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Preliminary evidence suggests that a ketogenic diet may be effective for bipolar disorder.
Aims
To assess the impact of a ketogenic diet in bipolar disorder on clinical, metabolic and magnetic resonance spectroscopy outcomes.
Method
Euthymic individuals with bipolar disorder (N = 27) were recruited to a 6- to 8-week single-arm open pilot study of a modified ketogenic diet. Clinical, metabolic and MRS measures were assessed before and after the intervention.
Results
Of 27 recruited participants, 26 began and 20 completed the ketogenic diet. For participants completing the intervention, mean body weight fell by 4.2 kg (P < 0.001), mean body mass index fell by 1.5 kg/m2 (P < 0.001) and mean systolic blood pressure fell by 7.4 mmHg (P < 0.041). The euthymic participants had average baseline and follow-up assessments consistent with them being in the euthymic range with no statistically significant changes in Affective Lability Scale-18, Beck Depression Inventory and Young Mania Rating Scale. In participants providing reliable daily ecological momentary assessment data (n = 14), there was a positive correlation between daily ketone levels and self-rated mood (r = 0.21, P < 0.001) and energy (r = 0.19 P < 0.001), and an inverse correlation between ketone levels and both impulsivity (r = −0.30, P < 0.001) and anxiety (r = −0.19, P < 0.001). From the MRS measurements, brain glutamate plus glutamine concentration decreased by 11.6% in the anterior cingulate cortex (P = 0.025) and fell by 13.6% in the posterior cingulate cortex (P = <0.001).
Conclusions
These findings suggest that a ketogenic diet may be clinically useful in bipolar disorder, for both mental health and metabolic outcomes. Replication and randomised controlled trials are now warranted.
Recent evidence from case reports suggests that a ketogenic diet may be effective for bipolar disorder. However, no clinical trials have been conducted to date.
Aims
To assess the recruitment and feasibility of a ketogenic diet intervention in bipolar disorder.
Method
Euthymic individuals with bipolar disorder were recruited to a 6–8 week trial of a modified ketogenic diet, and a range of clinical, economic and functional outcome measures were assessed. Study registration number: ISRCTN61613198.
Results
Of 27 recruited participants, 26 commenced and 20 completed the modified ketogenic diet for 6–8 weeks. The outcomes data-set was 95% complete for daily ketone measures, 95% complete for daily glucose measures and 95% complete for daily ecological momentary assessment of symptoms during the intervention period. Mean daily blood ketone readings were 1.3 mmol/L (s.d. = 0.77, median = 1.1) during the intervention period, and 91% of all readings indicated ketosis, suggesting a high degree of adherence to the diet. Over 91% of daily blood glucose readings were within normal range, with 9% indicating mild hypoglycaemia. Eleven minor adverse events were recorded, including fatigue, constipation, drowsiness and hunger. One serious adverse event was reported (euglycemic ketoacidosis in a participant taking SGLT2-inhibitor medication).
Conclusions
The recruitment and retention of euthymic individuals with bipolar disorder to a 6–8 week ketogenic diet intervention was feasible, with high completion rates for outcome measures. The majority of participants reached and maintained ketosis, and adverse events were generally mild and modifiable. A future randomised controlled trial is now warranted.
Set theory is a branch of mathematics with a special subject matter, the infinite, but also a general framework for all modern mathematics, whose notions figure in every branch, pure and applied. This Element will offer a concise introduction, treating the origins of the subject, the basic notion of set, the axioms of set theory and immediate consequences, the set-theoretic reconstruction of mathematics, and the theory of the infinite, touching also on selected topics from higher set theory, controversial axioms and undecided questions, and philosophical issues raised by technical developments.
Modern logic emerged in the period from 1879 to the Second World War. In the post-war period what we know as classical first-order logic largely replaced traditional syllogistic logic in introductory textbooks, but the main development has been simply enormous growth: The publications of the Association for Symbolic Logic, the main professional organization for logicians, became ever thicker. While 1950 saw volume 15 of the Journal of Symbolic Logic, about 300 pages of articles and reviews and a six‑page member list, 2000 saw volume 65 of that journal, over 1,900 pages of articles, plus volume 6 of the Bulletin of Symbolic Logic, 570 pages of reviews and a sixty‑page member list. Of so large a field, the present survey will have to be ruthlessly selective, with no coverage of the history of informal or inductive logic, or of philosophy or historiography of logic, and slight coverage of applications. Remaining are five branches of pure, formal, deductive logic, four being the branches of mathematical logic recognized in Barwise 1977, first of many handbooks put out by academic publishers: set theory, model theory, recursion theory, proof theory. The fifth is philosophical logic, in one sense of that label, otherwise called non-classical logic, including extensions of and alternatives to textbook logic. For each branch, a brief review of pre‑war background will be followed by a few highlights of subsequent history. The references will be a mix of primary and secondary sources, landmark papers and survey articles.
