Pulmonary RehabilitationNCT06600503
The Effect of a Mobile Application on Enhancing Pulmonary Rehabilitation After Lung Cancer Surgery
A study testing RehabLung mobile application and Healthcare interactive Web Platform in people with Pulmonary Rehabilitation and Telerehabilitation, run by National Cheng Kung University.
Trial summary
The goal of this clinical trial is to investigate the effect of a mobile application intervention on postoperative lung rehabilitation. The main purposes of this study are: 1. To understand the effectiveness of the pulmonary rehabilitation mobile application in improving lung function. 2. Read more about this study
- Who is it for?
- Ages 20 years and older
- Conditions the study is for
- Pulmonary Rehabilitation, Telerehabilitation, Lung Cancer
- What is being tested?
- RehabLung mobile application and Healthcare interactive Web Platform
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 36 participants
- Where
- No sites listed yet
- Study dates
- 1 Oct 2024to 31 Dec 2025
- 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 20 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- age over 20 years
- primary diagnosis of lung cancer at any stage and type
- referral to lung cancer resection by thoracotomy or videothoracoscopy
- ability to understand and consent to the trial procedures
- conscious and cognition intact
Who cannot join
- included adjuvant treatments (chemotherapy or radiotherapy)
- previous history of thoracic surgery
- neurological and/or musculoskeletal comorbidities
- visual or hearing impairment
- acute respiratory illness
Trial locations and contacts
No sites are listed yet.
About this study
Official title: The Effectiveness of a Mobile Lung Rehabilitation System on Patient Satisfaction and Lung Function After Lung Cancer Surgery
The goal of this clinical trial is to investigate the effect of a mobile application intervention on postoperative lung rehabilitation. The main purposes of this study are:
- To understand the effectiveness of the pulmonary rehabilitation mobile application in improving lung function.
- To assess the feasibility of the pulmonary rehabilitation mobile application in post-surgery rehabilitation care.
Read more
Researchers will compare the intervention group (using the pulmonary rehabilitation mobile application) to the usual care group to determine if the mobile application is effective in lung surgery rehabilitation.
Participants will join the study immediately after providing informed consent and will continue for up to 7 weeks post-surgery. Participants will be randomly allocated to either the intervention group or the control group. Both groups will receive regular pulmonary rehabilitation during their hospital stay (1 day before surgery and 2 to 3 days after surgery). Researchers will guide participants in the intervention group to use the mobile application for pulmonary rehabilitation exercises throughout the study period. Participants in the usual care group will receive health education and an exercise guide before discharge. Participants will undergo three study assessments: at baseline (within 1 week after enrollment), post-surgery (week 5), and at follow-up (week 8).
- Conditions
- Pulmonary Rehabilitation, Telerehabilitation, Lung Cancer
- Being tested
- RehabLung mobile application, Lung cancer postoperative standard care, Healthcare interactive Web Platform
- Keywords
- pulmonary rehabilitation, mobile application, Telerehabilitation, Lung cancer
- Medical subject headings
- Lung Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
RehabLung mobile applicationBehavioural
Also called The application group, RehabLung App
Participants in the intervention group will receive in-person pulmonary rehabilitation during their surgical admission and access to a mobile pulmonary rehabilitation application for self-training. This program begins one month before surgery and continues for seven weeks after surgery. The application is designed to encourage participants to engage in pulmonary rehabilitation exercises from preoperative preparation through postoperative care. It offers guided chest breathing exercises, using visual and movement instructions created and remotely prescribed by a physical therapist. Participants will receive daily breathing exercise prescriptions throughout the study period.
Lung cancer postoperative standard careBehavioural
Also called usual care, Standard chest rehabilitation
Participants in the usual care group will receive in-person pulmonary rehabilitation during surgical admission, pre-operative healthcare, and guidance on breathing exercises to practice before surgery. They will also receive post-operative breathing exercise prescriptions to follow at home.
Healthcare interactive Web PlatformOther
The healthcare interactive Web Platform provides patients with surgical information through animations. This includes an introduction to lung surgery, preparation procedures, answers to common patient questions, post-surgery wound care, and a brief guide to pulmonary rehabilitation.
| Study group | Role | What they receive |
|---|---|---|
| application inttervention group | Experimental | The experimental group will receive standard postoperative care, including chest rehabilitation, a mobile application for remote self-training every day after surgery, and an interactive healthcare web platform for health education. Receives: Behavioral: RehabLung mobile application; Other: Healthcare interactive Web Platform |
| Usual care group | Active comparator | The usual care group will receive standard postoperative care, including chest rehabilitation and an interactive healthcare web platform for health education Receives: Behavioral: Lung cancer postoperative standard care; Other: Healthcare interactive Web Platform |
What is being measured
The primary outcome is the main question the study is designed to answer.
