The unique solution combines the use of the only technology to objectively assess the worker's ability to cope with job demands, with an accessible digital referral platform for SME managers and the self employed, and connects these with occupational health service providers. The technology used is the Leucocyte CopingCapacity(TM) (LCC(TM)) test, a minimally invasive fingerprick test administered by a trained person, usually a nurse or health technician, and interpreted within 10 minutes. The benefit of this minimally invasive test is the valuable information gained in understanding worker health and _capacity to cope_ with work demands. We stream results to a worker centred software interface (the WorkWeLCC(TM) platform), for the worker to have understanding of their coping ability to meet job demands and seek assistance for occupational health (OH) referral and/or take early corrective action, as needed. Note that the LCC test is able to identify psychological as well as physical overstrain and thereby aims to prevent physiological ill health (psychological stress) and musculoskeletal (MSK) overstrain and related sickness absences. Corrective action could be by changing worker lifestyle and habits, such as by following sleep hygiene advice or perform breathing exercises, (this advice is provided through the WorkWeLCC platform), or initiating an occupational health referral to an OH provider if there is decompensation in health. The outcome of OH advice is to advise the SME manager on reasonable workplace adjustments to assist the worker to remain in work. The likely result of a patient centred approach and accessible referral platform will be an improved uptake of OH service provision with SME's and the self employed, resulting in quality outcome. The solution aims to improve work participation (minimise sickness absence and retirement) of especially older worker and those with chronic health conditions. The SME OH referral platform provides training to SME managers on the value of OH services. We develop the referral platform in consultation with SME managers to specifically target their needs, as outlined in this application. The platform is linked to OH professionals, such as occupational physicians, who are then able to do remote telephone assessments with the workers, adhering to parameters of medical confidentiality when providing advice on reasonable adjustments to SME managers. The route is also accessible to the self-employed. We will engage in the offshore energy sector, with a variety of manual, white collar, shift workers and technicians, in order to be able to generalise results.

Oxford MediStress is developing the advanced Leukocyte ImmunoTest (LIT)(tm) as a rapid (10-minute) fingerprick in vitro blood test to assess how well an individual's immune system is functioning. In previous studies involving patients with a variety of cancers, we have demonstrated the clinical potential of the technique. Results from the recent FORECAST clinical trial at UCLH showed strong correlation between the LIT score and eventual clinical outcome for 70 prostate cancer patients. Recently, OMS has been invited to participate in a COVID-19 study on health care workers and critically-ill coronavirus patients at a London research hospital. In that study the team hopes to demonstrate the potential for the technique for providing an early-warning indicator of poor immune function for frontline NHS healthcare workers in order to determine who is at greatest risk of contracting coronavirus. Eventually, the technique could be used in many other facets of COVID-19 treatment and clinical research, including providing a new and useful clinical parameter for monitoring COVID-19 patients in intensive care, providing a new clinical parameter for assessing immune status for use in developing new COVID-19 vaccines and therapies, and assessing impact of PTSD (which causes immunosuppression) on healthcare workers after the initial pandemic has passed. In this project the team will develop a novel digital platform to support data analysis. The platform will enable individual assessment of risk/vulnerability based on a number of clinical parameters including the new clinical parameter (LIT) which we have developed. We will develop new mathematical tools and a new smartphone app as part of the project. In the project extension, following discussions with clinical experts, the team will extend its clinical study to assess neutrophil function using LIT in patients severely ill with COVID-19, and in particular will monitor those in ICU, to determine whether LIT score can provide a new prognostic indication of likely disease severity. The team already has ethics approval for conducting such a study in Birmingham. The key benefit of this project for the general public is the development of a new rapid test for assessing the strength of an individual's immune system and for monitoring patients severely ill with COVID-19.

