• biompedance analysis
• user interface
• biomedical engineering
• body composiotion analysis
• clinical nutrition analysis
• medical device.

This thesis has been carried out at AKERN, an Italian company founded in 1980, dedicated to research and development of bioimpedance medical devices and software for body composition analysis.
Bioelectrical impedance analysis (BIA) is non-invasive technique to determine a person's body composition (i.e., analysis of fat, bone, water, and muscle). The basis of BIA is the idea that variable levels of resistance to an electrical current will be offered by fluid and cellular structures as it moves through a living system. The following measurements are provided by BIA: Reactance (Xc - Ohms), which measures tissue integrity, Phase Angle (PA - degrees), which represents the arctangent between R and Xc, and Resistance (R - Ohms), which measures cellular hydration (PA is a useful indicator of health and prognosis).
In clinical practice, the primary purpose of body composition assessments is to determine nutritional health by measuring fat free mass (FFM) and fat mass (FM). In hospitalized patients and nutritionally at-risk outpatients, a clinical assessment of nutritional status is indicated on a frequent basis. Over time, body composition reflects nutritional intakes, losses, and requirements. In cancer patients, malnutrition is correlated with lower survival, poor clinical outcome, and quality of life, as well as increased drug toxicity. In many clinical settings, such as sarcopenic obesity and chronic illnesses, bioelectrical impedance analysis measures FFM loss, whereas body weight reduction and body mass index only infrequently represent FFM loss. Body composition analysis provides for the validation of the efficacy of nutrition support, the customization of disease-specific and nutritional treatments, and the evaluation of their efficacy and potential toxicity. Simple body composition procedures that are integrated into the standard of care allow for consecutive assessments for an initial nutritional evaluation and objective patient follow-up. By allowing an earlier and objective management of undernutrition, body composition assessment could contribute to reduce undernutrition-induced morbidity, worsening of quality of life, and global health care costs by a timely nutrition intervention.
My project’s focus is the design of a user interface for Nutrilab Pro, which is a clinical bioimpedenziometer used in different settings within a hospital (mostly Intensive Care Unit, oncology, nephrology, cardiology, geriatrics, and clinical nutrition). Nutrilab is a class IIa Medical Device that allows to monitor patients in a non-invasive, operator-independent method in all clinical conditions from ambulatory to bedside up to homecare. Nutrilab Pro will be an update of the current Akern’s instrument Nutrilab and it will feature, other than a more ergonomic case, new electronics and a new user interface that will better meet the clinical need of the healthcare professionals that use it. As a matter of fact, bioelectrical impedance can give the clinician a big amount of information, but not all of them are always needed or completely understood. Also in the frenetic hospital environment, time and personnel are limited, and the correct attention to nutrition is not always given. My job was to understand what the real clinical need is, what are the most useful information, what is the easiest way to communicate them to the user, what are the latest guidelines from international health organizations, and to combine all these inputs in a user-friendly interface that will be implemented in Nutrilab Pro. This thesis will follow the development of the User Interface from the Research Phase, during which the clinical need and intended use of the device is established, to the Requirement and Specification phase, in which a precise description of all the functionalities of the firmware and its content are formalized.