Exercise capacity-oxygen consumption
Cardiorespiratory fitness is evaluated by a cardiopulmonary exercise test using a cycle ergometer. Participants will be encouraged to perform a cycle ergometer stress test to assess their cardiopulmonary function. During the test, the workload will gradually increase by 10 watts per minute until the participant reaches peak exercise capacity. Throughout the exercise test, participants will be carefully monitored for echocardiography and heart rate, and will wear a mask to analyze ventilatory outcomes using a computed gas analysis system. Peak oxygen consumption (VO2 peak) will be measured during the exercise test, and values for the difference and change in percent predicted (peak oxygen uptake [mL/kg/min], VO2 peak difference [mL/kg/min], VO2 peak change [%], and [% predicted]) will be obtained from gas analysis. The predicted values will be referenced from the system based on race, age, height, biological sex, and weight.
Measured: Baseline, post-surgery assessment at week 5, follow-up assessment at week 8
Exercise capacity-workload
Cardiorespiratory fitness is evaluated by a cardiopulmonary exercise test using a cycle ergometer. Participants will be encouraged to perform a cycle ergometer stress test to assess their cardiopulmonary function. During the test, the workload will gradually increase by 10 watts per minute until the participant reaches peak exercise capacity. Throughout the exercise test, participants will be carefully monitored for echocardiography and heart rate, and will wear a mask to analyze ventilatory outcomes using a computed gas analysis system.
The workload achieved during exercise test will be recored by peak work rate (watts), and peak work rate (%pred.) The predicted workload will be referenced from the system based on race, age, height, biological sex, and weight.
Measured: Baseline, post-surgery assessment at week 5, follow-up assessment at week 8
Exercise capacity-ventilatory efficiency
Cardiorespiratory fitness is evaluated by a cardiopulmonary exercise test using a cycle ergometer. Participants will be encouraged to perform a cycle ergometer stress test to assess their cardiopulmonary function. During the test, the workload will gradually increase by 10 watts per minute until the participant reaches peak exercise capacity. Throughout the exercise test, participants will be carefully monitored for echocardiography and heart rate, and will wear a mask to analyze ventilatory outcomes using a computed gas analysis system.
The gas analysis of oxygen exchange efficiency includes maximal ventilation (L/min), maximal ventilation (% predicted), ventilatory equivalents slope, VE/VCO2 slope, ventilatory equivalents, and VE/VCO2 (% predicted).
Measured: Baseline, post-surgery assessment at week 5, follow-up assessment at week 8
Exercise capacity-Anaerobic threshold
Cardiorespiratory fitness is evaluated by a cardiopulmonary exercise test using a cycle ergometer. Participants will be encouraged to perform a cycle ergometer stress test to assess their cardiopulmonary function. During the test, the workload will gradually increase by 10 watts per minute until the participant reaches peak exercise capacity. Throughout the exercise test, participants will be carefully monitored for echocardiography and heart rate, and will wear a mask to analyze ventilatory outcomes using a computed gas analysis system.
Anaerobic threshold (AT) (mL/kg/min) is defined as a nonlinear increase in CO2 production, which will be analyze during gas analysis in an incremental exercise test.
Measured: Baseline, post-surgery assessment at week 5, follow-up assessment at week 8
Pulmoanry function
The pulmonary function test, assessed by spirometry, is performed to evaluate lung volumes over time and ventilatory capacity. Participants will be guided by experienced therapists to take a maximal inspiration, then exhale with maximal effort for as long and as fast as possible. Measurements include forced vital capacity (FVC [L, % predicted]), forced expiratory volume in one second (FEV1 [L, % predicted]), and the ratio of the two volumes (FEV1/FVC [% predicted]). The predicted values will be referenced from large population studies of healthy adults, matched by race, age, height, biological sex, and weight.
Measured: Baseline, post-surgery assessment at week 5, follow-up assessment at week 8
Secondary outcomes (5)
Global respiratory muscle strength
Global respiratory muscle strength is assessed using a pressure gauge and a mouthpiece. Participants are guided to perform maximal exhalation followed by full inhalation, and then maximal inhalation followed by full exhalation through the mouth. Measurements include maximal inspiratory pressure (PImax [cmH2O, % predicted]) and maximal expiratory pressure (PEmax [cmH2O, % predicted]).
