Intermittent FastingENNUT-CINCT06330610
Evaluation of the Efficiency of Intermittent Enteral Nutrition on Multi-organ Failure From Patients With Mechanical Ventilation in Intensive Care Unit
A study testing Intermittent enteral nutrition in people with Intermittent Fasting and Septic Shock, run by University Hospital, Rouen at 1 site in France.
Trial summary
This study aims to evaluate the efficiency of intermittent enteral nutrition versus continuous enteral nutrition to prevent from organ failures for patients at the acute phase of sepsis shock with mechanical ventilation in ICU. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Intermittent Fasting, Septic Shock, Organ Failure, Multiple
- What is being tested?
- Intermittent enteral nutrition
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 174 participants
- Where
- 1 siteFrance
- Study dates
- 9 Jul 2024to 2 Aug 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patient admitted in ICU for less than 48h, with invasive mechanical ventilation predicted for at least 48h, that can undergo nasogastric feeding for 7 days.
- Patient under vasopressive drugs
- Adult patients (age ≥ 18 years)
- Informed person who has read and signed their consent
- If the patient is unable to sign their consent (emergency situation), the consent will be signed by a trusted person or a family member, and consent to continue the study will be requested subsequently.
- If the patient is unable to sign their consent (emergency situation) and no trusted person is present, the patient may be included in the study. In this case, consent to continue the study will be requested from a trusted person as soon as possible, or from the patient if they are able to understand and sign the consent.
- Affiliation to a social security scheme
- No current pregnancy: for women of childbearing age, a beta-HCG blood pregnancy test will be performed upon inclusion; for postmenopausal women, a confirmatory diagnosis must be obtained.
Who cannot join
- Contraindication to enteral nutrition and/or nasogastric tube insertion: esophageal varices and occlusive syndrome
- Artificial enteral nutrition that cannot be initiated within 48 hours of intubation
- Enteral nutrition ongoing for more than one hour at the time of inclusion
- Need for exclusive or supplemental parenteral nutrition
- Moribund patient
- Person deprived of liberty by an administrative or judicial decision or person placed under judicial protection/guardianship or curatorship
- Pregnant or breastfeeding woman
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Evaluation de l'efficacité du Support Nutritionnel entéral Intermittent Sur la défaillance d'Organes de Patients de réanimation Sous Ventilation assistée ENteral NUTrition - Continue Intermittent
This study aims to evaluate the efficiency of intermittent enteral nutrition versus continuous enteral nutrition to prevent from organ failures for patients at the acute phase of sepsis shock with mechanical ventilation in ICU.
Read the detailed description
Some pre-clinical and observational studies have suggested that intermittent fasting may have a positive impact on patients in ICU by increasing protein synthesis, sensibility to insulin, cetogenesis, autophagy by respecting the circadian rhythm. This study aims to evaluate the impact on organ failures of an intermittent enteral nutrition versus continuous enteral nutrition in patients at the acute phase of sepsis shock with mechanical ventilation in the ICU.
- Conditions
- Intermittent Fasting, Septic Shock, Organ Failure, Multiple
- Being tested
- Intermittent enteral nutrition
- Keywords
- Enteral nutrition, Mechanical ventilation, Intermittent fasting, Sepsis shock, Organ failure
- Medical subject headings
- Intermittent Fasting, Shock, Septic, Multiple Organ Failure
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Intermittent enteral nutritionOther
Patients will receive intermittent enteral nutrition, defined as 3 60-minute administrations every 8 hours.
| Study group | Role | What they receive |
|---|---|---|
| Intermittent enteral nutrition | Experimental | patients that receive intermittent enteral nutrition. Receives: Other: Intermittent enteral nutrition |
| continuous enteral nutrition | No intervention | patients that receive continuous enteral nutrition |
What is being measured
The primary outcome is the main question the study is designed to answer.
Evolution of variation of the SOFA (Sepsis-related organ failure assessment) score.
Comparison of variation of the SOFA score between patients with intermittent nutrition versus patients with continuous nutrition.
