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Propositional quantifiers are quantifiers binding proposition letters, understood as variables. This Element introduces propositional quantifiers and explains why they are especially interesting in the context of propositional modal logics. It surveys the main results on propositionally quantified modal logics which have been obtained in the literature, presents a number of open questions, and provides examples of applications of such logics to philosophical problems.
Childhood cancer survivors are at increased risk of developing cardiovascular diseases, presenting as the main causes of morbidity and mortality within this group. Besides the usual primary and secondary prevention in combination with screening during follow-up, the modifiable lifestyle factors of physical activity, nutrition, and body weight have not yet gained enough attention regarding potential cardiovascular risk reduction.
Objective:
These practical recommendations aim to provide summarised information and practical implications to paediatricians and health professionals treating childhood cancer survivors to reduce the risk of cardiovascular late effects.
Methods:
The content derives from either published guidelines or expert opinions from Association of European Paediatric and Congenital Cardiology working groups and is in accordance with current state-of-the-art.
Results:
All usual methods of prevention and screening regarding the risk, monitoring, and treatment of occurring cardiovascular diseases are summarised. Additionally, modifiable lifestyle factors are explained, and clear practical implications are named.
Conclusion:
Modifiable lifestyle factors should definitely be considered as a cost-effective and complementary approach to already implemented follow-up care programs in cardio-oncology, which can be actively addressed by the survivors themselves. However, treating physicians are strongly encouraged to support survivors to develop and maintain a healthy lifestyle, including physical activity as one of the major influencing factors. This article summarises relevant background information and provides specific practical recommendations on how to advise survivors to increase their level of physical activity.
It is often assumed, that adult patients with CHD (ACHD) have impairments regarding their cognitive function (CF) and health-related quality of life. In particular, it seems reasonable to assume that cyanosis may have a potential impact on CF as well as surgical or drug treatment into adulthood. This study assesses neuromental health aspects such as CF and health-related quality of life in ACHD patients.
Methods:
Seventy-eight ACHD patients (female n = 39 (50%); 34.1 ± 12.9 years; cyanotic CHD n = 49 (62.8%) with a cyanosis duration of 159.8 ± 196.2 month) who underwent open heart surgery as first intervention were asked to participate during routinely follow-up in 2018. Wechsler Intelligence Scale IV was used for CF and the Short Form 36 Health Survey to assess health-related quality of life.
Results:
Intelligence quotient measures showed significant differences comparing never cyanotic and with a cyanotic phase in verbal comprehension (p = 0.013). There was no association of CF with cyanosis duration, number of surgery or catheter, CHD severity, and time of first surgery. The group of early surgery showed significantly better results in physical function (p = 0.040) of health-related quality of life, and in comparison with their assigned reference, both groups showed significantly reduced results in all domains except in bodily pain and mental health. Full-Scale intelligence quotient correlates with physical function of health-related quality of life.
Conclusions:
The results show normal CF in ACHD. Health-related quality of life was weak in comparison with the reference. There is a need to improve the well-being of our ACHD with structured programmes, including physical activity programmes. This growing ACHD population should be focused in order of their needs, medical ones on one hand and on the other hand psychosocial matters.
Propositional modal logic over relational frames is naturally extended with propositional quantifiers by letting them range over arbitrary sets of worlds of the relevant frame. This is also known as second-order propositional modal logic. The propositionally quantified modal logic of a class of relational frames is often not axiomatizable, although there are known exceptions, most notably the case of frames validating the strong modal logic $\mathrm {S5}$. Here, we develop new general methods with which many of the open questions in this area can be answered. We illustrate the usefulness of these methods by applying them to a range of examples, which provide a detailed picture of which normal modal logics define classes of relational frames whose propositionally quantified modal logic is axiomatizable. We also apply these methods to establish new results in the multimodal case.
Impairments and developmental delay are often reported in infants and young children with CHD. However, currently, there is no data regarding cognitive abilities assessed by standardised intelligence tests in adults with CHD. This study assesses the cognitive function in Fontan patients compared with acyanotic CHD patients whether restrictions in cognitive function are present in adulthood and its association with health-related quality of life.
Methods:
Forty-four adult CHD (female n = 21 (47.7%); mean age 34.7 ± 11.9 years), 22 with Fontan circulation and 22 with acyanotic CHD, underwent the Wechsler Intelligence Scale for adults as patients during routine follow-up in 2018. The Medical Outcomes Study Questionnaire Short-Form 36 Health Survey (SF-36) assessed health-related quality of life.
Results:
Fontan patients showed significantly better results in the FSIQ (p = 0.020) and perceptual reasoning (p = 0.017) in comparison with patients with acyanotic CHD. All adult CHD patients showed normal IQ in subscales and full-scale IQ (FSIQ). In health-related quality of life, no association with cognitive function was found and no significant difference between both CHD groups, but trends to reduced values in acyanotic adult CHD.
