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Almost forty years after moving to Manhattan, author Richard Morris has achieved if not stratospheric renown then at least the accomplished career and caliber of fame that he envisioned for himself as a younger man. Now financially comfortable and artistically embittered, Richard is at his home upstate recuperating from heart surgery and nursing resentment toward his publisher and his reading public who have found new, more exciting writers and left his star to wane.

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May 13, - Published on Amazon. In his latest novel, Eric Bogosian offers a cautionary tale about life, death, love, and art though not in that order. Perforated Heart is the story of two Richard Morrises: one, a successful fiction writer in who, after heart surgery, goes to recuperate at his country home in Connecticut, where he rediscovers his journals from 30 years earlier; and the second is the young Richard, circa , just beginning as a writer and resident of New York City. Bogosian is back in his element with this first person narrative his last two novels were in the third person which is more the style of his monologues.

Young Richard is brash but passionate; old Richard is refined but cynical. The elder Richard is a bit of a recluse, but in his earlier life he was surrounded by a colorful cast of characters. Richard's acquaintances are rendered somewhat 2-dimensionally in his journals, serving mainly as his companions on a series of crazy party and nightlife adventures.

The most memorable of these characters is Big John, the mysterious, stuttering, little-known-history spouting drug dealer I kept waiting for John to say, "And these are my dogs, Harley and Davidson. What is he researching? Life--human existence. His transition from wild child to successful writer provides the main crux of the story although I imagine the path to sobriety is more difficult than Richard, or Bogosian, lets on.

But is all of his sexual and chemically induced "experience" supposed to convince us that Richard is a great writer? Here Bogosian stumbles somewhat with the story-within-the-story trap. There is occasional talk of Richard's new novel, "A Gentle Death," but we're just supposed to take it on faith that the book is really good. Don't tell me his book is good; show me, and I'll be the judge. Granted, Richard's journals are coherent, which would suggest that he's a competent writer, but with respect to "A Gentle Death"--there's no "there" there.

Despite his achievements and professional success, Richard's personal life is a disaster, but he has only himself to blame. He revisits some of his old friends and discovers a 3rd dimension to them, but it only seems to stoke the fires of his self-loathing or his loathing of his younger self, anyway. The climax is somewhat anticlimactic, but perhaps that's the point? That in our youth obsessed culture we tend to shoot our proverbial wad earlier than we'd like.

Tragically, however, Richard always wants what he can't have and rejects those who love or might love him.

Perforated Heart

June 2, - Published on Amazon. In this instance that obsession revolves around the life of a middle-aged, successful, American Jew writer in New York who reflects back on his path via his journal from the mid 70's, as he struggles in the present to reclaim his place atop the literary field. This is an intensely honest story and I could identify with it completely.

The Heart's Invisible Furies -- Book Talk

The main objective of the ES for the biopsy needle was to observe audio signal dynamical changes when the needle passes through two different tissue structures. In contrast the guide wire ES intended to analyse signal dynamics of perforation in vascular structures. For both experiments AE signals were acquired using a stethoscope connected to a microphone which was directly and firmly attached to the proximal end of the MID via a 3D printed adapter see top of Fig.

For each MID experiment qualitative and quantitative analysis were performed and a database for each ES was implemented for the quantitative case. A gelatine phantom filled with different fruits, chicken breast and liver located 6 cm deep was used for the biopsy needle qualitative analysis, while for quantitative analysis the gelatine phantom was filled with ex-vivo porcine tissue.

The needle insertion was performed manually for qualitative analysis and automatically for quantitative analysis. The qualitative and quantitative guide wire perforation tests were performed on ex-vivo porcine coronary arteries. The guide wire was placed inside a flushed micro catheter. This was shaped to mimic a natural tortuous pathway to the coronaries. The Matlab Rb was used for the audio signal analysis.

In order to show repeatability of the approach the time instants of object entry t in and exit t out were manually annotated. For that the force from the testing machine was recorded synchronous with the audio and a video camera was placed in front of the phantom see Fig. The main objective of that was to set t in at the time instant of first signal deflection when the force started to change contact of the needle with the tissue and to synchronize this time instant with the one observed when the needle touches the tissue in the video.

In this way video and audio were also synchronized and t out was taken directly from the synchronized video see Fig. Determination of time instants of tissue entry and exit and synchronization of the video with the audio. We have performed experiments at two additional velocities in order to study the performances of our approach when the needle insertion velocity is changed.

For the guide wire ES, audio signals of 30 seconds duration were recorded during the tip perforation of coronary arteries belonging to 10 porcine hearts see Fig. The main objective of the created database was to analyse performances on classifying the audio signals as a perforation or as an artefact.

Therefore, additional recordings with different types of induced guide wire audio artefacts were performed, including friction between the guide wire and the artery wall recordings and tiny guide wire bumps recordings. The block diagram of Fig. Each signal was first decimated and then bandpass filtered. Finally an indicator based on tracking the pole of maximal energy was computed.