Measured: day-1 (nutrition start) and day-7
Secondary outcomes (11)
evaluation of caloric intake
evaluation of caloric intake (kcal/day)
Measured: from day-1 (nutrition start) to day-7
evaluation of protein intake
evaluation of protein intake (g/kg/day)
Measured: from day-1 (nutrition start) to day-7
Measurement of nutritionnal status
measurement of weight (kg)
Measured: day-1 (nutrition start) and day-7
Evaluation of the digestive tolerance
Number of vomit (number)
Measured: from day-1 (nutrition start) to day-7
Evaluation of the nosocomial infections
Type of infection
Measured: from day-1 (nutrition start) to day-7
Adverse events
Number of adverse event
Measured: from day-1 (nutrition start) to day-7
Evaluation of the metabolic response
metabolomics analysis (96 proteins assay)
Measured: day 1, day 4 and day 7
Evaluation of the duration of hospitalisation
number of days at hospital
Measured: day 1 to day 90
Evaluation of the intensive care neuromuscular weakness
MRC score
Measured: Up to day 10
Evaluation of death
Death data collection
Measured: from day 1 to day 90
Evaluation of quality of life
SF-36 score
Measured: up to day 90
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 Mar 2024
- Study start9 Jul 2024
- Primary completion2 Aug 2026
- Study completion2 Aug 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (23)Papers the sponsor has linked to this study.
- Other trials for Intermittent FastingStudies of the same condition, open and under way.
- More trials run by University Hospital, RouenThe sponsor's other registered studies.
- 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
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 174 participants (actual)
Sponsor and investigators
- Lead sponsor
- University Hospital, Rouen
- Sponsor type
- University, hospital or other
- Collaborators
- University Hospital, Lille, University Hospital, Caen, Amiens University Hospital, Centre Hospitalier Saint-Philibert, GHICL, Centre Hospitalier Intercommunal Elbeuf-Louviers-Val de Reuil, Groupe Hospitalier du Havre, Centre Hospitalier de Dieppe
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06330610
- Sponsor's protocol ID
- 2021/0378/HP
- Acronym
- ENNUT-CI
- Status last verified
- Sep 2026
- First submitted
- 1 Mar 2024
- Last updated
- 6 Nov 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Tebani A, Demailly Z, Bekri S, Maizel J, Marchalot A, Bourel C, Du Cheyron D, Michot JB, Schnell G, Vanderlinden T, Tamion F. Clinical and metabolic phenotyping of continuous versus intermittent ENteral NUTrition in ventilated adults with shock: ENNUT trial protocol. BMJ Open. 2025 Aug 1;15(7):e099761. doi: 10.1136/bmjopen-2025-099761.
PubMed 40750277Atherton PJ, Etheridge T, Watt PW, Wilkinson D, Selby A, Rankin D, Smith K, Rennie MJ. Muscle full effect after oral protein: time-dependent concordance and discordance between human muscle protein synthesis and mTORC1 signaling. Am J Clin Nutr. 2010 Nov;92(5):1080-8. doi: 10.3945/ajcn.2010.29819. Epub 2010 Sep 15.
PubMed 20844073McNelly AS, Bear DE, Connolly BA, Arbane G, Allum L, Tarbhai A, Cooper JA, Hopkins PA, Wise MP, Brealey D, Rooney K, Cupitt J, Carr B, Koelfat K, Damink SO, Atherton PJ, Hart N, Montgomery HE, Puthucheary ZA. Effect of Intermittent or Continuous Feed on Muscle Wasting in Critical Illness: A Phase 2 Clinical Trial. Chest. 2020 Jul;158(1):183-194. doi: 10.1016/j.chest.2020.03.045. Epub 2020 Apr 2.
PubMed 32247714Gonzalez JT, Dirks ML, Holwerda AM, Kouw IWK, van Loon LJC. Intermittent versus continuous enteral nutrition attenuates increases in insulin and leptin during short-term bed rest. Eur J Appl Physiol. 2020 Sep;120(9):2083-2094. doi: 10.1007/s00421-020-04431-4. Epub 2020 Jul 10.
PubMed 32651634Marcheva B, Ramsey KM, Peek CB, Affinati A, Maury E, Bass J. Circadian clocks and metabolism. Handb Exp Pharmacol. 2013;(217):127-55. doi: 10.1007/978-3-642-25950-0_6.
PubMed 23604478Baggs JE, Hogenesch JB. Genomics and systems approaches in the mammalian circadian clock. Curr Opin Genet Dev. 2010 Dec;20(6):581-7. doi: 10.1016/j.gde.2010.08.009.