Nations love to go to war, argue leftist pacifists in democratic Western societies. By this account, governments cannot resist the temptation to assert their selfish interests by violent means. Political leaders use the language of just war to hide their real intentions: imperialistic domination and economic profit. These pacifists charge that with the Iraq war, the disastrous consequences of such politics have become hideously clear again.
Computability and Logic has become a classic because of its accessibility to students without a mathematical background and because it covers not simply the staple topics of an intermediate logic course, such as Godel's incompleteness theorems, but also a large number of optional topics, from Turing's theory of computability to Ramsey's theorem. This 2007 fifth edition has been thoroughly revised by John Burgess. Including a selection of exercises, adjusted for this edition, at the end of each chapter, it offers a simpler treatment of the representability of recursive functions, a traditional stumbling block for students on the way to the Godel incompleteness theorems. This updated edition is also accompanied by a website as well as an instructor's manual.
This fourth edition of one of the classic logic textbooks has been thoroughly revised by John Burgess. The aim is to increase the pedagogical value of the book for the core market of students of philosophy and for students of mathematics and computer science as well. This book has become a classic because of its accessibility to students without a mathematical background, and because it covers not simply the staple topics of an intermediate logic course such as Godel's Incompleteness Theorems, but also a large number of optional topics from Turing's theory of computability to Ramsey's theorem. John Burgess has now enhanced the book by adding a selection of problems at the end of each chapter, and by reorganising and rewriting chapters to make them more independent of each other and thus to increase the range of options available to instructors as to what to cover and what to defer.
§1. I propose to address not so much Gödel's own philosophy of mathematics as the philosophical implications of his work, and especially of his incompleteness theorems. Now the phrase “philosophical implications of Gödel's theorem” suggests different things to different people. To professional logicians it may summon up thoughts of the impact of the incompleteness results on Hilbert's program. To the general public, if it calls up any thoughts at all, these are likely to be of the attempt by Lucas [1961] and Penrose [1989] to prove, if not the immortality of the soul, then at least the non-mechanical nature of mind. One goal of my present remarks will be simply to point out a significant connection between these two topics.
But let me consider each separately a bit first, starting with Hilbert. As is well known, though Brouwer's intuitionism was what provoked Hilbert's program, the real target of Hilbert's program was Kronecker's finitism, which had inspired objections to the Hilbert basis theorem early in Hilbert's career. (See the account in Reid [1970].) But indeed Hilbert himself and his followers (and perhaps his opponents as well) did not initially perceive very clearly just how far Brouwer was willing go beyond anything that Kronecker would have accepted. Finitism being his target, Hilbert made it his aim to convince the finitist, for whom no mathematical statements more complex than universal generalizations whose every instance can be verified by computation are really meaningful, of the value of “meaningless” classical mathematics as an instrument for establishing such statements.
John Burgess is the author of a rich and creative body of work which seeks to defend classical logic and mathematics through counter-criticism of their nominalist, intuitionist, relevantist, and other critics. This selection of his essays, which spans twenty-five years, addresses key topics including nominalism, neo-logicism, intuitionism, modal logic, analyticity, and translation. An introduction sets the essays in context and offers a retrospective appraisal of their aims. The volume will be of interest to a wide range of readers across philosophy of mathematics, logic, and philosophy of language.
Philosophy is a subject in which there is very little agreement. This is so almost by definition, for if it happens that in some area of philosophy inquirers begin to achieve stable agreement about some substantial range of issues, straightaway one ceases to think of that area as part of “philosophy,” and begins to call it something else. This happened with physics or “natural philosophy” in the seventeenth century, and has happened with any number of other disciplines in the centuries since. Philosophy is left with whatever remains a matter of doubt and dispute.
Philosophy of mathematics, in particular, is an area where there are very profound disagreements. In this respect philosophy of mathematics is radically unlike mathematics itself, where there are today scarcely ever any controversies over the correctness of important results, once published in refereed journals. Some professional mathematicians are also amateur philosophers, and the best way for an observer to guess whether such persons are talking mathematics or philosophy on a given occasion is to look whether they are agreeing or disagreeing.
One major issue dividing philosophers of mathematics is that of the nature and existence of mathematical objects and entities, such as numbers, by which I will always mean positive integers 1, 2, 3, and so on. The problem arises because, though it is common to contrast matter and mind as if the two exhausted the possibilities, numbers do not fit comfortably into either the material or the mental category.