi: 10.1089/bfm.2022.29207.kbm.
PubMed 35576513Grzeskowiak LE, Saha MR, Ingman WV, Nordeng H, Ystrom E, Amir LH. Incidence, antibiotic treatment and outcomes of lactational mastitis: Findings from The Norwegian Mother, Father and Child Cohort Study (MoBa). Paediatr Perinat Epidemiol. 2022 Mar;36(2):254-263. doi: 10.1111/ppe.12824. Epub 2021 Nov 28.
PubMed 34841537Castro I, Garcia-Carral C, Furst A, Khwajazada S, Garcia J, Arroyo R, Ruiz L, Rodriguez JM, Bode L, Fernandez L. Interactions between human milk oligosaccharides, microbiota and immune factors in milk of women with and without mastitis. Sci Rep. 2022 Jan 25;12(1):1367. doi: 10.1038/s41598-022-05250-7.
PubMed 35079053
Study at a glance
From the registry record, last updated by the sponsor on 12 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- OPTIMISTOptimizing Mastitis Identification and Treatment
- ClinicalTrials.gov ID
- NCT05794945
- Acronym / sponsor ID
- OPTIMIST / 2023/578416 (REK)
- Conditions
- Mastitis Postpartum
- Keywords
- Breast inflammation, Clinical mastitis, Sub-clinical mastitis
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 300 participants (estimated)
- Lead sponsor
- University of TromsoUniversity, hospital or other
- Collaborators
- Norwegian Institute of Public Health, The University of Western Australia, Helse Nord
- Study start
- 1 Oct 2023 (actual)
- Primary completion
- 1 Oct 2027 (estimated)
- Study completion
- 1 Oct 2028 (estimated)
- First posted
- 3 Apr 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this observational study is to gain more information about the aetiology and progression of mastitis and breast inflammation, in order to develop evidence-based clinical guidelines and treatment plans, especially concerning judicious use of antibiotics.
The main questions it aims to answer are:
- Do clinical symptoms differ between inflammatory and infectious mastitis?
- What is the microbial composition in human milk, and does it change before, during, and after episodes of mastitis?
- Does the bacterial composition change due to antibiotic treatment?
- Are all mastitis episodes treated with antibiotics bacterial mastitis?
- Do mothers with recurrent mastitis have a distinct microbial composition?
- Are there immunological markers that can differentiate between bacterial and inflammatory mastitis?
Researchers will compare breastfeeding women with and without mastitis to see if the microbiological composition in milk and on the skin of the breast and breast nipple differs.
Detailed description
Mastitis (breast inflammation) is experienced by up to one-fifth of all breastfeeding mothers. Mastitis is a painful condition and a leading cause of early weaning, an undesired outcome with potentially negative implications for both mother and baby. Empirical evidence explaining the aetiology of mastitis is lacking; thus the definitions and treatment of mastitis is conflicting. The recent mechanobiological model proposes that the mechanical forces of lactation, especially at the onset of milk production, can cause damage to the mammary tissue, which induces an inflammatory response. Concurrently a growing amount of evidence shows that bacteria previously written off as contaminants have a role in mastitis which has been overlooked. The dynamics between the mechanobiological model and bacterial colonization have not yet been investigated. To fill this knowledge gap, researchers will conduct a longitudinal study collecting milk samples and questionnaires during the breastfeeding period with a particular emphasis on mastitis. Milk and skin swab samples will be used for culture dependent and culture independent assessment of the microbial composition in mastitis, and will be compared to the composition found in mothers without mastitis.
The main objective of this clinical study is to gather empirical data to provide an evidence-based update to the clinical guidelines for mastitis diagnosis and care. This will provide a foundation for improving the treatment and prevention of mastitis, with better outcomes for mothers and newborns.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Breastfeeding mothers | – | –In this study breastfeeding mothers will be included. Samples will be collected from breast-feeding mothers experiencing mastitis Samples will be collected from breast-feeding mothers after the mastitis episode is resolved Breastfeeding mothers will be sampled at each mastitis episode, and with the final sample collected after a maximum of 12 months |
Who may qualify
- Ages
- 18 to 50 years
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult
- Study population
- Pregnant mothers aged > 18 years planning to give birth at University Hospital Noth Norway (UNN), with the intention to breastfeed and with an address in Tromsø municipality.
Key inclusion criteria (4 listed)
- Pregnant mothers aged > 18
- mothers must understand information given in Norwegian or English
- participants must be willing to complete study questionnaires
- participants must be willing to and provide biological samples
Key exclusion criteria (1 listed)
- No exclusion criteria
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Determination of the microbial composition in human milk from mothers without mastitis by MALDTI-TOF and Illumina sequencing
Time frame: 18 months
In order to investigate if there is a particular microbial composition of the human milk that leads to mastitis, the microbial composition in human milk from mothers without mastitis will be assessed. The investigators will collect milk samples from all enrolled mothers at day 6-7 after birth. Milk samples will be stored at -20 until further processing. Mothers who develop mastitis will be further sampled as described in outcome 2. Samples will be analyzed using culture dependent and culture independent methods. Following culturing of the milk samples, colonies will be analysed by Matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) to identify bacterial species. DNA will be isolated from the same milk sample.16S rRNA amplicon sequencing of DNA from milk samples will be performed using the Illumina technology, in order to get an overview of the total bacterial composition.