Conclusions:
Interestingly, our study results in adult Fontan patients showed that it is possible to live an adult life with normal cognitive function and good health-related quality of life with a univentricular heart. Thus, this study could be a guidepost for more in-depth studies on cognitive function in Fontan survivors. In addition, the focus should be on health-related quality of life of adult CHD with simple CHD in particular, since a reduced health-related quality of life is not only medically based.
The Homa Peninsula has been known to science since 1911, and fossil specimens from the area comprise many type specimens for common African mammalian paleospecies. Here we discuss the fauna and the paleoenvironmental information from the Homa Peninsula. The Homa Peninsula is a 200 km2 area in Homa Bay County, situated on the southern margin of the Winam Gulf of Lake Victoria in Kenya (Figure 29.1). Lake Victoria is estimated to be the third largest lake in the world, with a surface area of 68,900 km2 and a maximum length of approximately 616 km. Although its catchment is extensive, it is relatively shallow compared to any other lake of similar size, with a maximum depth of 84 m. Lake Victoria is located in a depression formed by the western and eastern branches of the East African Rift System (EARS), and is at an average elevation of 1135 m a.s.l. (Database for Hydrological Time Series of Inland Waters, 2017).
Congenital heart defects (CHDs) are the most common congenital malformations. Patients with CHD have a higher morbidity and mortality rate and are at greater risk for infectious diseases. The risk might even be higher if complex CHD occurs and if CHD is associated with additional co-morbidities. Therefore, immunisations in these children are essential.
Materials and Methods:
Individuals were recruited at the outpatient centre of the Department of Congenital Heart Defects and Pediatric Cardiology at the German Heart Center Munich in the time between February 2016 and February 2017. Included were children between 23 months and 17 years and a diagnosis of CHD. The vaccination certificate aimed to assess the immunization status.
Results:
In total, 657 children with CHD were included and analysed. Regarding primary immunisation, only 34 % (n = 221) of the children reached the complete vaccination status within the allowed catch-up time. Among these primary immunisation rates, vaccinations against Hepatitis B, Meningococci, Varicella and Pneumococci were found to have the lowest coverage with all being below 80%. The vaccination rate was partly influenced by the previously performed number of surgeries but not by the diagnosis of specific genetic diseases. At the age of school entry, the immunisation rate in children with CHD was also lower than in the comparable healthy population.
Conclusion:
The vaccination coverage rate in children with CHD is lower than in comparable healthy children, although this is a vulnerable patient group. Further education of parents and treating physicians of children with CHD regarding vaccination is still needed.
Can conjunctive propositions be identical without their conjuncts being identical? Can universally quantified propositions be identical without their instances being identical? On a common conception of propositions, on which they inherit the logical structure of the sentences which express them, the answer is negative both times. Here, it will be shown that such a negative answer to both questions is inconsistent, assuming a standard type-theoretic formalization of theorizing about propositions. The result is not specific to conjunction and universal quantification, but applies to any binary operator and propositional quantifier. It is also shown that the result essentially arises out of giving a negative answer to both questions, as each negative answer is consistent by itself.
Despite evidence for the general effectiveness of psychological therapies, there exists substantial heterogeneity in patient outcomes. We aimed to identify factors associated with baseline severity of depression and anxiety symptoms, rate of symptomatic change over the course of therapy, and symptomatic recovery in a primary mental health care setting.
Methods
Using data from a service evaluation involving 35 527 patients in England's psychological and wellbeing [Improving Access to Psychological Therapies (IAPT)] services, we applied latent growth models to explore which routinely-collected sociodemographic, clinical, and therapeutic variables were associated with baseline symptom severity and rate of symptomatic change. We used a multilevel logit model to determine variables associated with symptomatic recovery.
Results
Being female, younger, more functionally impaired, and more socioeconomically disadvantaged was associated with higher baseline severity of both depression and anxiety symptoms. Being older, less functionally impaired, and having more severe baseline symptomatology was associated with more rapid improvement of both depression and anxiety symptoms (male gender and greater socioeconomic disadvantage were further associated with rate of change for depression only). Therapy intensity and appointment frequency seemed to have no correlation with rate of symptomatic improvement. Patients with lower baseline symptom severity, less functional impairment, and older age had a greater likelihood of achieving symptomatic recovery (as defined by IAPT criteria).
Conclusions
We must continue to investigate how best to tailor psychotherapeutic interventions to fit patients’ needs. Patients who begin therapy with more severe depression and/or anxiety symptoms and poorer functioning merit special attention, as these characteristics may negatively impact recovery.
A formal result is proved which is used in Juhani Yli-Vakkuri's ‘Epistemicism and Modality’ to argue that certain two-dimensional possible world models are inadequate for a language with operators for ‘necessarily’, ‘actually’, and ‘definitely’.
