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106-630: Niven Busch (April 26, 1903 – August 25, 1991) was an American novelist and screenwriter of movies such as the acclaimed The Postman Always Rings Twice . His novels included Duel in the Sun (1944) and California Street (1959). He was married to actress Teresa Wright for ten years beginning in 1942. Born in New York City, Busch began his writing career in the early twenties, when he went to work for Time Magazine (co-founded by Busch's cousin, Briton Hadden ). Before departing for Hollywood

212-483: A New York Times editorial challenging Misplaced Pages's categorization of American female novelists within a distinct category , which precipitated a significant amount of press coverage describing that Misplaced Pages's approach to categorization as sexism. For her, the public representation of women novelists within another category marginalizes and defines women novelists like herself outside of a field of "American novelists" dominated by men. However, other commentators, discussing

318-510: A Novelist", highlight such moral and ethical justifications for their approach to both writing novels and criticizing them. When defining her description of the role of the modernist novelist in the essay " Modern Fiction ", Virginia Woolf argues for a representation of life not interested in the exhaustive specific details represented in realism in favor of representing a "myriad of impressions" created in experience life. Her definition made in this essay, and developed in others, helped define

424-662: A Panda-Leopard , at the age of 15, which brought him considerable critical attention. Similarly, Barbara Newhall Follett 's The House Without Windows , was accepted and published in 1927 when she was 13 by the Knopf publishing house and earned critical acclaim from the New York Times , the Saturday Review , and H. L. Mencken . Occasionally, these works will achieve popular success as well. For example, though Christopher Paolini 's Eragon (published at age 15)

530-486: A Scottish identity that the upper-class British society could embrace. In American fiction, the concept of American literary regionalism ensures that many genres of novel associated with particular regions often define the reception of the novelists. For example, in writing Western novels , Zane Grey has been described as a "place-defining novelist", credited for defining the western frontier in America consciousness at

636-585: A cause (e.g., aortic stenosis ) or as a consequence (e.g., mitral regurgitation ) of heart failure. Reverse insufficiency of the left ventricle causes congestion in the blood vessels of the lungs so that symptoms are predominantly respiratory. Reverse insufficiency can be divided into the failure of the left atrium, the left ventricle, or both within the left circuit. Patients will experience shortness of breath (dyspnea) on exertion and, in severe cases, dyspnea at rest. Increasing breathlessness while lying down, called orthopnea , also occurs. It can be measured by

742-503: A century after the novel form first solidified at the beginning of the 19th century. Often such British regional literature captures the social and local character of a particular region in Britain, focussing on specific features, such as dialect, customs, history, and landscape (also called local colour ): "Such a locale is likely to be rural and/or provincial." Thomas Hardy 's (1840–1928) novels can be described as regional because of

848-497: A decade later, Busch had risen to editor at the weekly, working simultaneously for The New Yorker , where he contributed profiles on famous Americans. (These articles were collected into his first book, the non-fiction Twenty-One Americans .) In 1932, realizing he had gone as far as he was likely to go as a New York-based magazine writer/editor, Busch re-connected with agent Myron Selznick , whom Busch knew through his father, an executive who had worked for Myron's father Lewis in

954-465: A decrease in intracardiac pressures or in ejection during systole , reducing cardiac output to the rest of the body. The filling failure and high intracardiac pressure can lead to fluid accumulation in ventricles of the heart. This manifests as water retention and swelling due to fluid accumulation ( edema ) called congestion . Impaired ejection can lead to inadequate blood flow to the body tissues, resulting in ischemia . Congestive heart failure

1060-555: A distance) to note the order of their Coaches and Carriages..As if (presented to a Novelist) it had bin the spoyles of a Tryumph leading Captive, or a preparation to some sad Execution" According to the Google Ngrams, the term novelist first appears in the Google Books database in 1521. The difference between professional and amateur novelists often is the author's ability to publish. Many people take up novel writing as

1166-450: A distinction between novelists who report reality by "taking life as it already exists, not to report it, but to make an object, toward the end that the finished work might contain this life inside it, and offer it to the reader" and journalists, whose role is to act as "crusaders" advocating for particular positions, and using their craft as a political tool. Similarly, writing in the 1950s, Ralph Ellison in his essay "Society, Morality, and

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1272-513: A fee paid by the writer. In these settings, unlike the more traditional publishing industry, activities usually reserved for a publishing house, like the distribution and promotion of the book, become the author's responsibility. The rise of the Internet and electronic books has made self publishing far less expensive and a realistic way for authors to realize income. Novelists apply a number of different methods to writing their novels, relying on

1378-470: A group of writers known as the " Angry young men ," which included the novelists Alan Sillitoe and Kingsley Amis , who came from the working class and who wrote about working class culture . Some novelists deliberately write for a working class audience for political ends, profiling "the working classes and working-class life; perhaps with the intention of making propaganda". Such literature, sometimes called proletarian literature , maybe associated with

1484-460: A hobby, but the difficulties of completing large scale fictional works of quality prevent the completion of novels. Once authors have completed a novel, they often will try to publish it. The publishing industry requires novels to have accessible profitable markets, thus many novelists will self-publish to circumvent the editorial control of publishers. Self-publishing has long been an option for writers, with vanity presses printing bound books for

