To determine how many elements are in exactly two of four sets, one can apply the principle of inclusion-exclusion. The formula involves calculating the total number of elements in each set, subtracting the intersections of pairs, and adding back intersections of triples, while subtracting the intersection of all four sets. For example, if each set has 28 elements, with specific intersections provided, the cardinality of elements in exactly two sets can be derived by considering the complements of the other sets. The approach requires careful manipulation of set identities and intersections. Ultimately, solving this problem hinges on accurately applying these principles to the specific data provided.