PubMed 20926286Jamshed H, Beyl RA, Della Manna DL, Yang ES, Ravussin E, Peterson CM. Early Time-Restricted Feeding Improves 24-Hour Glucose Levels and Affects Markers of the Circadian Clock, Aging, and Autophagy in Humans. Nutrients. 2019 May 30;11(6):1234. doi: 10.3390/nu11061234.
PubMed 31151228Pickel L, Sung HK. Feeding Rhythms and the Circadian Regulation of Metabolism. Front Nutr. 2020 Apr 17;7:39. doi: 10.3389/fnut.2020.00039. eCollection 2020.
PubMed 32363197Gunst J. Recovery from critical illness-induced organ failure: the role of autophagy. Crit Care. 2017 Aug 7;21(1):209. doi: 10.1186/s13054-017-1786-y.
PubMed 28784175Vanhorebeek I, Gunst J, Derde S, Derese I, Boussemaere M, Guiza F, Martinet W, Timmermans JP, D'Hoore A, Wouters PJ, Van den Berghe G. Insufficient activation of autophagy allows cellular damage to accumulate in critically ill patients. J Clin Endocrinol Metab. 2011 Apr;96(4):E633-45. doi: 10.1210/jc.2010-2563. Epub 2011 Jan 26.
PubMed 21270330Hermans G, Casaer MP, Clerckx B, Guiza F, Vanhullebusch T, Derde S, Meersseman P, Derese I, Mesotten D, Wouters PJ, Van Cromphaut S, Debaveye Y, Gosselink R, Gunst J, Wilmer A, Van den Berghe G, Vanhorebeek I. Effect of tolerating macronutrient deficit on the development of intensive-care unit acquired weakness: a subanalysis of the EPaNIC trial. Lancet Respir Med. 2013 Oct;1(8):621-629. doi: 10.1016/S2213-2600(13)70183-8. Epub 2013 Sep 10.
PubMed 24461665Martinez-Lopez N, Tarabra E, Toledo M, Garcia-Macia M, Sahu S, Coletto L, Batista-Gonzalez A, Barzilai N, Pessin JE, Schwartz GJ, Kersten S, Singh R. System-wide Benefits of Intermeal Fasting by Autophagy. Cell Metab. 2017 Dec 5;26(6):856-871.e5. doi: 10.1016/j.cmet.2017.09.020. Epub 2017 Oct 26.
PubMed 29107505Newman JC, Verdin E. beta-Hydroxybutyrate: A Signaling Metabolite. Annu Rev Nutr. 2017 Aug 21;37:51-76. doi: 10.1146/annurev-nutr-071816-064916.
PubMed 28826372Cox PJ, Kirk T, Ashmore T, Willerton K, Evans R, Smith A, Murray AJ, Stubbs B, West J, McLure SW, King MT, Dodd MS, Holloway C, Neubauer S, Drawer S, Veech RL, Griffin JL, Clarke K. Nutritional Ketosis Alters Fuel Preference and Thereby Endurance Performance in Athletes. Cell Metab. 2016 Aug 9;24(2):256-68. doi: 10.1016/j.cmet.2016.07.010. Epub 2016 Jul 27.
PubMed 27475046Zou X, Meng J, Li L, Han W, Li C, Zhong R, Miao X, Cai J, Zhang Y, Zhu D. Acetoacetate Accelerates Muscle Regeneration and Ameliorates Muscular Dystrophy in Mice. J Biol Chem. 2016 Jan 29;291(5):2181-95. doi: 10.1074/jbc.M115.676510. Epub 2015 Dec 8.
PubMed 26645687
Study at a glance
From the registry record, last updated by the sponsor on 6 Nov 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Evaluation de l'efficacité du Support Nutritionnel entéral Intermittent Sur la défaillance d'Organes de Patients de réanimation Sous Ventilation assistée ENteral NUTrition - Continue Intermittent
- ClinicalTrials.gov ID
- NCT06330610
- Acronym / sponsor ID
- ENNUT-CI / 2021/0378/HP
- Conditions
- Intermittent Fasting, Septic Shock, Organ Failure, Multiple
- Keywords
- Enteral nutrition, Mechanical ventilation, Intermittent fasting, Sepsis shock, Organ failure
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 174 participants (actual)
- Lead sponsor
- University Hospital, RouenUniversity, hospital or other
- Collaborators
- University Hospital, Lille, University Hospital, Caen, Amiens University Hospital, Centre Hospitalier Saint-Philibert, GHICL, Centre Hospitalier Intercommunal Elbeuf-Louviers-Val de Reuil, Groupe Hospitalier du Havre, Centre Hospitalier de Dieppe
- Study start
- 9 Jul 2024 (actual)
- Primary completion
- 2 Aug 2026 (actual)
- Study completion
- 2 Aug 2026 (actual)
- First posted
- 26 Mar 2024 (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.