1590-681: A myocardial infarction is suspected, various cardiac markers may be used. Blood tests routinely performed include electrolytes ( sodium , potassium ), measures of kidney function , liver function tests , thyroid function tests , a complete blood count , and often C-reactive protein if infection is suspected. Hyponatremia (low serum sodium concentration) is common in heart failure. Vasopressin levels are usually increased, along with renin, angiotensin II, and catecholamines to compensate for reduced circulating volume due to inadequate cardiac output. This leads to increased fluid and sodium retention in

1696-590: A normal ECG virtually excludes left ventricular systolic dysfunction. N-terminal pro-BNP (NT-proBNP) is the favored biomarker for the diagnosis of heart failure, according to guidelines published 2018 by NICE in the UK . Brain natriuretic peptide 32 (BNP) is another biomarker commonly tested for heart failure. An elevated NT-proBNP or BNP is a specific test indicative of heart failure. Additionally, NT-proBNP or BNP can be used to differentiate between causes of dyspnea due to heart failure from other causes of dyspnea. If

1802-482: A novel's fictional content. For this reason, the environment within which a novelist works and the reception of their novels by both the public and publishers can be influenced by their demographics or identity. Similarly, some novelists have creative identities derived from their focus on different genres of fiction , such as crime , romance or historical novels . While many novelists compose fiction to satisfy personal desires, novelists and commentators often ascribe

1908-685: A particular character based on the national identity of the authors. In some literature, national identity shapes the self-definition of many novelists. For example, in American literature , many novelists set out to create the " Great American Novel ", or a novel that defines the American experience in their time. Other novelists engage politically or socially with the identity of other members of their nationality, and thus help define that national identity. For instance, critic Nicola Minott-Ahl describes Victor Hugo's Notre-Dame de Paris directly helping in

2014-414: A particular social responsibility or role to novel writers. Many authors use such moral imperatives to justify different approaches to novel writing, including activism or different approaches to representing reality "truthfully." Novelist is a term derivative from the term "novel" describing the "writer of novels." The Oxford English Dictionary recognizes other definitions of novelist, first appearing in

2120-419: A person with a failure of one ventricle lives long enough, it will tend to progress to failure of both ventricles. For example, left ventricular failure allows pulmonary edema and pulmonary hypertension to occur, which increases stress on the right ventricle. Though still harmful, right ventricular failure is not as deleterious to the left side. Since heart failure is a syndrome and not a disease, establishing

2226-485: A person with heart failure may have a reduced force of contraction due to overloading of the ventricle . In a normal heart, increased filling of the ventricle results in increased contraction force by the Frank–Starling law of the heart , and thus a rise in cardiac output . In heart failure, this mechanism fails, as the ventricle is loaded with blood to the point where heart muscle contraction becomes less efficient. This

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2332-423: A result of a blocked coronary artery . Cardiomyopathy refers specifically to problems within the heart muscle, and these problems can result in heart failure. Ischemic cardiomyopathy implies that the cause of muscle damage is coronary artery disease. Dilated cardiomyopathy implies that the muscle damage has resulted in enlargement of the heart. Hypertrophic cardiomyopathy involves enlargement and thickening of

2438-512: A result, coronary catheterization may be used to identify possibilities for revascularisation through percutaneous coronary intervention or bypass surgery . Heart failure is commonly stratified by the degree of functional impairment conferred by the severity of the heart failure, as reflected in the New York Heart Association (NYHA) functional classification . The NYHA functional classes (I–IV) begin with class I, which

2544-489: A secondary hobby. Few novelists become literary celebrities or become very wealthy from the sale of their novels alone. Often those authors who are wealthy and successful will produce extremely popular genre fiction. Examples include authors like James Patterson , who was the highest paid author in 2010, making 70 million dollars, topping both other novelists and authors of non-fiction. Other famous literary millionaires include popular successes like J. K. Rowling , author of

2650-490: A small monetary advance before publication of their debut novel; in the rare exceptions when a large print run and high volume of sales are anticipated, the advance can be larger. However, once an author has established themselves in print, some authors can make steady income as long as they remain productive as writers. Additionally, many novelists, even published ones, will take on outside work, such as teaching creative writing in academic institutions , or leave novel writing as

2756-457: A strong focus by novelists from there on the significance of family, religion, community, the use of the Southern dialect , along with a strong sense of place. The South 's troubled history with racial issues has also continually concerned its novelists. In Latin America a literary movement called Criollismo or costumbrismo was active from the end of the 19th century to the beginning of

2862-466: A tale of returning veterans, was followed by The Furies (1950), which became a film that starred Barbara Stanwyck . Another notable film of the period — for which Busch wrote the original screenplay — was Pursued starring Robert Mitchum and Teresa Wright, one of the first psychological Westerns with " noir " overtones. Around the same time, Busch also adapted the noir thriller The Postman Always Rings Twice (1946), for Metro-Goldwyn-Mayer . In

2968-480: A total of over 2.8 billion words. Novelists do not usually publish their first novels until later in life. However, many novelists begin writing at a young age. For example, Iain Banks began writing at eleven, and at sixteen completed his first novel, "The Hungarian Lift-Jet", about international arms dealers, "in pencil in a larger-than-foolscap log book". However, he was thirty before he published his first novel,

