Accuracy of Bayley Scores as Outcome Measures in Trials of...

Introduction Long-term follow-up of high risk preterm infants has become increasingly important as the proportion of infants surviving has increased steadily over the past several decades. It is well known that these infants are at increased risk of cognitive impairment. (Class) With this increase in at risk survivors, many clinical research questions arise that can only be answered by long-term follow-up studies. (Vohr, Teune) Clinical trials that examine common perinatal therapies should also include a long term follow-up component in their research to examine later neurodevelopmental outcomes in their cohorts. Although there is no prescribed protocol dictating which specific neurodevelopmental tests are to be completed during follow-up, the Bayley Scales of Infant and Toddler Development and all its revisions, is the most widely used test to assess neurodevelopment of very preterm infants in the first three years of life (Luttikhuizen) and is a common outcome measure used in clinical researc h trials. Standardized developmental assessments such as the Bayley that are used in a pediatric clinical trial setting as primary outcome measures need to be reliably administered and scored. Trained test administrators and scorers are generally careful that the tests they are administering are conducted and scored correctly. However, given the range of numerical calculations and transcriptions required in scoring the results of these tests, there is always a chance that errors

Stephen Cranes Red Badge of Courage as Bildungsroman Essay

Stephen Cranes Red Badge of Courage as Bildungsroman In the Red Badge of Courage, by Stephen Crane, the main character Henry Fleming joins the army as a young fledging and ultimately matures to a courageous soldier ready for battle. The Red Badge of Courage is considered a Bildungsroman since the reader traces Henry’s development morally, psychologically, and intellectually. Henry progresses from a feared youth who in the course of a couple of days, in the line of fire, has crossed the threshold to manhood. Henry Fleming’s growth is demonstrated after the first battle when he becomes mentally stronger and surmounts his fear of being a coward. Henry Fleming is a romantic dreamer, inspired by visions of a chivalric†¦show more content†¦He had not been aware of the process. He had slept and awakening, found himself a knight (Hart).† Henry’s hopes and confidence are suddenly crushed when the enemy reappears and Henry finds himself running from his post with the others and his worst fears are realized in this testimonial. Henry is still in the stages of development and although he overcomes his first testimonial, he still is a â€Å"fresh fish† in many ways. Henry suffers from shame when he realizes that his comrades have all held in line. Henry tries to justify with himself that he did the natural thing: run. This was what the squirrel did when he threw a pine at it and it was only natural to run to steer away from danger. Later, Henry encounters the tattered soldier and several men who display their â€Å"red badge of courage.† Henry wishes he had a wound displaying courage. The only wound Henry possesses is in his soul since he has such low self-esteem. It is the death of Jim Conklin, the epitome of courage, that makes Henry begin to realize the realities of war as he is beginning to e ncounter more with death. â€Å"The red sun was pasted in the sky like a wafer (Crane, 71).† The sun seems to be a symbol of Jim’s wound and of courage (Solomon). The death of Jim Conklin represented Henry’s childhood and the tattered soldier represents Henry’s idealized self, which is dying. Henry is deserting the image he had of himself before he joinedShow MoreRelatedRed Badge of Courage Essay1271 Words   |  6 PagesTo Be or Not to Be†¦ A Man The Red Badge of Courage written by Stephen Crane is a prime example of bildungsroman, or a coming of age story. Crane begins with a cowardly boy, Henry Fleming, and ends with an experienced war hero who has learned not just what war really is, but who he really is. Mark Twain once said, â€Å"The fear of death follows from the fear of life. A man who lives fully is prepared to die at any time.† [Epigraph] Although he struggles to learn that being a soldier means more thanRead MoreSymbolic Meaning of the Land in Gone with the Wind6993 Words   |  28 Pages1949 she was killed in a car accident crossing Peachtree Street in Atlanta. Gone with the Wind differs from most Civil War novels by appreciating the South and depreciating the North. Other popular novels about the Civil War, such as Stephen Cranes The Red Badge of Courage, are told from a Northern perspective and tend to exalt the Norths values. Mitchells novel is unique also for its portrayal of a strong-willed, independent woman, Scarlett OHara, who has many same characteristics with Mitchell