This study aims to evaluate the efficiency of intermittent enteral nutrition versus continuous enteral nutrition to prevent from organ failures for patients at the acute phase of sepsis shock with mechanical ventilation in ICU.
Detailed description
Some pre-clinical and observational studies have suggested that intermittent fasting may have a positive impact on patients in ICU by increasing protein synthesis, sensibility to insulin, cetogenesis, autophagy by respecting the circadian rhythm. This study aims to evaluate the impact on organ failures of an intermittent enteral nutrition versus continuous enteral nutrition in patients at the acute phase of sepsis shock with mechanical ventilation in the ICU.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Intermittent enteral nutrition | Experimental | Other: Intermittent enteral nutritionpatients that receive intermittent enteral nutrition. |
| continuous enteral nutrition | No intervention | –patients that receive continuous enteral nutrition |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- Patient admitted in ICU for less than 48h, with invasive mechanical ventilation predicted for at least 48h, that can undergo nasogastric feeding for 7 days.
- Patient under vasopressive drugs
- Adult patients (age ≥ 18 years)
- Informed person who has read and signed their consent
- Affiliation to a social security scheme
Key exclusion criteria (7 listed)
- Contraindication to enteral nutrition and/or nasogastric tube insertion: esophageal varices and occlusive syndrome
- Artificial enteral nutrition that cannot be initiated within 48 hours of intubation
- Enteral nutrition ongoing for more than one hour at the time of inclusion
- Need for exclusive or supplemental parenteral nutrition
- Moribund patient
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Intermittent enteral nutritionPatients will receive intermittent enteral nutrition, defined as 3 60-minute administrations every 8 hours. | Other | Intermittent enteral nutrition |
Primary outcome
Evolution of variation of the SOFA (Sepsis-related organ failure assessment) score.
Time frame: day-1 (nutrition start) and day-7
Comparison of variation of the SOFA score between patients with intermittent nutrition versus patients with continuous nutrition.
11 secondary outcomes
evaluation of caloric intake
Time frame: from day-1 (nutrition start) to day-7
evaluation of protein intake
Time frame: from day-1 (nutrition start) to day-7
Measurement of nutritionnal status
Time frame: day-1 (nutrition start) and day-7
Evaluation of the digestive tolerance
Time frame: from day-1 (nutrition start) to day-7
Evaluation of the nosocomial infections
Time frame: from day-1 (nutrition start) to day-7
Adverse events
Time frame: from day-1 (nutrition start) to day-7
Evaluation of the metabolic response
Time frame: day 1, day 4 and day 7
Evaluation of the duration of hospitalisation
Time frame: day 1 to day 90
Evaluation of the intensive care neuromuscular weakness
Time frame: Up to day 10
Evaluation of death
Time frame: from day 1 to day 90
Evaluation of quality of life
Time frame: up to day 90
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 Nov 2026.
- Background: PubMed 40750277Tebani A, Demailly Z, Bekri S, Maizel J, Marchalot A, Bourel C, Du Cheyron D, Michot JB, Schnell G, Vanderlinden T, Tamion F. Clinical and metabolic phenotyping of continuous versus intermittent ENteral NUTrition in ventilated adults with shock: ENNUT trial protocol. BMJ Open. 2025 Aug 1;15(7):e099761. doi: 10.1136/bmjopen-2025-099761.
- Background: PubMed 20844073Atherton PJ, Etheridge T, Watt PW, Wilkinson D, Selby A, Rankin D, Smith K, Rennie MJ. Muscle full effect after oral protein: time-dependent concordance and discordance between human muscle protein synthesis and mTORC1 signaling. Am J Clin Nutr. 2010 Nov;92(5):1080-8. doi: 10.3945/ajcn.2010.29819. Epub 2010 Sep 15.