3074-440: A variety of approaches to inspire creativity. Some communities actively encourage amateurs to practice writing novels to develop these unique practices, that vary from author to author. For example, the internet-based group, National Novel Writing Month , encourages people to write 50,000-word novels in the month of November, to give novelists practice completing such works. In the 2010 event, over 200,000 people took part – writing

3180-429: Is a pathophysiological condition in which the heart's output is insufficient to meet the needs of the body and lungs. The term "congestive heart failure" is often used because one of the most common symptoms is congestion or fluid accumulation in the tissues and veins of the lungs or other parts of a person's body. Congestion manifests itself particularly in the form of fluid accumulation and swelling (edema) , in

3286-420: Is a common, costly, and potentially fatal condition, and is the leading cause of hospitalization and readmission in older adults. Heart failure often leads to more drastic health impairments than the failure of other, similarly complex organs such as the kidneys or liver. In 2015, it affected about 40 million people worldwide. Overall, heart failure affects about 2% of adults, and more than 10% of those over

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3392-702: Is a worsening of chronic heart failure symptoms, which can result in acute respiratory distress . High-output heart failure can occur when there is increased cardiac demand that results in increased left ventricular diastolic pressure which can develop into pulmonary congestion (pulmonary edema). Several terms are closely related to heart failure and may be the cause of heart failure, but should not be confused with it. Cardiac arrest and asystole refer to situations in which no cardiac output occurs at all. Without urgent treatment, these events result in sudden death. Myocardial infarction ("Heart attack") refers to heart muscle damage due to insufficient blood supply, usually as

3498-480: Is about the San Francisco newspaper publishing business, with the title taken from California Street in the city. Busch appears in the film The Unbearable Lightness of Being , playing the role of "Old Man" in the scene in which Sabina ( Lena Olin ) receives the letter informing her of Tómas and Tereza's deaths. Busch was 84 at the time of the filming. Busch died from congestive heart failure in 1991 at

3604-576: Is based on, and nearly geographically identical to, Lafayette County, of which his hometown of Oxford, Mississippi . In addition to the geographical component of Southern literature, certain themes have appeared because of the similar histories of the Southern states in regard to slavery , the American Civil War , and Reconstruction . The conservative culture in the South has also produced

3710-471: Is by the side of the heart involved (left heart failure versus right heart failure). Right heart failure was thought to compromise blood flow to the lungs compared to left heart failure compromising blood flow to the aorta and consequently to the brain and the remainder of the body's systemic circulation. However, mixed presentations are common, and left heart failure is a common cause of right heart failure. A more accurate classification of heart failure type

3816-421: Is caused by any condition that reduces the efficiency of the heart muscle, through damage or overloading . Over time, these increases in workload, which are mediated by long-term activation of neurohormonal systems such as the renin–angiotensin system and the sympathoadrenal system, lead to fibrosis , dilation, and structural changes in the shape of the left ventricle from elliptical to spherical. The heart of

3922-410: Is consistent with an international 2021 report termed "Universal Definition of Heart Failure". Score-based algorithms have been developed to help in the diagnosis of HFpEF , which can be challenging for physicians to diagnose. The AHA / ACC / HFSA defines heart failure as symptoms and signs consistent with heart failure in combination with shown "structural and functional alterations of the heart as

4028-432: Is defined as a person who experiences no limitation in any activities and has no symptoms from ordinary activities. People with NYHA class II heart failure have slight, mild limitations with everyday activities; the person is comfortable at rest or with mild exertion. With NYHA class III heart failure, a marked limitation occurs with any activity; the person is comfortable only at rest. A person with NYHA class IV heart failure

4134-491: Is due to the reduced ability to cross-link actin and myosin myofilaments in over-stretched heart muscle. No diagnostic criteria have been agreed on as the gold standard for heart failure, especially heart failure with preserved ejection fraction (HFpEF). In the UK , the National Institute for Health and Care Excellence recommends measuring N-terminal pro-BNP (NT-proBNP) followed by an ultrasound of

4240-605: Is exposure to certain toxins such as lead and cobalt . Additionally, infiltrative disorders such as amyloidosis and connective tissue diseases such as systemic lupus erythematosus have similar consequences. Obstructive sleep apnea (a condition of sleep wherein disordered breathing overlaps with obesity, hypertension, and/or diabetes) is regarded as an independent cause of heart failure. Recent reports from clinical trials have also linked variation in blood pressure to heart failure and cardiac changes that may give rise to heart failure. High-output heart failure happens when

4346-422: Is made by measuring ejection fraction , or the proportion of blood pumped out of the heart during a single contraction. Ejection fraction is given as a percentage with the normal range being between 50 and 75%. The types are: Heart failure may also be classified as acute or chronic. Chronic heart failure is a long-term condition, usually kept stable by the treatment of symptoms. Acute decompensated heart failure

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4452-506: Is mentioned in the Ebers Papyrus around 1550 BCE. When the heart functions poorly as a pump and does not circulate blood adequately via the circulatory system to meet the demands of the body the term cardiovascular insufficiency is sometimes used. This generally leads to the syndrome of heart failure, a combination of signs and symptoms It develops when the heart fails to properly fill with blood during diastole , resulting in