Measured: Baseline, post-surgery assessment at week 5, follow-up assessment at week 8
Six Minute Walk Test, 6MWT
The six-minute walk test is conducted by having a therapist encourage the participant to walk continuously at a comfortable speed for six minutes. The distance covered during the six-minute walk test (m) will be recorded. Throughout the test, vital signs will be carefully monitored.
Measured: Baseline, post-surgery assessment at week 5, follow-up assessment at week 8
Postoperative pulmonary complications
Postoperative pulmonary complications (PPCs) will be recorded from medical records including atelectasis, pneumothorax, respiratory infection, respiratory failure, pleural effusion, bronchospasm, aspiration pneumonitis, acute respiratory distress syndrome,
Measured: Baseline, post-surgery assessment at week 5, follow-up assessment at week 8
Quality of life - EORTC QLQ-C30
Quality of life specific to lung cancer patients is assessed using the EORTC QLQ-C30 (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30). This questionnaire evaluates various aspects of quality of life, including physical, role, cognitive, emotional, and social functioning, as well as cancer-related symptoms and overall health status. Scores range from 0 to 100 across the 30 items. A higher score on the global scale indicates a better quality of life.
Measured: Baseline, post-surgery assessment at week 5, follow-up assessment at week 8
Qulaity of life-WHOQOL-BREF
The measurement of quality of life in participants is assessed using the WHOQOL-BREF questionnaire (World Health Organization Quality of Life Brief Version). This questionnaire includes 26 items that assess perceptions of quality of life across physical, psychological, social, and environmental domains, with scores ranging from 0 to 100. Higher scores indicate better quality of life.
Measured: Baseline, post-surgery assessment at week 5, follow-up assessment at week 8
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Sep 2024
- Study start1 Oct 2024 (estimated)
- Primary completion31 Oct 2025 (estimated)
- Study completion31 Dec 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Pulmonary RehabilitationStudies 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
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 36 participants (estimated)
Sponsor and investigators
- Lead sponsor
- National Cheng Kung University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Kun-Ling Tsai, National Cheng Kung University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06600503
- Sponsor's protocol ID
- A-ER-111-055
- Status last verified
- Sep 2024
- First submitted
- 10 Sep 2024
- Last updated
- 19 Sep 2024
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: IPD sharing plan will be decided after summarized data being published.
Publications
Yang HL, Hung CH, Huang YT, Cheng HC, Tseng YL, Su JM, Tsai KL. The effectiveness of the AI-based RehabLung mobile rehabilitation system on cardiopulmonary function and user satisfaction in lung cancer patients undergoing thoracic surgery: a protocol for a two-arm randomized clinical trial. Ther Adv Respir Dis. 2026 Jan-Dec;20:17534666261427319. doi: 10.1177/17534666261427319. Epub 2026 Feb 28.
PubMed 41762649
Study at a glance
From the registry record, last updated by the sponsor on 19 Sep 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effectiveness of a Mobile Lung Rehabilitation System on Patient Satisfaction and Lung Function After Lung Cancer Surgery
- ClinicalTrials.gov ID
- NCT06600503
- Acronym / sponsor ID
- A-ER-111-055
- Conditions
- Pulmonary Rehabilitation, Telerehabilitation, Lung Cancer
- Keywords
- pulmonary rehabilitation, mobile application, Telerehabilitation, Lung cancer
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 36 participants (estimated)
- Lead sponsor
- National Cheng Kung UniversityUniversity, hospital or other
- Study start
- 1 Oct 2024 (estimated)
- Primary completion
- 31 Oct 2025 (estimated)
- Study completion
- 31 Dec 2025 (estimated)
- First posted
- 19 Sep 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.
The goal of this clinical trial is to investigate the effect of a mobile application intervention on postoperative lung rehabilitation. The main purposes of this study are:
- To understand the effectiveness of the pulmonary rehabilitation mobile application in improving lung function.
- To assess the feasibility of the pulmonary rehabilitation mobile application in post-surgery rehabilitation care.
Researchers will compare the intervention group (using the pulmonary rehabilitation mobile application) to the usual care group to determine if the mobile application is effective in lung surgery rehabilitation.