I consider the first-order modal logic which counts as valid those sentences which are true on every interpretation of the non-logical constants. Based on the assumptions that it is necessary what individuals there are and that it is necessary which propositions are necessary, Timothy Williamson has tentatively suggested an argument for the claim that this logic is determined by a possible world structure consisting of an infinite set of individuals and an infinite set of worlds. He notes that only the cardinalities of these sets matters, and that not all pairs of infinite sets determine the same logic. I use so-called two-cardinal theorems from model theory to investigate the space of logics and consequence relations determined by pairs of infinite sets, and show how to eliminate the assumption that worlds are individuals from Williamson's argument.
This article explores the connection between two theses: the principle of conditional excluded middle for the counterfactual conditional, and the claim that it is a contingent matter which (coarse grained) propositions there are. Both theses enjoy wide support, and have been defended at length by Robert Stalnaker. We will argue that, given plausible background assumptions, these two principles are incompatible, provided that conditional excluded middle is understood in a certain modalized way. We then show that some (although not all) arguments for conditional excluded middle can in fact be extended to motivate this modalized version of the principle.
Robert Stalnaker has recently advocated propositional contingentism, the claim that it is contingent what propositions there are. He has proposed a philosophical theory of contingency in what propositions there are and sketched a possible worlds model theory for it. In this paper, such models are used to interpret two propositional modal languages: one containing an existential propositional quantifier, and one containing an existential propositional operator. It is shown that the resulting logic containing an existential quantifier is not recursively axiomatizable, as it is recursively isomorphic to second-order logic, and a natural candidate axiomatization for the resulting logic containing an existential operator is shown to be incomplete.
This article introduces the French philosopher Jean-Luc Nancy to theologians by placing him in critical dialogue with Karl Rahner. It examines how Nancy's deconstruction of Christianity accuses Western reason, including Christianity, of forgetting the body and supporting an ethos of disembodiment. Nancy proposes a new opening of reason (déclosion, “dis-closure”) and a corresponding praxis (“adoration”). This reason and praxis involve an exit from Christianity. Rahnerian essays on matter, spirit, and sacramentality demonstrate that while Christianity has, historically, fallen prey to the pathologies Nancy identifies, it also has thought in terms of something like dis-closed reason and has practiced something like “adoration.” While Nancy's insistence on the need for an exit from Christianity is not necessarily well posed, his deconstruction of Christianity can help Christian theologians as they develop thinking that supports an ethos sensitive to the body—or that keeps the body's sense open.
In this work, we propose a model to quantify strain induced conductordiscontinuities based on measuring electrical resistance while applying tensilestrain to metal-polymer systems. Under strain, changing conductor geometry andinduced conductor discontinuity increase electrical resistance. On Kaptonsubstrates strained to ε = .07, evaporated gold films did notdeform and resistance increase was only caused by geometry change. Conversely,discontinuity caused 31% and 72% of the resistance increase in evaporated andprinted silver films at the same strain. On PDMS substrates, the same magnitudeof discontinuity, causing 31% of the resistance increase, occurred at onlyε = .024 in evaporated silver films. At the same strain,discontinuity caused 86% of the resistance increase in evaporated gold films.Printed silver films were inelastic. The results suggest that traditionalfabrication techniques may be more suitable to flexible hybrid electronicsapplications than additively manufactured conductors.
Cleanliness is a prerequisite for obtaining economically feasible yield levels in the semiconductor industry. For the next generation of lithographic equipment, EUV lithography, the size of yield-loss inducing particles for the masks will be smaller than 20 nm. Consequently, equipment for handling EUV masks should not add particles larger than 20 nm. Detection methods for 20 nm particles on large area surfaces are needed to qualify the equipment for cleanliness. Detection of 20 nm particles is extremely challenging, not only because of the particle size, but also because of the large surface area and limited available time.
In 2002 TNO developed the RapidNano, a platform that is capable of detecting nanoparticles on flat substrates. Over the last decade, the smallest detectable particle size was decreased while the inspection rate was increased. This effort has led to a stable and affordable detection platform that is capable of inspecting the full surface of a mask blank.
The core of RapidNano is a dark-field imaging technique. Every substrate type has a typical background characteristic, which strongly affects the size of the smallest detectable particle. The noise level is induced by the speckle generated by the surface roughness of the mask. The signal-to-noise ratio can be improved by illuminating the inspection area from nine different angles. This improvement was first shown on test bench level and then applied in the RapidNano3. The RapidNano3 is capable of detecting 42nm latex sphere equivalents (and larger) on silicon surfaces. RapidNano4, the next generation, will use 193 nm light and the same nine angle illumination mode. Camera sensitivity and available laser power determine the achievable throughput. Therefore, special care was given to the optical design, particularly the optical path. With RapidNano4, TNO will push the detection limit of defects on EUV blanks to below 20nm.
According to propositional contingentism, it is contingent what propositions there are. This paper presents two ways of modeling contingency in what propositions there are using two classes of possible worlds models. The two classes of models are shown to be equivalent as models of contingency in what propositions there are, although they differ as to which other aspects of reality they represent. These constructions are based on recent work by Robert Stalnaker; the aim of this paper is to explain, expand, and, in one aspect, correct Stalnaker’s discussion.