4558-409: Is not a question of the subject matter or political stance of a particular author, but of her gender : her position as a woman within the literary marketplace. However, the publishing market's orientation to favor the primary reading audience of women may increasingly skew the market towards female novelists; for this reason, novelist Teddy Wayne argued in a 2012 Salon article titled "The agony of

4664-883: Is not the same as cardiac arrest , in which blood flow stops completely due to the failure of the heart to pump. Diagnosis is based on symptoms, physical findings, and echocardiography . Blood tests , and a chest x-ray may be useful to determine the underlying cause. Treatment depends on severity and case. For people with chronic, stable, or mild heart failure, treatment usually consists of lifestyle changes, such as not smoking , physical exercise , and dietary changes, as well as medications. In heart failure due to left ventricular dysfunction, angiotensin-converting-enzyme inhibitors , angiotensin II receptor blockers (ARBs), or angiotensin receptor-neprilysin inhibitors , along with beta blockers , mineralocorticoid receptor antagonists and SGLT2 inhibitors are recommended. Diuretics may also be prescribed to prevent fluid retention and

4770-585: Is particularly associated with the rural English Midlands, whereas Arnold Bennett (1867–1931) is the novelist of the Potteries in Staffordshire , or the "Five Towns", (actually six) that now make-up Stoke-on-Trent . Similarly, novelist and poet Walter Scott 's (1771–1832) contribution in creating a unified identity for Scotland and were some of the most popular in all of Europe during the subsequent century. Scott's novels were influential in recreating

4876-625: Is symptomatic at rest and becomes quite uncomfortable with any physical activity. This score documents the severity of symptoms and can be used to assess response to treatment. While its use is widespread, the NYHA score is not very reproducible and does not reliably predict walking distance or exercise tolerance on formal testing. In its 2001 guidelines, the American College of Cardiology / American Heart Association working group introduced four stages of heart failure: The ACC staging system

4982-475: Is the X-ray imaging of blood vessels , which is done by injecting contrast agents into the bloodstream through a thin plastic tube ( catheter ), which is placed directly in the blood vessel. X-ray images are called angiograms. Heart failure may be the result of coronary artery disease, and its prognosis depends in part on the ability of the coronary arteries to supply blood to the myocardium (heart muscle). As

5088-494: Is the precipitating cause, and may manifest as regional wall motion abnormalities on echo. Chest X-rays are frequently used to aid in the diagnosis of CHF. In a person who is compensated, this may show cardiomegaly (visible enlargement of the heart), quantified as the cardiothoracic ratio (proportion of the heart size to the chest). In left ventricular failure, evidence may exist of vascular redistribution (upper lobe blood diversion or cephalization), Kerley lines , cuffing of

5194-491: Is useful since stage A encompasses "pre-heart failure" – a stage where intervention with treatment can presumably prevent progression to overt symptoms. ACC stage A does not have a corresponding NYHA class. ACC stage B would correspond to NYHA class I. ACC stage C corresponds to NYHA class II and III, while ACC stage D overlaps with NYHA class IV. Histopathology can diagnose heart failure in autopsies . The presence of siderophages indicates chronic left-sided heart failure, but

5300-629: The Harry Potter series, Dan Brown author of The Da Vinci Code , historical novelist Bernard Cornwell , and Twilight author Stephenie Meyer . "[the novelist's] honesty is bound to the vile stake of his megalomania [...] The novelist is the sole master of his work. He is his work." Milan Kundera The personal experiences of the novelist will often shape what they write and how readers and critics will interpret their novels. Literary reception has long relied on practices of reading literature through biographical criticism , in which

5406-616: The shortening fraction is the preferred measure of systolic function. Normally, the EF should be between 50 and 70%; in systolic heart failure, it drops below 40%. Echocardiography can also identify valvular heart disease and assess the state of the pericardium (the connective tissue sac surrounding the heart). Echocardiography may also aid in deciding specific treatments, such as medication, insertion of an implantable cardioverter-defibrillator , or cardiac resynchronization therapy . Echocardiography can also help determine if acute myocardial ischemia

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5512-451: The 16th and 17th centuries to refer to either "An innovator (in thought or belief); someone who introduces something new or who favours novelty" or "An inexperienced person; a novice." However, the OED attributes the primary contemporary meaning of "a writer of novels" as first appearing in the 1633 book "East-India Colation" by C. Farewell citing the passage "It beeing a pleasant observation (at

5618-766: The 20th century, which is considered equivalent to American literary regionalism. It used a realist style to portray the scenes, language, customs and manners of the country the writer was from, especially the lower and peasant classes, criollismo led to an original literature based on the continent's natural elements, mostly epic and foundational. It was strongly influenced by the wars of independence from Spain and also denotes how each country in its own way defines criollo , which in Latin America refers to locally-born people of Spanish ancestry. Novelists often will be assessed in contemporary criticism based on their gender or treatment of gender. Largely, this has to do with

5724-474: The Author " that the author no longer should dictate the reception and meaning derived from their work. Other, theoretical approaches to literary criticism attempt to explore the author's unintentional influence over their work; methods like psychoanalytic theory or cultural studies , presume that the work produced by a novelist represents fundamental parts of the author's identity . Milan Kundera describes