Evidence for and against the Serotonin Hypothesis of Depression

Question: Discuss About Evidence For And Against The Serotonin Hypothesis Of Depression? Answer: Introduction The fundamental idea stating the cause of depression as a serotonin imbalance within the body elicits a discussion that can be justified as a hypothesis, which adequately deserves ample evidence to either support or dispute. The serotonin hypothesis of depression, from Dr. Schildkraust in 1965, states that low levels or lack of serotonin within the brain causes depression, a condition that could be treated by antidepressants. The hypothesis, when compared to an earlier belief, is presently discussed that the mood disorders occurring repetitively in depression are brain infections or disorders that result from a variety of factors such as various degrees of biological, genetic and environmental factors that gradually change in the brain (Sanders, 1988). The serotonin hypothesis of depression over the years has stated that low levels of serotonin in the brain nerve cells cause depression. It has led to the development of antidepressant medication such as the Selective Serotonin Reuptake Inhibitors (SSRIs). SSRIs work to maintain a high level of the neurotransmitter serotonin in the nerve cells of the brain by inhibiting its re absorption into the cells releasing it (Moreno and Kramer, 2002). According to Paul Andrews (2004), a professor of psychology and neuroscience at Mc Master University in Canada, the hypothesis might be incomplete since depression patients often find it hard to recover from the serotonin boosting medications. Many scientists have refuted the use of SSRIs in treatment of depression because when you accurately analyze their use, they put an obstacle in the path towards the recovery of a depressed patient instead of helping them. It occurs because, instead of them helping people to overcome depression, they interfere with the mechanisms of recovery within the brain (Louie and Meltzer, 2004). A decrease in the levels of serotonin (5-HT) has been hypothesized as the main pathogenic factor resulting to depression for almost half a century. SSRIs increase the levels of serotonin in the nerve cell spaces known as the synapses in a quick manner. In spite of this, the effect of the antidepressant will take many weeks to develop. According to Paul Andrews (2004), SSRIs work in repairing damage in the brain by the use of hormones and stress chemicals, a gradual process that takes several weeks (Louie and Meltzer, 2004). Moreover, Clomipramine, a tricyclic antidepressant (TCA), showed a similar antidepressant efficacy with other TCAs. It stopped the serotonin uptake with a higher affinity of more than 100 folds and above than other inhibitors by the noradrenalin uptake. Such pharmacological studies have supported and facilitated the hypothesis of depression. This clinical observation of an increase in the release of serotonin contributes to an anti depressant effect that has been repeatedly supported .Nevertheless, for instance, the efficacy of SSRIs versus placebos(slow) may be strong in a moderately depressed in comparison to severely depressed patients (Sanders, 1988). It is difficult to quantify the amount of serotonin used and released in a safe way by the human brain. This can be estimated from evidence about serotonin levels metabolized by the brain and by inferences from animal studies. The best evidence against the hypothesis of depression states that not less but more serotonin is used and released during an episode of depression. This is to say that patients are left in worse conditions after using antidepressants. Furthermore, many forms of depression are beneficial adaptation to stress and are natural thus this might be against the serotonin hypothesis of depression and the use of antidepressants (Louie and Meltzer, 2004). Meltzer and Louie (1987) argue that a pharmacological lessening of the functions of serotonin enhances depression; nevertheless, the primary cause cannot be entirely attributed to serotonin deficiency. In the scientific literature and the lay media, it is frequently assumed that serotonin deficiency causes depression. This theoretically attractive assumption might be an overgeneralization or be premature. Clinical presentations of depression are wide since they include various syndromes which were initially