- Background: PubMed 32247714McNelly AS, Bear DE, Connolly BA, Arbane G, Allum L, Tarbhai A, Cooper JA, Hopkins PA, Wise MP, Brealey D, Rooney K, Cupitt J, Carr B, Koelfat K, Damink SO, Atherton PJ, Hart N, Montgomery HE, Puthucheary ZA. Effect of Intermittent or Continuous Feed on Muscle Wasting in Critical Illness: A Phase 2 Clinical Trial. Chest. 2020 Jul;158(1):183-194. doi: 10.1016/j.chest.2020.03.045. Epub 2020 Apr 2.
- Background: PubMed 32651634Gonzalez JT, Dirks ML, Holwerda AM, Kouw IWK, van Loon LJC. Intermittent versus continuous enteral nutrition attenuates increases in insulin and leptin during short-term bed rest. Eur J Appl Physiol. 2020 Sep;120(9):2083-2094. doi: 10.1007/s00421-020-04431-4. Epub 2020 Jul 10.
- Background: PubMed 23604478Marcheva B, Ramsey KM, Peek CB, Affinati A, Maury E, Bass J. Circadian clocks and metabolism. Handb Exp Pharmacol. 2013;(217):127-55. doi: 10.1007/978-3-642-25950-0_6.
- Background: PubMed 20926286Baggs JE, Hogenesch JB. Genomics and systems approaches in the mammalian circadian clock. Curr Opin Genet Dev. 2010 Dec;20(6):581-7. doi: 10.1016/j.gde.2010.08.009.
- Background: PubMed 31151228Jamshed H, Beyl RA, Della Manna DL, Yang ES, Ravussin E, Peterson CM. Early Time-Restricted Feeding Improves 24-Hour Glucose Levels and Affects Markers of the Circadian Clock, Aging, and Autophagy in Humans. Nutrients. 2019 May 30;11(6):1234. doi: 10.3390/nu11061234.
- Background: PubMed 32363197Pickel L, Sung HK. Feeding Rhythms and the Circadian Regulation of Metabolism. Front Nutr. 2020 Apr 17;7:39. doi: 10.3389/fnut.2020.00039. eCollection 2020.
- Background: PubMed 28784175Gunst J. Recovery from critical illness-induced organ failure: the role of autophagy. Crit Care. 2017 Aug 7;21(1):209. doi: 10.1186/s13054-017-1786-y.
- Background: PubMed 21270330Vanhorebeek I, Gunst J, Derde S, Derese I, Boussemaere M, Guiza F, Martinet W, Timmermans JP, D'Hoore A, Wouters PJ, Van den Berghe G. Insufficient activation of autophagy allows cellular damage to accumulate in critically ill patients. J Clin Endocrinol Metab. 2011 Apr;96(4):E633-45. doi: 10.1210/jc.2010-2563. Epub 2011 Jan 26.
- Background: PubMed 24461665Hermans G, Casaer MP, Clerckx B, Guiza F, Vanhullebusch T, Derde S, Meersseman P, Derese I, Mesotten D, Wouters PJ, Van Cromphaut S, Debaveye Y, Gosselink R, Gunst J, Wilmer A, Van den Berghe G, Vanhorebeek I. Effect of tolerating macronutrient deficit on the development of intensive-care unit acquired weakness: a subanalysis of the EPaNIC trial. Lancet Respir Med. 2013 Oct;1(8):621-629. doi: 10.1016/S2213-2600(13)70183-8. Epub 2013 Sep 10.
- Background: PubMed 29107505Martinez-Lopez N, Tarabra E, Toledo M, Garcia-Macia M, Sahu S, Coletto L, Batista-Gonzalez A, Barzilai N, Pessin JE, Schwartz GJ, Kersten S, Singh R. System-wide Benefits of Intermeal Fasting by Autophagy. Cell Metab. 2017 Dec 5;26(6):856-871.e5. doi: 10.1016/j.cmet.2017.09.020. Epub 2017 Oct 26.
- Individual participant dataSharing planned: Undecided
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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. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Intermittent enteral nutrition in people with Intermittent Fasting and Septic Shock, run by University Hospital, Rouen at 1 site in France.
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 8 inclusion and 7 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: finished, as of the sponsor's last update on 6 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in France. 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Evolution of variation of the SOFA (Sepsis-related organ failure assessment) score. (time frame: day-1 (nutrition start) and day-7). 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 NCT06330610, which also lists 23 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 6 Nov 2026.