5830-684: The Novel", sees the novelist as needing to "re-create reality in the forms which his personal vision assumes as it plays and struggles with the vivid illusory "eidetic-like" imagery left in the mind's eye by the process of social change." However, Ellison also describes novelists of the Lost Generation , like Ernest Hemingway , not taking full advantage of the moral weight and influence available to novelists, pointing to Mark Twain and Herman Melville as better examples. A number of such essays, such as literary critic Frank Norris 's "Responsibilities of

5936-530: The age of 70. Rates are predicted to increase. The risk of death in the first year after diagnosis is about 35%, while the risk of death in the second year is less than 10% in those still alive. The risk of death is comparable to that of some cancers. In the United Kingdom, the disease is the reason for 5% of emergency hospital admissions. Heart failure has been known since ancient times in Egypt ; it

6042-407: The age of eighty-eight. Novelist Novelists come from a variety of backgrounds and social classes, and frequently this shapes the content of their works. Public reception of a novelist's work , the literary criticism commenting on it, and the novelists' incorporation of their own experiences into works and characters can lead to the author's personal life and identity being associated with

6148-437: The alien and external as possible?" Congestive heart failure Heart failure ( HF ), also known as congestive heart failure ( CHF ), is a syndrome caused by an impairment in the heart 's ability to fill with and pump blood . Although symptoms vary based on which side of the heart is affected, HF typically presents with shortness of breath , excessive fatigue , and bilateral leg swelling . The severity of

6254-453: The amount of blood pumped out is more than typical and the heart cannot keep up. This can occur in overload situations such as blood or serum infusions, kidney diseases, chronic severe anemia , beriberi (vitamin B 1 / thiamine deficiency), hyperthyroidism , cirrhosis , Paget's disease , multiple myeloma , arteriovenous fistulae , or arteriovenous malformations . Chronic stable heart failure may easily decompensate (fail to meet

6360-418: The areas around the bronchi , and interstitial edema. Ultrasound of the lung may also detect Kerley lines. An electrocardiogram (ECG or EKG) may be used to identify arrhythmias , ischemic heart disease , right and left ventricular hypertrophy , and presence of conduction delay or abnormalities (e.g. left bundle branch block ). Although these findings are not specific to the diagnosis of heart failure,

6466-404: The author's life is presumed to have influence on the topical and thematic concerns of works. Some veins of criticism use this information about the novelist to derive an understanding of the novelist's intentions within his work. However, postmodern literary critics often denounce such an approach; the most notable of these critiques comes from Roland Barthes who argues in his essay " Death of

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6572-569: The beginning of the 20th century while becoming linked as an individual to his depiction of that space. Similarly, novelist such as Mark Twain , William Faulkner , Eudora Welty , and Flannery O'Connor are often describe as writing within a particular tradition of Southern literature , in which subject matter relevant to the South is associated with their own identities as authors. For example, William Faulkner set many of his short stories and novels in Yoknapatawpha County , which

6678-407: The blood , is a late sign of extremely severe pulmonary edema. Other signs of left ventricular failure include a laterally displaced apex beat (which occurs when the heart is enlarged) and a gallop rhythm (additional heart sounds), which may be heard as a sign of increased blood flow or increased intracardiac pressure. Heart murmurs may indicate the presence of valvular heart disease, either as

6784-604: The body first, causing foot and ankle swelling in people who are standing up and sacral edema in people who are predominantly lying down. Nocturia (frequent night-time urination) may occur when fluid from the legs is returned to the bloodstream while lying down at night. In progressively severe cases, ascites (fluid accumulation in the abdominal cavity causing swelling) and liver enlargement may develop. Significant liver congestion may result in impaired liver function ( congestive hepatopathy ), jaundice, and coagulopathy (problems of decreased or increased blood clotting). Dullness of

6890-457: The body's metabolic needs). This most commonly results from a concurrent illness (such as myocardial infarction (a heart attack) or pneumonia ), abnormal heart rhythms , uncontrolled hypertension , or a person's failure to maintain a fluid restriction, diet, or medication. Other factors that may worsen CHF include: anemia, hyperthyroidism, excessive fluid or salt intake, and medication such as NSAIDs and thiazolidinediones . NSAIDs increase

6996-412: The body; the rate of fluid retention is higher than the rate of sodium retention in the body, this phenomenon causes hypervolemic hyponatremia (low sodium concentration due to high body fluid retention). This phenomenon is more common in older women with low body mass. Severe hyponatremia can result in accumulation of fluid in the brain, causing cerebral edema and intracranial hemorrhage . Angiography

7102-478: The brain. Right-sided heart failure is often caused by pulmonary heart disease (cor pulmonale), which is typically caused by issues with pulmonary circulation such as pulmonary hypertension or pulmonic stenosis . Physical examination may reveal pitting peripheral edema, ascites, liver enlargement , and spleen enlargement . Jugular venous pressure is frequently assessed as a marker of fluid status, which can be accentuated by testing hepatojugular reflux . If