Participants will join the study immediately after providing informed consent and will continue for up to 7 weeks post-surgery. Participants will be randomly allocated to either the intervention group or the control group. Both groups will receive regular pulmonary rehabilitation during their hospital stay (1 day before surgery and 2 to 3 days after surgery). Researchers will guide participants in the intervention group to use the mobile application for pulmonary rehabilitation exercises throughout the study period. Participants in the usual care group will receive health education and an exercise guide before discharge. Participants will undergo three study assessments: at baseline (within 1 week after enrollment), post-surgery (week 5), and at follow-up (week 8).
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| application inttervention group | Experimental | Behavioral: RehabLung mobile application, Other: Healthcare interactive Web PlatformThe experimental group will receive standard postoperative care, including chest rehabilitation, a mobile application for remote self-training every day after surgery, and an interactive healthcare web platform for health education. |
| Usual care group | Active comparator | Behavioral: Lung cancer postoperative standard care, Other: Healthcare interactive Web PlatformThe usual care group will receive standard postoperative care, including chest rehabilitation and an interactive healthcare web platform for health education |
Who may qualify
- Ages
- 20 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- age over 20 years
- primary diagnosis of lung cancer at any stage and type
- referral to lung cancer resection by thoracotomy or videothoracoscopy
- ability to understand and consent to the trial procedures
- conscious and cognition intact
Key exclusion criteria (5 listed)
- included adjuvant treatments (chemotherapy or radiotherapy)
- previous history of thoracic surgery
- neurological and/or musculoskeletal comorbidities
- visual or hearing impairment
- acute respiratory illness
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 |
|---|---|---|
| RehabLung mobile applicationAlso: The application group, RehabLung AppParticipants in the intervention group will receive in-person pulmonary rehabilitation during their surgical admission and access to a mobile pulmonary rehabilitation application for self-training. This program begins one month before surgery and continues for seven weeks after surgery. The application is designed to encourage participants to engage in pulmonary rehabilitation exercises from preoperative preparation through postoperative care. It offers guided chest breathing exercises, using visual and movement instructions created and remotely prescribed by a physical therapist. Participants will receive daily breathing exercise prescriptions throughout the study period. | Behavioural | application inttervention group |
| Lung cancer postoperative standard careAlso: usual care, Standard chest rehabilitationParticipants in the usual care group will receive in-person pulmonary rehabilitation during surgical admission, pre-operative healthcare, and guidance on breathing exercises to practice before surgery. They will also receive post-operative breathing exercise prescriptions to follow at home. | Behavioural | Usual care group |
| Healthcare interactive Web PlatformThe healthcare interactive Web Platform provides patients with surgical information through animations. This includes an introduction to lung surgery, preparation procedures, answers to common patient questions, post-surgery wound care, and a brief guide to pulmonary rehabilitation. | Other | Usual care group, application inttervention group |
Primary outcome
Exercise capacity-oxygen consumption
Time frame: Baseline, post-surgery assessment at week 5, follow-up assessment at week 8
Cardiorespiratory fitness is evaluated by a cardiopulmonary exercise test using a cycle ergometer. Participants will be encouraged to perform a cycle ergometer stress test to assess their cardiopulmonary function. During the test, the workload will gradually increase by 10 watts per minute until the participant reaches peak exercise capacity. Throughout the exercise test, participants will be carefully monitored for echocardiography and heart rate, and will wear a mask to analyze ventilatory outcomes using a computed gas analysis system. Peak oxygen consumption (VO2 peak) will be measured during the exercise test, and values for the difference and change in percent predicted (peak oxygen uptake [mL/kg/min], VO2 peak difference [mL/kg/min], VO2 peak change [%], and [% predicted]) will be obtained from gas analysis. The predicted values will be referenced from the system based on race, age, height, biological sex, and weight.
Exercise capacity-workload
Time frame: Baseline, post-surgery assessment at week 5, follow-up assessment at week 8
Cardiorespiratory fitness is evaluated by a cardiopulmonary exercise test using a cycle ergometer. Participants will be encouraged to perform a cycle ergometer stress test to assess their cardiopulmonary function. During the test, the workload will gradually increase by 10 watts per minute until the participant reaches peak exercise capacity. Throughout the exercise test, participants will be carefully monitored for echocardiography and heart rate, and will wear a mask to analyze ventilatory outcomes using a computed gas analysis system. The workload achieved during exercise test will be recored by peak work rate (watts), and peak work rate (%pred.) The predicted workload will be referenced from the system based on race, age, height, biological sex, and weight.