separate and various disease aspects especially in melancholic versus an endogenous depression ( Meltzer and Louie, 1987, p. 136). In such clinical manifestations that are diverse, depression could represent various overlapping sources of pain that arise from unique and distinct causes. Moreover, symptomatology in depression can also arise from diverse neurological (for example the Alzheimers disease), endocrine (Cushing disease) and immunological causes (e.g. interferon treatment). Stressors of life such as social isolation, financial difficulties, childhood trauma and job insecurity are also significant factors in depression that demonstrate the importance of the environment in depression ( Mannl , 1989). In the past 40 years , several anomalies in regards to putative biomarkers of the central serotonin functions have been repeatedly reported in patients with depression, indicating that a deficiency in serotonin could be evidenced in depression especially the severely depressed or in suicidal patients. Iproniazid, a drug developed to treat tuberculosis, surprisingly showed an antidepressant activity in patients diagnosed with TB and who concurrently suffered from depression. Clinical studies indicated that Iproniziad inhibited the monoamine oxidase (MOA) enzyme A and B. These enzymes are responsible in metabolizing serotonin and subsequent monoamines .Furthermore; it also increased the serotonin concentrations in the brain thus helping in supporting the serotonin hypothesis of depression (Louie and Meltzer, 2004). Tryptophan Levels. In many clinical studies, an acute depletion of tryptophan leads to a frequent occurrence of mild depression symptoms even after treatment with antidepressants, this occurs by lowering the serotonin levels in the brain thus it can be a fundamental aspect in supporting the hypothesis. Tryptophan depletion in the brain is somehow a non-selective tool in probing the hypothesis, furthermore, its studies were not effective in alleviating depression (Fairburn and Smith, 1997). Tryptophan is an amino acid which most likely affects protein synthesis. The decrease in its levels probably affects the brain and mood by starving pathways of metabolism for example by impairing the kynurenic acid synthesis or neurobiological and quinoline substances.50 percent of patients diagnosed and treated with interferon alpha develop symptoms of depression after treatment. Another evidence that correlates with this study indicates that interferon alpha enhances the induction of indole amine 2, 3 dioxygenase, thus leading to the decrease in levels of tryptophan in the brain, therefore decrease in serotonin is involved herein (Fairburn and Smith, 1997). Another drug Imipramine, a tricyclic antidepressant (TCA) prototype, was originally developed to treat schizophrenia but unluckily, the drug failed and it did not induce its antipsychotic effect but favorably showed actions against depression symptoms in patients with schizophrenia. Consequently, imipramine was successfully adopted to induce the antidepressant effect on the body. In the 1960, chemical studies showed that other TCAs and imipramine blocked the serotonin reuptake .Within that same period, reports indicated that the precursors of serotonin, induced antidepressant effects and increased the brain serotonin levels in study animals (Fairburn and Smith, 1997). It has been reported that in particular patients, depression is precipitated by chronic depletion of serotonin due to vesicular monoamine transport inhibitor, reserpin. In high doses, it depletes extracellular and storage levels of serotonin, noradrenalin, and dopamine making it consistent to ascribe depressogenic effects of reserpine to one neurotransmitter. Studies have indicated that the link between depression and chronic reserpine treatment remains contentious. Studies done later on chronic reserpine treatments indicated less frequent depressogenic effects, a factor in varying the findings could be attributed to the differential schedules of dosing. In addition to that, chronic reserpine induces a weak antidepressant effect rather than a pro-depressant effect, so the cause of disagreement still lies in establishing whether the probability of depression is elicited by the deficiency of serotonin in neurotransmission (Stanley, 1985). Biomarkers or indirect measures have been used to probe for the brains