7208-497: The capital needed to market books by an unknown author to the public. Responding to the difficulty of successfully writing and publishing first novels, especially at a young age, there are a number of awards for young and first time novelists to highlight exceptional works from new and/or young authors (for examples see Category:Literary awards honouring young writers and Category:First book awards ). In contemporary British and American publishing markets, most authors receive only

7314-584: The controversy also note that by removing such categories as "Women novelist" or "Lesbian writer" from the description of gendered or sexual minorities, the discover-ability of those authors plummet for other people who share that identity. Similarly, because of the conversations brought by feminism, examinations of masculine subjects and an author's performance of "maleness" are a new and increasingly prominent approach critical studies of novels. For example, some academics studying Victorian fiction spend considerable time examining how masculinity shapes and effects

7420-476: The creation of French political and social identity in mid-nineteenth century France. Some novelists become intimately linked with a particular place or geographic region and therefore receive a place-based identity . In his discussion of the history of the association of particular novelists with place in British literature , critic D. C. D. Pocock, described the sense of place not developing in that canon until

7526-507: The early fifties, Busch and Wright divorced, and Busch left Hollywood for northern California, where he devoted himself to cattle ranching and the full-time writing of novels. There he would meet his fourth wife Carmencita Baker and fifth wife Suzanne de Sanz. Before Busch's final novel The Titan Game he had become one of San Francisco's leading literary lights and a Regent's Professor at the University of California . California Street

7632-687: The educated middle classes. However, working men and women began publishing novels in the twentieth century. This includes in Britain Walter Greenwood 's Love on the Dole (1933), from America B. Traven 's, The Death Ship (1926) and Agnes Smedley , Daughter of Earth (1929) and from the Soviet Union Nikolay Ostrovsky 's How the Steel Was Tempered (1932). Later, in 1950s Britain, came

7738-606: The effects of diuretic medications. Gossypol can increase the effects of diuretics, leading to toxicity. Gynura can cause low blood pressure. Licorice can worsen heart failure by increasing blood pressure and promoting fluid retention. Lily of the Valley can cause abnormally slow heart rates with mechanisms similar to those of digoxin. Tetrandrine can lower blood pressure by inhibiting L-type calcium channels . Yohimbine can exacerbate heart failure by increasing blood pressure through alpha-2 adrenergic receptor antagonism. Heart failure

7844-468: The exception rather than the norm. Other critics and writers defending the merits of genre fiction often point towards King as an example of bridging the gap between popular genres and literary merit. Both literary critics and novelists question what role novelists play in society and within art. For example, Eudora Welty writing in 1965 for in her essay "Must the Novelist Crusade?" draws

7950-523: The force with which the heart ejects blood , thus are not recommended in people with heart failure with a reduced ejection fraction. Breast cancer patients are at high risk of heart failure due to several factors. After analyzing data from 26 studies (836,301 patients), the recent meta-analysis found that breast cancer survivors demonstrated a higher risk heart failure within first ten years after diagnosis (hazard ratio = 1.21; 95% CI: 1.1, 1.33). The pooled incidence of heart failure in breast cancer survivors

8056-509: The form of peripheral edema (causing swollen limbs and feet) and pulmonary edema (causing difficulty breathing) and ascites (swollen abdomen). Pulse pressure , which is the difference between the systolic ("top number") and diastolic ("bottom number") blood pressures, is often low/narrow (i.e. 25% or less of the level of the systolic) in people with heart failure, and this can be an early warning sign. Symptoms of heart failure are traditionally divided into left-sided and right-sided because

8162-678: The formation of prostaglandins , NSAIDs may exacerbate heart failure through several mechanisms, including promotion of fluid retention, increasing blood pressure , and decreasing a person's response to diuretic medications. Similarly, the ACC/AHA recommends against using COX-2 inhibitor medications in people with heart failure. Thiazolidinediones have been strongly linked to new cases of heart failure and worsening of pre-existing congestive heart failure due to their association with weight gain and fluid retention. Certain calcium channel blockers, such as diltiazem and verapamil , are known to decrease

8268-549: The genre or within their own interests. In describing the place within the industry, novelist Kim Wright says that many authors, especially authors who usually write literary fiction, worry about "the danger that genre is a cul-de-sac" where publishers will only publish similar genre fiction from that author because of reader expectations, "and that once a writer turns into it, he'll never get out." Similarly, very few authors start in genre fiction and move to more "literary" publications; Wright describes novelists like Stephen King as

8374-739: The heart if positive. In Europe , the European Society of Cardiology , and in the United States, the AHA / ACC / HFSA , recommend measuring NT-proBNP or BNP followed by an ultrasound of the heart if positive. This is recommended in those with symptoms consistent with heart failure such as shortness of breath . The European Society of Cardiology defines the diagnosis of heart failure as symptoms and signs consistent with heart failure in combination with "objective evidence of cardiac structural or functional abnormalities". This definition

8480-525: The heart failure is mainly decided based on ejection fraction and also measured by the severity of symptoms. Other conditions that have symptoms similar to heart failure include obesity , kidney failure , liver disease , anemia , and thyroid disease . Common causes of heart failure include coronary artery disease , heart attack , high blood pressure , atrial fibrillation , valvular heart disease , excessive alcohol consumption , infection , and cardiomyopathy . These cause heart failure by altering