Exercise capacity-ventilatory efficiency
Time frame: Baseline, post-surgery assessment at week 5, follow-up assessment at week 8
Cardiorespiratory fitness is evaluated by a cardiopulmonary exercise test using a cycle ergometer. Participants will be encouraged to perform a cycle ergometer stress test to assess their cardiopulmonary function. During the test, the workload will gradually increase by 10 watts per minute until the participant reaches peak exercise capacity. Throughout the exercise test, participants will be carefully monitored for echocardiography and heart rate, and will wear a mask to analyze ventilatory outcomes using a computed gas analysis system. The gas analysis of oxygen exchange efficiency includes maximal ventilation (L/min), maximal ventilation (% predicted), ventilatory equivalents slope, VE/VCO2 slope, ventilatory equivalents, and VE/VCO2 (% predicted).
Exercise capacity-Anaerobic threshold
Time frame: Baseline, post-surgery assessment at week 5, follow-up assessment at week 8
Cardiorespiratory fitness is evaluated by a cardiopulmonary exercise test using a cycle ergometer. Participants will be encouraged to perform a cycle ergometer stress test to assess their cardiopulmonary function. During the test, the workload will gradually increase by 10 watts per minute until the participant reaches peak exercise capacity. Throughout the exercise test, participants will be carefully monitored for echocardiography and heart rate, and will wear a mask to analyze ventilatory outcomes using a computed gas analysis system. Anaerobic threshold (AT) (mL/kg/min) is defined as a nonlinear increase in CO2 production, which will be analyze during gas analysis in an incremental exercise test.
Pulmoanry function
Time frame: Baseline, post-surgery assessment at week 5, follow-up assessment at week 8
The pulmonary function test, assessed by spirometry, is performed to evaluate lung volumes over time and ventilatory capacity. Participants will be guided by experienced therapists to take a maximal inspiration, then exhale with maximal effort for as long and as fast as possible. Measurements include forced vital capacity (FVC [L, % predicted]), forced expiratory volume in one second (FEV1 [L, % predicted]), and the ratio of the two volumes (FEV1/FVC [% predicted]). The predicted values will be referenced from large population studies of healthy adults, matched by race, age, height, biological sex, and weight.
5 secondary outcomes
Global respiratory muscle strength
Time frame: Baseline, post-surgery assessment at week 5, follow-up assessment at week 8
Six Minute Walk Test, 6MWT
Time frame: Baseline, post-surgery assessment at week 5, follow-up assessment at week 8
Postoperative pulmonary complications
Time frame: Baseline, post-surgery assessment at week 5, follow-up assessment at week 8
Quality of life - EORTC QLQ-C30
Time frame: Baseline, post-surgery assessment at week 5, follow-up assessment at week 8
Qulaity of life-WHOQOL-BREF
Time frame: Baseline, post-surgery assessment at week 5, follow-up assessment at week 8
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 19 Sep 2024.
- Derived from this study: PubMed 41762649Yang HL, Hung CH, Huang YT, Cheng HC, Tseng YL, Su JM, Tsai KL. The effectiveness of the AI-based RehabLung mobile rehabilitation system on cardiopulmonary function and user satisfaction in lung cancer patients undergoing thoracic surgery: a protocol for a two-arm randomized clinical trial. Ther Adv Respir Dis. 2026 Jan-Dec;20:17534666261427319. doi: 10.1177/17534666261427319. Epub 2026 Feb 28.
- Individual participant dataSharing planned: No. IPD sharing plan will be decided after summarized data being 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. This study is not recruiting at the moment.
Questions about this trial
What is this clinical trial studying?
A study testing RehabLung mobile application and Healthcare interactive Web Platform in people with Pulmonary Rehabilitation and Telerehabilitation, run by National Cheng Kung University.
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 5 inclusion and 5 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: status not confirmed, as of the sponsor's last update on 19 Sep 2024. Status can change between updates, so confirm with the study contact before making plans.
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?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Kun-Ling Tsai, Ph.D. (886-6-2353535 ext. 6219, kunlingtsai@mail.ncku.edu.tw), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Exercise capacity-oxygen consumption (time frame: Baseline, post-surgery assessment at week 5, follow-up assessment at week 8). The study lists 5 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 NCT06600503, which also lists 1 linked publication.
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 19 Sep 2024.