serotonin system integrity over the last four decades. A primary metabolite of cerebrospinal fluids serotonin is 5 hydroxyindoleacetic acid. It reflects the levels of 5-HIAA utilized as an index of neurotransmission within the brain. Studies have indicated a correlation between depression and low levels of CSF 5- HIAA and regarded them as inconsistent. The finding that is more robust is the relationship between aggression, suicidality or impulsivity with low 5 HIAA (Stanley, 1985). Acute stimulation of serotonin triggers a secretion of hormone prolactin, there is a complex mechanism involved in the release of the hormone, which is not defined. It appears that the mechanism involved includes oxytocin neurotransmitters .The amount of prolactin in the plasma increases fenfluramine, a brain serotonin biomarker, that challenges prolactin, where lower serotonin levels reflect a blunted response by the hormone ( Stanley, 1985). In depressed patients, low 5HIAA indicates that there is a minimal response of plasma prolactin to fenfluramine. Furthermore, inhibiting plasma prolactin due to activation of fenfluramine is more insightful in severely depressed patients. In addition to that, aggression and suicidality are also present. Increased cortical receptors, 5HT2AR of serotonin have been associated with depression, there is also a link between an increase in frontal 5 HT2ARs receptors and suicide. In contrast to this, there is a decrease in hippocampal receptors 5HT2ARs in chronic depressed people therefore indicating that necessarily, up regulation of serotonin receptors does not occur in depressed patients. A large groups of scientists report a lack of association in the levels of frontal cortex 5HT2ARr and suicide (Louie and Meltzer, 2004). In conclusion, the serotonin hypothesis might not be wrong or true but it might be incomplete. The association of serotonin levels with depression as the primary syndrome is not entirely conclusive. Considering the diversity of symptoms, disease severity in patients and the numerous etiology that underlie depression as a syndrome, its extremely difficult to associate depression to a particular body mechanism such as serotonin depletion within the brain. Nevertheless, when we shift focus to the analysis of severe depression or suicidality, an association of serotonin biomarker findings suggest that the serotonin deficiency could be linked to depression in some populations but the link does not essentially prove to be the cause. SSRI antidepressants reveal a superiority that is convincing over placebos entirely in depression that is severe while in adult depressed patients, studies indicate that antidepressants have the least effect against depression. It is therefore much persuading to include a hypothesis on serotonin deficiency (lack or a low level) as significantly a causal factor in particular subsets of depression patients and not completely all cases of depression. References Angel, M. (2000). Essential pharmacological neuroscientific basis and practical applications. Cambridge: Cambridge University Press. Coppen, O.D. (1967). The biochemistry of serotonin and depression. British journal of Psychiatry, 114(12), 37 64. Fairburn, C.G. Smith, K.A. (1997). Depression relapses after a quick depletion of tryptophan. British Journal of Psychiatry, 34 (4), 5 9. Kandel, E.R. Schwartz, J. H. (1992). Principles of Neuroscience. New York: Elsevier Science. Louie, A.K. Meltzer, H.Y. (2004). Serotonin potentiating of antidepressant treatment. Journal of Clinical Psychopharmacology, 4(6), 316-322. Mannl, J. (1989). Evidence of the serotonin hypothesis of suicide. A review of postmortem studies. Journal of Psychiatry, 155, 7-14. Meltzer,H.Y. Lowy,M.T. (1987). The Serotonin Hypothesis of Depression in Psychopharmacology. The Third Generation of Progress. (2nd Edition). New York: Raven Press. Moreno, F. Kramer, P. (2002). Roles of serotonin and depression. Journal of Clinical Psychiatry. 51 (1), 5-1. Sanders, B. E. (1988). The serotonin receptors. New Jersey: Clifton Press. Smith, W.K. (1987). The stress analogy. (1st Edition). New York: Mc Graw Hill. Stanley, M. (1985). Correlations between aminergic metabolites simultaneously obtained from human CSF brain. Journal of Life Science, 37 (12), 79-86. Steward, 0. (1988). Principles of cellular molecular and developmental neuroscience. New York: McGraw Hill.