8586-535: The heart muscle. An echocardiogram ( ultrasound of the heart) is commonly used to support a clinical diagnosis of heart failure. This can determine the stroke volume (SV, the amount of blood in the heart that exits the ventricles with each beat), the end-diastolic volume (EDV, the total amount of blood at the end of diastole), and the SV in proportion to the EDV, a value known as the ejection fraction (EF). In pediatrics,

8692-599: The heart's myocardial tissue (termed myocarditis ) can similarly contribute to the development of heart failure. Genetic predisposition plays an important role. If more than one cause is present, progression is more likely and prognosis is worse. Heart damage can predispose a person to develop heart failure later in life and has many causes including systemic viral infections (e.g., HIV ), chemotherapeutic agents such as daunorubicin , cyclophosphamide , trastuzumab and substance use disorders of substances such as alcohol , cocaine , and methamphetamine . An uncommon cause

8798-752: The highly controversial The Wasp Factory in 1984. The success of this novel enabled Banks to become a full-time novelist. Often an important writers' juvenilia , even if not published, is prized by scholars because it provides insight into an author's biography and approach to writing; for example, the Brontë family 's juvenilia that depicts their imaginary world of Gondal , currently in the British Library , has provided important information on their development as writers. Occasionally, novelists publish as early as their teens. For example, Patrick O'Brian published his first novel, Caesar: The Life Story of

8904-404: The hills of Encino with his growing family, Busch began writing novels. The Carrington Incident , published in 1941, was followed by the best-seller Duel in the Sun , which Lewis Selznick's other son David purchased and turned into the 1946 blockbuster of the same title . He now alternated between the writing of screenplays and novels, most of which became best-sellers. They Dream of Home ,

9010-571: The impacts of cultural expectations of gender on the literary market, readership and authorship. Literary criticism , especially since the rise of feminist theory , pays attention to how women, historically, have experienced a very different set of writing expectations based on their gender; for example, the editors of The Feminist Companion to Literature in English point out: "Their texts emerge from and intervene in conditions usually very different from those which produced most writing by men." It

9116-430: The left and right ventricles supply different parts of the circulation. In biventricular heart failure, both sides of the heart are affected. Left-sided heart failure is the more common. The left side of the heart takes oxygen-rich blood from the lungs and pumps it to the rest of the circulatory system in the body (except for the pulmonary circulation ). Failure of the left side of the heart causes blood to back up into

9222-443: The literary movement of modernist literature . She argues that the novelist should represent "not a series of gig-lamps symmetrically arranged; [rather] life is luminous halo, a semitransparent envelope surrounding us from the beginning of the conscious to the end. Is it not the task of the novelist to convey this varying, this unknown and uncircumscribed spirit, whatever aberration or complexity it may display, with as little mixture of

9328-441: The lung fields when percussed and reduced breath sounds at the base of the lungs may suggest the development of a pleural effusion (fluid collection between the lung and the chest wall ). Though it can occur in isolated left- or right-sided heart failure, it is more common in biventricular failure because pleural veins drain into both the systemic and pulmonary venous systems. When unilateral, effusions are often right-sided. If

9434-446: The lungs, causing breathing difficulties and fatigue due to an insufficient supply of oxygenated blood. Common respiratory signs include increased respiratory rate and labored breathing (nonspecific signs of shortness of breath). Rales or crackles are heard initially in the lung bases and when severe in all lung fields indicate the development of pulmonary edema (fluid in the alveoli ). Cyanosis , indicates deficiency of oxygen in

9540-413: The male novelist" that midlist male novelists are less likely to find success than midlist female novelist, even though men tend to dominate "literary fiction" spaces. The position of women in the literary marketplace can change public conversation about novelists and their place within popular culture, leading to debates over sexism. For example, in 2013, American female novelist Amanda Filipacchi wrote

9646-575: The number of pillows required to lie comfortably, with extreme cases of orthopnea forcing the patient to sleep sitting up. Another symptom of heart failure is paroxysmal nocturnal dyspnea : a sudden nocturnal attack of severe shortness of breath, usually occurring several hours after falling asleep. There may be " cardiac asthma " or wheezing . Impaired left ventricular forward function can lead to symptoms of poor systemic perfusion such as dizziness , confusion , and cool extremities at rest. Loss of consciousness may also occur due to loss of blood supply to

9752-718: The political agendas of the Communist party or left wing sympathizers, and seen as a "device of revolution". However, the British tradition of working class literature, unlike the Russian and American, was not especially inspired by the Communist Party, but had its roots in the Chartist movement , and socialism , amongst others. Novelists are often classified by their national affiliation, suggesting that novels take on

9858-503: The resulting shortness of breath. Depending on the case, an implanted device such as a pacemaker or implantable cardiac defibrillator may sometimes be recommended. In some moderate or more severe cases, cardiac resynchronization therapy (CRT) or cardiac contractility modulation may be beneficial. In severe disease that persists despite all other measures, a cardiac assist device ventricular assist device , or, occasionally, heart transplantation may be recommended. Heart failure

9964-403: The right ventricular pressure is increased, a parasternal heave which causes the compensatory increase in contraction strength may be present. Backward failure of the right ventricle leads to congestion of systemic capillaries. This generates excess fluid accumulation in the body. This causes swelling under the skin ( peripheral edema or anasarca ) and usually affects the dependent parts of

