11.   One hopeful sign is that some Chinese intellectuals are themselves standing up to call for systemic change.

12.   Still, systemic changes will have to be made in the European economy to place the euro on a sounder base.

13.   That the cardinals are talking about purging gay men instead of confronting the need for systemic change suggests a profound misunderstanding of the crisis at hand.

14.   The report might have caused the Navy to delve into the underlying causes of the crash, making systemic changes where needed and disciplining the commanders who were responsible.

15.   The state rejected his offer to settle for systemic changes.

16.   Thus, in conversations about what motivates them to get into philanthropy, they often tend to speak about the need for systemic change.

17.   To be sure, not all analysts see systemic changes at work.

18.   To respond, chief executives have begun a delicate two-step intended to answer their critics and still defeat efforts at systemic change.

19.   Without systemic change, the realignment of any single segment of the health care industry would serve no one but the lobbyists with the deepest pockets.