The Whitsun Weddings Essay Example For Students

The Whitsun Weddings Essay But this is all he is talking about, in these poems he would be most discriminated for, yet all he is thinking about is his own feelings and thoughts, not about the womens at all, so i dont feel that anyone can judge if he sympathises with the women or not as he isnt taking them into consideration. True he does talk about women as objects but only because he wishes he could as this would give him more power in that respect. He proves he doesnt believe in himself through the fact that he ended up dating the friend who he didnt find as attractive as the other bosomy rose. We will write a custom essay on The Whitsun Weddings specifically for you for only $16.38 $13.9/page Order now Like the previous two poems, Faith Healing could be thought of as also being about himself in the way that they were about his way of thinking and the way he acts or his relationships. Even though this poem is seemingly about women, we are able to notice a rather jealous tone when Larkin speaks about how women file up like a flock of sheep and will follow whatever is said to them using in this case a religious speaker. Larkin describes the speaker as being Godly; rimless glasses, silver hair, dark suit, white collar being able to persuade women to do whatever he wants them to do, believe whatever he wants them to believe. One may think that this is another mention of his fantasies; being able to tell women what to do yet i feel the poem does in-fact have a sympathetic tone to it. Either sympathetic towards the women not being able to think for themselves, even though he is rather patronising towards them by using animalistic terms such as hoarse tears, thick tongues and sheepishly stray or towards himself for not being the person who he wants to be. One poem that most definitely contrasts to the other poems is Selfs the Man, this is because there is blatant sympathy showed by Larkin, sympathy that still may not please people but i feel no-one will be able to argue with Larkins truthful feelings portrayed in this poem. Larkin tells us in this poem about his friend Arnold and his married life. Larkin tells us that Arnold is less selfish than he is in the way that Larkin feels he is a swine because he has a better life than him. He feels sorry for Arnold because he is stuck with a woman all day and she orders him round so much that he has no time at all. Larkin spends the first half of the poem describing Arnolds life, sympathising with him but also laughing at him for being such a fool. Towards the end of the poem we see Larkin starting to question his theory by asking himself if it was such a mistake and finishing off the poem saying he knows what i can stand or i suppose i can which shows he is thoroughly doubting who is better off. So in this poem we can see a change in Larkins views from the sympathetic, mocking view to hesitating on whether in-fact are people sympathising with him because of his situation. The final poem i will look at, i feel of one of the saddest poems Larkin has written as in Afternoons we see him describe a stage in a young mothers life where her youth is fading and she has got stuck into a routine. This routine is also described by saying the mothers assemble rather than meet up which suggests they have a strict and controlled life. The word hollows also conveys an emptiness in their lives, words such as hollows, fading and fall create a very sad tone that has not been seen in many of Larkins poems as they suggest a huge loss in their lives, causing Larkin to sympathise with the young mothers. .u1f21fd6e54adb59675daceaf59419d09 , .u1f21fd6e54adb59675daceaf59419d09 .postImageUrl , .u1f21fd6e54adb59675daceaf59419d09 .centered-text-area { min-height: 80px; position: relative; } .u1f21fd6e54adb59675daceaf59419d09 , .u1f21fd6e54adb59675daceaf59419d09:hover , .u1f21fd6e54adb59675daceaf59419d09:visited , .u1f21fd6e54adb59675daceaf59419d09:active { border:0!important; } .u1f21fd6e54adb59675daceaf59419d09 .clearfix:after { content: ""; display: table; clear: both; } .u1f21fd6e54adb59675daceaf59419d09 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u1f21fd6e54adb59675daceaf59419d09:active , .u1f21fd6e54adb59675daceaf59419d09:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u1f21fd6e54adb59675daceaf59419d09 .centered-text-area { width: 100%; position: relative ; } .u1f21fd6e54adb59675daceaf59419d09 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u1f21fd6e54adb59675daceaf59419d09 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u1f21fd6e54adb59675daceaf59419d09 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u1f21fd6e54adb59675daceaf59419d09:hover .ctaButton { background-color: #34495E!important; } .u1f21fd6e54adb59675daceaf59419d09 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u1f21fd6e54adb59675daceaf59419d09 .u1f21fd6e54adb59675daceaf59419d09-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u1f21fd6e54adb59675daceaf59419d09:after { content: ""; display: block; clear: both; } READ: Beyond the arabin poetry EssayAlso we can see Larkin sympathise with married women in general which is very surprising in itself as he says that stand husbands, their children and an estateful of washing dominate their lives. From this i have come to the conclusion that in relation to the question how fair is the criticism Larkin has a lack of sympathy in his poetry i believe it is not fair, Larkin is sympathetic. Perhaps he is not as sympathetic as some poets but i feel that for a man with Larkins views, through his poetry he is able to sympathise with himself and his own views and also sympathise with others if that is what he was not to write about. I do not feel that Larkin should be discriminated because of his poetry purely because his poetry is his views; he should have to start sympathising with people if that is not what he believed in. From this selection of poems, i personally have identified sympathy in all the poems i have looked at. I feel that sympathy towards yourself can still count as being sympathetic and i honestly feel that Larkin often was not happy with himself in the ways he felt inadequate and not able to be someone he wishes he would be. Afternoons showed the most sympathy and unusually towards women which was very rare for him to look at a womans point of view. Still it proves he can still sympathise with women if he actually thinks about them and their views. In his other poems he usually only concentrates of himself which might cause readers to think that he isnt being sympathetic but why would you need to talk about other people in your own poetry? He would not have thought of a target audience that a novelist would. He usually does talk about himself but as proven in Afternoons, when he does choose to think away from his point of view Larkin does show a sympathetic side backed up with an even more surprising saddened tone. This showing that even a stubborn man such as Larkin can still identify with other people in a sympathetic manor. Georgina Sims Show preview only The above preview is unformatted text This student written piece of work is one of many that can be found in our GCSE Philip Larkin section.