The audio signal was first decimated to simplify the tracking of dynamical changes using the AR pole representation. The resulting signal was then bandpass filtered to focus the analysis in the frequency range significant for the used stethoscope. When an MID crosses a given tissue structure the resulting friction on the cutting edges produces an audio signal whose dynamics involve characteristics that are strongly variant in time. Additionally, when the MID passes through two different tissue structures boundary between two different tissue layers for example during and after the tissue transition the audio signal present important transient dynamics that can abruptly change.

All these dynamical characteristics, together with the fact that the audio signals present significant background noise, and therefore a poor signal-to-noise-ratio SNR , make the signal difficult to process and the information that this signal conveys must be decoded. What we propose in this work is to find an acoustic signature in the signal that provides information concerning tissue transition in the needle case and vessel perforation characteristic in the guide wire case.

Due to the signal characteristics described above, classical methods for stationary processes no longer can be used to follow the dynamical changes that this signal involves and cannot describe many conditions in processes where transient phenomena are involved. In the presence of time-varying characteristics the classical way to follow these variations is tracking and TV-AR modelling is well suited for extracting signature from audio signal using pole representation 22 , 23 , The classical AR modelling for stationary processes is a well-known technique for parametrical spectral estimation and a huge amount of literature has been written showing its advantages over non-parametrical based methods for detailed information about classical AR modelling we suggest to consult One advantage is that when an appropriate model is selected it presents a higher spectral resolution even in signals with poor SNR and using less data than classical methods.

But another really important advantage for our work is that in its TV version it allows the decomposition of different TV dynamics through the pole representation allowing the tracking of those dynamical changes.

Coronary Perforation and Covered Stents: An Update and Review

The main difference between the stationary AR version and the TV-AR one that we used in this work is that the parameters of the AR model are now time dependent, which results in a time-dependent representation of the transfer function:. This give rise to a time-varying spectrum. As mentioned above dynamical changes of a nonstationary process can be tracked using a pole approach. Different poles should be associated with different dynamic components of the signal.

This is why we decided for this approach to track only one pole, the dominant one. We assume that transitions between tissue layers would be modelled mainly by one pole which at each time instant would contain the maximal energy of the spectrum.


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  8. We can assume that when the MID passes from one medium to another, this dominant pole would change position and the time instant when the pole abruptly move would be the time instant of transition between two tissue layers. For estimating the Time Varying Maximal Energy Pole TV-MEP , first the poles z k n were obtained by finding the roots of the AR coefficient in the denominator of the time-varying pole representation transfer function that was obtained from equation 1 22 :.

    Then the equation 3 was used for computing the evolution of the maximal energy pole, i. Then the spectral power P k of the resonant frequency k was obtained from the real part of the residue term r k :. Finally at each time instant n the maximal energy pole was computed as the frequency belonging to the pole having the maximal power from the r resonant frequencies. The algorithms described in the Methods section are available to editors and referees upon request. For the needle ES an algorithm that has as input an audio signal and as output the detected time instants of the porcine tissue entry and exit can be provided.

    For the guide wire ES the full classification algorithm can be provided. In this section, qualitative and quantitative results are presented for both ES. We analyse performances on detecting abrupt dynamical changes produced by the needle tip during its entry and exit of tissue and on classifying a guide wire event as a perforation or as an artefact.

    In this work the TV-AR model parameters were computed over a sliding window of width w and an overlap of Ov. In each window, a p order AR model was used to estimate the AR parameters using the Yule-Walker method and for each of the windows the AR spectrum and poles were computed.

    For the needle ES, the bandpass filter consist of a 7 th order Butterworth filter with a bandpass of 3—6 KHz. Due to the more transient characteristics of guide wire perforation dynamics the bandpass filter for this signal was implemented using Discrete Wavelet Transform DWT. For that the signal was decomposed in 10 scales using a Daubechies DWT and finally reconstructed with selected middle-frequency wavelet scales as presented in The ES for the biopsy needle attempts to emulate different structures of tissue in order to analyse the different types of AE response that can be obtained as a result of the friction with cutting edges of the needle tip.

    The tested tissues were two fruits, persimmon and grape, and two chicken parts, breast and liver, all of them having different structure characteristics. We can see in the original signal that only for the grape it is possible to clearly identify a dynamical change during the time interval between entry and exit from the tissue.


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    6. However, it is difficult to determine the onset and offset of this dynamical change. In the other tissue object cases it is not at all evident when exactly the needle enters and passes through the object.

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      Since the 3D printed box is not isolated from the outside the audio recordings involve different artefacts that can be more or less disturbing. It is therefore necessary to apply a signal processing strategy in order to enhance the information that otherwise stays hidden to the human eye. In this sense the bandpass filtered signals already enhances the information obtained from the penetration of the needle in the different tissues. The needle entering and leaving the persimmon becomes now visually evident and the TV-MEP significantly changes its frequency as a result of change of friction dynamics when the tip passes through the persimmon.