"Drug companies are continuing to develop new and improved drugs and medications in the fight against cancer, and more cancer patients are benefiting from these so-called ""chemotherapy"" drugs. However, a key challenge is the risk of unwanted drug side effects which are called adverse drug responses (ADRs). A common ADR that is also quite severe affects the white blood cells of the immune system, reducing the effectiveness of the body to ward off infection (a condition known as ""neutropenia""). Patients with severe neutropenia are more susceptible to bacterial infection and, without prompt medical attention, the condition may become life-threatening. To address this unmet clinical need, Oxford MediStress (OMS) has recently developed the Leukocyte ImmunoTest(tm) (LIT(tm)) for rapidly assessing the function of neutrophils (a type of white blood cell and a key aspect of the immune system). This blood test is rapid (taking only ten minutes), portable, and uses a hand-held point-of-care (POC) electronic device; it uses a tiny pinprick of blood and shows how well your immune system is working. This shows the doctor how well your body is responding to you medication; it shows this quickly and at any point in time. Importantly, the device can eventually be developed for use at home (much like the well-known home diabetes test). Eventually, we will also have a smartphone-enabled app to communicate the results directly to the doctor (but that is not part of this project). Importantly, in order to make it suitable for home-use, some aspects of the device need to be improved. In this project, Oxford MediStress will lead a small team to improve the device by developing a new reagent cartridge that has the necessary chemicals already pre-loaded so that it is easier and quicker to use. As a side benefit, we will also learn whether and how our test can be used to monitor other disease conditions and how doctors in the NHS would likely use this technology to help both the patients (by saving lives) and the healthcare service (by reducing cost and making the provision of excellent healthcare more efficient)."

"Prostate cancer is the most common cancer in European males, with over 340,000 new cases and 71,000 deaths each year in the EU. Indeed, experts predict up to 1 in 8 men in the EU will be diagnosed with prostate cancer during their lifetime. Significant progress has been made in recent years in detecting the onset of prostate cancer. In particular, prostate-specific antigen (PSA) from blood tests has been found to be a useful marker of prostate disease; however, a number of studies have shown that it often results in ""false positives"" that can lead to worry and anxiety among patients. Therefore, a need exists for new tools to rapidly classify patients based on likely disease severity, to monitor disease progression and to enable the development of home monitoring kits for monitoring disease progression and recurrence. To address this unmet clinical need, Oxford MediStress (OMS) has developed the Leukocyte ImmunoTest(tm) (LIT(tm)) for rapidly assessing neutrophil function, a key aspect of the immune system. The rapid, portable, hand-held point-of-care (POC) test analyses a pinprick of blood and quantitatively evaluates how well an individual's white blood cells (their so-called ""neutrophils"") are capable of responding to chemical ""stimulation"" in a test tube when mixed with our patented chemicals. The test has been successfully evaluated recently in a clinical trial involving prostate cancer patients in London to see if the ten-minute test could pick out which patients had the most severe disease. According to our collaborating cancer experts, these results provide confidence the test could one day act as a risk stratification method and as a method to monitor disease progression in prostate and other cancers, including breast cancer. The outputs of the proposed feasibility study will increase our understanding of how the test can be used in current clinical practice for risk stratification and disease monitoring in prostate cancer and to see whether it could be used in other areas of prostate cancer monitoring, as well as in other cancers. Finally, the project will improve our understanding of the clinical-regulatory and manufacturing strategies that the Company will need to adopt to be successful and, at the same time, benefit the patient and healthcare-provider."

Affecting one in three people over the course of their lifetimes, cancer represents a significant burden to healthcare systems around the world, costing the UK economy £11 billion annually. Oxford MediStress, an Oxford University spinout company, has recently developed a new fingerprick blood test that allows the quantitative assessment of a key component of the immune system by evaluating the vitality of white blood cells in a rapid, easy-to-use format. The Company believes this technology holds considerable promise to provide an early indication of cancer, given the way it measures immune function. It also has the potential to become an important new tool with which doctors can monitor cancer progression. However, a key optical component in the system is quite costly, meaning the system is too expensive to be marketed to the general public currently. In this project the team will evaluate alternative optical components that promise to the job just as well at a fraction of the cost. A key output of the project will be demonstration of a prototype that can perform the test at a substantially lower cost.

Affecting one in three people over the course of their lifetimes, cancer represents a significant burden to healthcare systems around the world, costing the UK economy £11 billion annually. Oxford MediStress, an Oxford University spinout company, has recently developed a new fingerprick blood test that allows the quantitative assessment of a key component of the immune system by evaluating the vitality of white blood cells in a rapid, easy-to-use format. The Company believes this technology holds considerable promise to provide an early indication of cancer, given the way it measures immune function. It also has the potential to become an important new tool with which doctors can monitor cancer progression. In this project we will discuss its potential use in cancer with a cancer specialist and conduct an early-stage proof-of-principle study.