Determination of the microbial composition in human milk from mothers at onset of mastitis by MALDTI-TOF and Illumina sequencing
Time frame: 18 months
The investigators will investigate if the microbial composition in human milk changes at onset of mastitis. By analysing possible changes in microbial composition the investigators will assess if the mastitis symptoms are caused by microorganisms, or if the symptoms of mastitis are inflammatory. Milk samples will be collected by the mother at onset of mastitis, 24 hours after onset of symptoms and after resolution of symptoms. If the mastitis episode is treated with antibiotics, a new sample will be taken 24 hours after cessation of antibiotic treatment. Milk samples will be stored at -20 until further processing. Samples will be analyzed using culture dependent, and culture independent methods. Following culturing of the samples, colonies will be analysed by MALDI-TOF to identify bacterial species. 16S rRNA amplicon sequencing of DNA from milk samples will be performed using the Illumina technology, in order to get an overview of the total bacterial composition.
Assessment of the microbial composition on nipples of mothers without mastitis
Time frame: 18 months
It is no agreement on if mastitis causing bacteria originate from the breast nipple, or if they are part of the milk microbiome. We will sample the breast nipples in order to investigate if microorganisms colonizing the breast skin enter the mammary glands, and potentially cause mastitis. A skin swab of the nipple (both breasts) will be taken at day 6-7 after birth. Following culturing of the swab, bacterial colonies will be analysed by MALDI-TOF to identify bacterial species. The skin swabs will be collected at the same timepoints as collection of milk samples.
Assessment of the microbial composition on nipples of mothers with mastitis
Time frame: 18 months
It is no agreement on if mastitis causing bacteria originate from breast nipple, or if they are part of the milk microbiome. We will sample the breast nipples in order to investigate if microorganisms colonizing the breast skin enter the mammary glands, and potentially cause mastitis. When the mother experiences symptoms of mastitis the mother will collect a skin swab sample. Following culturing of the swab, bacterial colonies will be analysed by MALDI-TOF to identify bacterial species. The skin swabs will be collected at the same timepoints as collection of milk samples.The microbial composition on nipples of mothers with mastitis will also be compared to the nipple microflora of mothers without mastitis in order to see if there is a correlation between particular skin colonizing bacteria that cause mastitis.
The concentration of immunological markers in milk from mothers without mastitis
Time frame: 18 months
A milk sample will be collected at day 6-7 after birth, and the concentration of immunological markers will be assessed in the milk of mothers without mastitis. The concentration (pg/ml) of 8 immune factors, including innate immune factors (IL6, IFNγ, TNFα), acquired immune factors (IL2, IL4, IL10), chemokines (IL8), and growth factor (GMCSF), will be determined by magnetic bead-based multi- plex immunoassays, using a Bioplex 200 instrument (Bio-Rad, Hercules, CA, USA).
The concentration of immunological markers in milk from mothers with mastitis
Time frame: 18 months
In order to determine if there is an increase in the immunological markers present in milk from mothers with mastitis, milk samples will be collected at onset of mastitis symptoms and 24 hours after cessation of symptoms. If the mother requires antibiotic treatment , samples will be collected at onset of treatment and 24 hours after cessation of antibiotic treatment. The concentration (pg/ml) of 8 immune factors, including innate immune factors (IL6, IFNγ, TNFα), acquired immune factors (IL2, IL4, IL10), chemokines (IL8), and growth factor (GMCSF), will be determined by magnetic bead-based multi- plex immunoassays, using a Bioplex 200 instrument (Bio-Rad, Hercules, CA, USA).The investigators will assess if the concentration of immunological markers differs in bacterial mastitis and inflammatory mastitis.
Mapping of mastitis symptoms by detailed Questionnaires
Time frame: 18 months
The mothers will be asked to fill in a detailed questionnaire regarding breastfeeding practice and symptoms of mastitis. The questionnaire will accompany the collection of milk samples as described in outcome 1and 2.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 12 Mar 2026.
- Results publication: PubMed 32286139Wilson E, Woodd SL, Benova L. Incidence of and Risk Factors for Lactational Mastitis: A Systematic Review. J Hum Lact. 2020 Nov;36(4):673-686. doi: 10.1177/0890334420907898. Epub 2020 Apr 14.
- Results publication: PubMed 35576513Mitchell KB, Johnson HM, Rodriguez JM, Eglash A, Scherzinger C, Zakarija-Grkovic I, Cash KW, Berens P, Miller B; Academy of Breastfeeding Medicine. Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum, Revised 2022. Breastfeed Med. 2022 May;17(5):360-376. doi: 10.1089/bfm.2022.29207.kbm.
- Results publication: PubMed 34841537Grzeskowiak LE, Saha MR, Ingman WV, Nordeng H, Ystrom E, Amir LH. Incidence, antibiotic treatment and outcomes of lactational mastitis: Findings from The Norwegian Mother, Father and Child Cohort Study (MoBa). Paediatr Perinat Epidemiol. 2022 Mar;36(2):254-263. doi: 10.1111/ppe.12824. Epub 2021 Nov 28.
- Results publication: PubMed 35079053Castro I, Garcia-Carral C, Furst A, Khwajazada S, Garcia J, Arroyo R, Ruiz L, Rodriguez JM, Bode L, Fernandez L. Interactions between human milk oligosaccharides, microbiota and immune factors in milk of women with and without mastitis. Sci Rep. 2022 Jan 25;12(1):1367. doi: 10.1038/s41598-022-05250-7.
- Individual participant dataSharing planned: Yes. Researchers will share questionnaires, Informed consent forms and protocol, after data is published.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Jorunn Pauline Cavanagh, PhD principal investigator
The Arctic university of Norway-UiT
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Mastitis Postpartum, run by University of Tromso at 2 sites in Norway.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 12 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Norway. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Jorunn Pauline Cavanagh, PhD (40498490 ext. 47, pauline.cavanagh@uit.no), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Determination of the microbial composition in human milk from mothers without mastitis by MALDTI-TOF and Illumina sequencing (time frame: 18 months). The study lists 7 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05794945, which also lists 4 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Mar 2026.