10070-626: The risk twofold. A number of medications may cause or worsen the disease. This includes NSAIDs , COX-2 inhibitors , a number of anesthetic agents such as ketamine , thiazolidinediones, some cancer medications , several antiarrhythmic medications , pregabalin , alpha-2 adrenergic receptor agonists , minoxidil , itraconazole , cilostazol , anagrelide , stimulants (e.g., methylphenidate ), tricyclic antidepressants , lithium , antipsychotics , dopamine agonists , TNF inhibitors , calcium channel blockers (especially verapamil and diltiazem ), salbutamol , and tamsulosin . By inhibiting

10176-399: The sole master of his work. He is his work." The close intimacy of identity with the novelist's work ensures that particular elements, whether for class, gender, sexuality, nationality, race, or place-based identity, will influence the reception of their work. Historically, because of the amount of leisure time and education required to write novels, most novelists have come from the upper or

10282-436: The structure or the function of the heart or in some cases both. There are different types of heart failure: right-sided heart failure , which affects the right heart , left-sided heart failure , which affects the left heart , and biventricular heart failure, which affects both sides of the heart. Left-sided heart failure may be present with a reduced ejection fraction or with a preserved ejection fraction . Heart failure

10388-440: The teens and early twenties. Myron Selznick soon secured work for Busch at Warner Bros. Pictures , and Busch decamped to Los Angeles to write his first film, Howard Hawks 's The Crowd Roars . One of four writers on the production, Busch's name was misspelled in the credits. Through the rest of the thirties, Busch worked for most of the major Hollywood studios, scripting mostly B-movies like The Big Shakedown . In 1938 he

10494-462: The tensions between the novelist's own identity and the work that the author produces in his essay in The New Yorker titled "What is a novelist?"; he says that the novelist's "honesty is bound to the vile stake of his megalomania [...]The work is not simply everything a novelist writes-notebooks, diaries, articles. It is the end result of long labor on an aesthetic project[...]The novelist is

10600-541: The underlying cause for the clinical presentation", for HFmrEF and HFpEF specifically requiring "evidence of spontaneous or provokable increased left ventricle filling pressures". The European Society of Cardiology has developed a diagnostic algorithm for HFpEF , named HFA-PEFF. HFA-PEFF considers symptoms and signs, typical clinical demographics (obesity, hypertension, diabetes, elderly, atrial fibrillation), and diagnostic laboratory tests, ECG, and echocardiography. One historical method of categorizing heart failure

10706-565: The underlying cause is vital to diagnosis and treatment. In heart failure, the structure or the function of the heart or in some cases both are altered. Heart failure is the potential end stage of all heart diseases. Common causes of heart failure include coronary artery disease , including a previous myocardial infarction (heart attack), high blood pressure , atrial fibrillation , valvular heart disease , excess alcohol use , infection , and cardiomyopathy of an unknown cause. In addition, viral infection and subsequent inflammation of

10812-504: The way he makes use of these elements in relation to a part of the West of England, that he names Wessex . Other British writers that have been characterized as regional novelists, are the Brontë sisters , and writers like Mary Webb (1881–1927), Margiad Evans (1909–58) and Geraint Goodwin (1903–42), who are associate with the Welsh border region. George Eliot (1801–86) on the other hand

10918-960: The works, because of its prominence within fiction from the Victorian period. Traditionally, the publishing industry has distinguished between " literary fiction ", works lauded as achieving greater literary merit , and " genre fiction ", novels written within the expectations of genres and published as consumer products. Thus, many novelists become slotted as writers of one or the other. Novelist Kim Wright , however, notes that both publishers and traditional literary novelist are turning towards genre fiction because of their potential for financial success and their increasingly positive reception amongst critics. Wright gives examples of authors like Justin Cronin , Tom Perrotta and Colson Whitehead all making that transition. However, publishing genre novels does not always allow novelist to continue writing outside

11024-488: Was 4.44 (95% CI 3.33-5.92) per 1000 person-years of follow-up. Certain alternative medicines carry a risk of exacerbating existing heart failure, and are not recommended. This includes aconite , ginseng , gossypol , gynura , licorice , lily of the valley , tetrandrine , and yohimbine . Aconite can cause abnormally slow heart rates and abnormal heart rhythms such as ventricular tachycardia. Ginseng can cause abnormally low or high blood pressure and may interfere with

11130-473: Was nominated for an Academy Award for In Old Chicago , which was based on his story We the O'Learys , but failed to win. In 1940 he co-wrote The Westerner for director William Wyler and producer Samuel Goldwyn . Soon thereafter he went to work as Goldwyn's story editor, recommending Pride of the Yankees , in which Gary Cooper and Busch's soon-to-be wife Teresa Wright co-starred. Settling in

11236-640: Was not a great critical success, its popularity among readers placed it on the New York Times Children's Books Best Seller list for 121 weeks. First-time novelists of any age often are unable to have their works published, because of a number of reasons reflecting the inexperience of the author and the economic realities of publishers. Often authors must find advocates in the publishing industry, usually literary agents , to successfully publish their debut novels . Sometimes new novelists will self-publish , because publishing houses will not risk

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