José Machado da Silva

Abstract
Heart failure (HF) is a multifactorial chronic syndrome with progressive increasing incidence causing a huge financial burden worldwide. Remote monitoring should, in theory, improve HF management, but given increasing morbidity and mortality, a question remains: are we monitoring it properly? Device-based home monitoring enables objective and continuous measurement of vital variables and non-invasive devices should be first choice for elderly patients. There is no shortage of literature on the subject, however, most studies were designed to monitor a single variable or class of variables that were not properly assembled and, to the best of our knowledge, there are no large randomized studies about their impact on HF patient management. To overcome this problem, we carefully selected the most critical possible HF decompensating factors to design MONITORIA, a non-invasive device for comprehensive HF home monitoring. MONITORIA stands for MOnitoring Non-Invasively To Overcome mortality Rates of heart Insufficiency on Ambulatory, and in this paper, which is part I of a series of three articles, we discuss the theoretical basis for its design. MONITORIA and its inherent follow-up strategy will optimize HF patient care as it is a promising device, which will essentially adapt innovation not to the disease but rather to the patients. © 2020 Sociedade Portuguesa de Cardiologia

Abstract
Introduction: Heart failure (HF) represents a huge financial and economic burden worldwide. Some authors advocate that remote monitoring should be implemented to improve HF management, but given its increasing incidence, as well as its morbidity and mortality, a question still remains: are we monitoring it properly? There is no shortage of literature on home monitoring devices, however, most of them are designed to monitor an unsuitable array of variables and, to the best of our knowledge, there are no large randomized studies about their impact on morbidity/mortality of HF patients. Objective: Description of a novel monitoring device. Methods: As a solution, we designed MONITORIA (MOnitoring NonInvasively To Overcome mortality Rates of heart Insufficiency on Ambulatory). Results: This is a multimodal device that will provide real time monitoring of vital, electrophysiological, hemodynamic and chemical signs, transthoracic impedance, and physical activity levels. The device is meant to perform continuous analysis and transmission of all data. Significant alterations in a patient's variable will alert the attending physician and, in case of potentially life-threatening situations, the national emergency medical system. The MONITORIA device will, also, have a function that sends shocks or functions as a pacemaker to treat certain arrhythmias/blockades. This function can be activated the very first time the patient utilizes it, based on their risk of sudden cardiac death. Discussion/Conclusions: MONITORIA is a promising device mostly because it is included in a follow-up program that takes into account a multi-perspective feature of HF development and is based on the real world patient, adapting innovations not to the disease but rather to the patients. © 2021 Sociedade Portuguesa de Cardiologia

Abstract
The Biot-Granier (Gbt) is a new thermal dissipation-based sap flow measurement methodology, comprising sensors, data management and automatic data processing. It relies on the conventional Granier (Gcv) methodology upgraded with a modified Granier sensor set, as well as on an algorithm to measure the absolute temperatures in the two observation points and perform the Biot number approach. The work described herein addresses the construction details of the Gbt sensors and the characterization of the overall performance of the Gbt method after comparison with a commercial sap flow sensor and independent data (i.e., volumetric water content, vapor pressure deficit and eddy covariance technique). Its performance was evaluated in three trials: potted olive trees in a greenhouse and two vineyards. The trial with olive trees in a greenhouse showed that the transpiration measures provided by the Gbt sensors showed better agreement with the gravimetric approach, compared to those provided by the Gcv sensors. These tended to overestimate sap flow rates as much as 4 times, while Gbt sensors overestimated gravimetric values 1.5 times. The adjustments based on the Biot equations obtained with Gbt sensors contribute to reduce the overestimates yielded by the conventional approach. On the other hand, the heating capacity of the Gbt sensor provided a minimum of around 7? C and maximum about 9? C, contrasting with a minimum around 6? C and a maximum of 12? C given by the Gcv sensors. The positioning of the temperature sensor on the tip of the sap flow needle proposed in the Gbt sensors, closer to the sap measurement spot, allow to capture sap induced temperature variations more accurately. This explains the higher resolution and sensitivity of the Gbt sensor. Overall, the alternative Biot approach showed a significant improvement in sap flow estimations, contributing to adjust the Granier sap flow index, a vulnerability of that methodology. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.

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