China and the Internet essays

China and the Internet essays The worldwide network of computers known as the Internet poses an interesting dilemma to the government of China. The widespread and cheap access to unrestricted information that the Internet offers could pose a serious threat to the authoritarian government of China. In contrast, the benefits to business and efficiency that the Internet can bring are too great to be ignored, especially as China makes an entrance into the World Trade Organization and the global economy. How will China handle these conflicting pressures? Todays Internet can trace its roots back to the ARPAnet, a collection of computers designed to share information among universities and researchers. ARPAnet was conceived by the United States government in 1969 and has grown steadily since. Now a truly global network of computers located all over the world, no single nation owns the Internet. Global governing bodies and standards have been established to control and direct the continued growth of the Internet. Since a single nation cannot control the content that can be found on the Internet, those that wish to restrict or control access must resort to content filtering or blocking through software and hardware barriers, laws controlling and patrolling access, and the limiting of physical access to an internet connection. To filter and block content the Chinese government employs both software filtering and limited physical access to the Internet. In early 2001, China rolled out government developed filtering software dubbed Internet Police 110 (reportedly named for Chinas emergency police telephone number) that will not only block Web surfers from viewing offensive pornographic and violent online content a not uncommon practice throughout the Internet world but will also steer Internet users away from sites the government views as threatening to the Chinese Communist Party regime. (Gebler, Chinese Web F...

Discussion 3 Dissertation Example | Topics and Well Written Essays - 250 words

Discussion 3 - Dissertation Example The documentation of this system involved extensive usage of Unified Modeling Language or UML. It was an immense challenge to incorporate all the actors such as the drivers, the students, admin and other personnel associated with the system into the UML format. The collaboration tool assisted in understanding the design of the system. The process of creating sequence diagram was very challenging as it involved the incorporation of details of the different interfaces, message orders, responsibilities, timeouts etc. to be incorporated along with various other details. Over all the use of UML simplified the step by step construction of the vehicle management system. The one ‘impossible’ task was made possible only by the hierarchal step by step construction of the system via UML diagrams. ANSWER NO.2 2a. and 2b. There are two errors explained with reasons: ERROR#1: The restocking fee is already set and fixed, so there is no need of setRestockingFee(inNewFee:double) because it will remain all the same throughout.

A real hero Essay Example | Topics and Well Written Essays - 750 words

A real hero - Essay Example These superheroes joined forces (Moore & Gibbons chapter 1:3) after the death of Edward Blake. In accordance to my opinion, I believe that Doctor Manhattan qualifies as the real hero in the comic book as evidenced from being expressed as the main character in the story, he is close to perfection plus he is not a costumed hero. Doctor Manhattan is expressed as the main character in the story. Moore and Gibbons (chapter 3: 5) describe Doctor Manhattan as the character on which other superheroes rely on. Born as normal human beings, but later transformed to a superhero after an accident while conducting a nuclear physics experiment, Doctor Manhattan acquired god-like powers, telekinesis power, superhuman strength, teleportation ability, and control over matter existing at subatomic level. He also has the ability to perceive the present, past and future â€Å"... particles which travel backward through what... *you* perceive as time... therefore obscuring my vision of the present†¦ †(Moore & Gibbons chapter 3: 7). Not any superhero mentioned in the comic book surpassed the powers which Doctor Manhattan possessed hence remaining as the true hero. Among all others superheroes, it is only Doctor Manhattan that is perceived as a close to â€Å"perfection† creation (Moore & Gibbons chapter 4: 6). ... He acts as the leader of the superheroes as he possesses an ability that can only be equated to a god (Moore & Gibbons chapter 4:8). Lauri, Nite Owl, Rorschach, and Veidt are not real heroes as they had powers, but did not surpass that of Doctor Manhattan. In addition, these superheroes usually followed orders from Doctor Manhattan on what to do since they were dependent on his intellect abilities to make decisions on what to do. Doctor Manhattan was a real hero since he was not a costumed hero like the rest of the superheroes like Dan, Laurie and Rorschach. In the comic, other costumed heroes become disturbed when Doctor Manhattan gets picked up by the United States army and kept as the ultimate weapon in case of attack. In addition, he is dubbed as a real super hero making the costumed superheroes more worried of what might become of them (Moore & Gibbons chapter 4:9). Hence, the costumed superheroes more so depended on Doctor Manhattan a lot to make sound decisions. It is via Doct or’s Manhattan intelligence that the military is able to build sophisticated weapons that they could use in fighting their enemies. The costumed superheroes also took advantage of these. In summary, Doctor Manhattan is a real superhero in the comic book as evidenced from his depiction as a main character of which the story is dependent on him. In addition, he is a real hero since he is equated to a perfect being in the sense that he is equated to a god and could not be killed easily like the rest of the superheroes who expressed various weaknesses. Furthermore, Doctor Manhattan is depicted in the comic book as a real hero as evidenced from him being taken by the U.S government army to help them in the fight of their enemies. This did not happen to the other costumed superheroes and at