Splicing dual-range EELS spectra: Identifying and correcting artefacts.

This article focuses on rater severity and consistency and their relation to major changes in the rating system in a high-stakes testing context. The study is based on longitudinal data collected from 2009 to 2019 from the second language (L2) Finnish speaking subtest in the National Certificates of Language Proficiency in Finland. We investigated whether rater severity and consistency changed over that period and whether the changes could be explained by major changes in the rating system, such as the change of lead examiner, the modus of rating and training (on-site or remote), and the composition of the rater group. The data consisted of 45 rating sessions with 104 raters and 59,899 examinees and were analysed using the many-facet Rasch model and generalized linear mixed models. The analyses indicated that raters as a group became somewhat more lenient over time. In addition, the results showed that the rater community and its practices, the lead examiners, and the modus of rating and training can influence rating behaviour. Finally, we elaborate on implications for both research and practice.

Birth and succession of a current of learning in Korean medicine: the supporting yang current of learning

Gynecology teaching frameworks in Canada amid the transition to competence by design

To prevent wide-area disturbances, and enhance power system reliability, various forms of system protection scheme (SPS) have been designed and implemented by utilities. One of the main concerns in SPS deployment is to ensure that the system will fit with the reliability requirement specification in terms of dependability, and security. After major changes in system operating practices, or physical changes of the protected system, a refinement of the SPS decision process may be required. This paper uses a currently operational SPS as an example to demonstrate a refinement study. By incorporating an interval theory, a risk reduction worth importance concept, and a probabilistic risk-based index, the proposed procedure conducts parameter uncertainty analysis, identifies critical factors in the reliability model, performs risk assessments, and determines a better option for the refinement of the studied SPS decision process logic module.

Becoming sustainable is no longer an option. Current industry methods will not be able to support the necessary changes our growing society demands. In order to keep up with ever increasing demands industry will be aimed toward making major system changes toward a fully sustainable model. As of right now only basic sustainability actions have been put in place. Industry needs to make a strategic change toward resilient systems with an end goal of evolving into fully biomimic systems. This thesis covers a brief history of production leading to the Industrial Revolution which created a need for increased sustainability efforts. The Environmental Movement was started in hopes of creating these changes and is extensively studied in this thesis logically leading up to industry’s current sustainable actions. A discussion of widely applied sustainability methods helps to describe a need for a framework that will help move industry toward increased resiliency. The culmination of this thesis is the creation of a three-piece framework for change, called RISE (Reshaping Industry Sustainably Efforts). This framework is the product of extensive research into current sustainability efforts, collected survey results, and the need to increase understanding of resilience and biomimicry from an applied system perspective.

As an afterword to the special issue of JMEMS “Performance beyond Drama,” this essay reflects on the complex ways that premodern performances and their embodied actors are captured in, mediated by, or dependent on the texts that we use to study them, and on the special importance of examining this process across a temporal framework—the fifteenth to eighteenth centuries—that challenges the periodizing schema of modernity. In particular, three major systemic changes impacted European performance practices and their documentation during this era: the more widespread availability and manufacture of paper, which made writing easier and reading cheaper, coupled with the introduction of print technology after 1455; the upheaval of the Protestant Reformation and its Catholic counterpart, and the bloody aftermath of religious wars, persecutions, and witch hunts that (re)shaped performance traditions; and the commodification and policing of entertainment through enclosure and regulation. Taken together, this special issue's contributions reveal fascinating convergences and continuities in performance across the medieval/modern frontier, while also showing how some medieval practices were made to conform with postmedieval political and religious projects, thereby obscuring or blurring the evidence for those earlier practices.

ObjectiveTo describe the characteristics of emergency department (ED) visits for motor vehicle injuries in Utah using 2016 syndromic surveillance data.IntroductionMotor vehicle injury is the leading cause of death in injury category in the United States. In 2016, motor vehicle crashes were one of the main causes of death resulting from injury (8.8 per 100,000 population) in Utah. Motor vehicle crashes can lead to physical and economic consequences that impact the lives of individuals and their families. In addition, the treatment of injuries places an enormous burden on hospital Emergency Departments (EDs). Currently; there are no data sources other than syndromic data in the Utah Department of Health to monitor ED visits due to motor vehicle injuries in real time.MethodsUtah participates in the National Syndromic Surveillance Program (NSSP) to which all hospitals in the state submit ED visit data via the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE). ESSENCE was used to analyze 2016 ED visit data. Total population data were obtained from Utah population estimates. Data from 2017 was not included due to major system changes at a major healthcare system that interrupted data feeds resulting in lower than expected data volume.Motor vehicle injury is defined by existing subsyndrome definition in the Centers for Disease Control and Prevention ESSENCE system. All ED visit data were analyzed by querying key terms in the chief complaint field including any mention of: vehicle, wheeler, motorcycle, motor scooter, motor cycle, motor cross, truck, motorbike etc. Exclusion terms included any mention of: car dealership, hit head and car door. Ages were divided into seven groups for data distribution and comparison: 0–17, 18–24, 25–34, 35–44, 45–54, 55–64 and ≥ 65 years.ResultsIn 2016, a total of 28,472 ED visits (2% of total visits) were identified using the motor vehicle injury query. The ED visit rate for motor vehicle injuries was highest among persons aged 18–24 years (1,682 per 100,000 population). Rates continued to decline with increasing age after 18–24 years. The rate of females visiting the ED was higher than males (1,040 versus 826 per 100,000 population respectively; p < 0.01) (Figure 1). The majority of injuries (11722(52%)) were reported between 10:00 a.m. and 5:59 p.m. Injuries were highest August-September (5913(22%)).ConclusionsSyndromic data is a robust source of data for analyzing ED visits due to motor vehicle injuries in real time, and providing information to injury prevention programs for targeting interventions. Our data suggest an increased risk of visiting an ED due to motor vehicle injuries by age group (18-24 year olds), sex (females), month (August-September), and time (10:00 a.m. to 5:59 p.m.). These results do not include visits with incomplete or incorrectly coded chief complaints or discharge codes, patients of motor vehicle injuries who do not present to the ED, or not classified as ‘emergency’ patient class.

This chapter addresses the general readership of this book, not only the specialist in comparative systems and socialist economies; therefore, it cannot avoid including information known to the experts. It focuses on phenomena that prevailed throughout the 1968–1985 period and characterize the present state of affairs, with only occasional backward glances. The Hungarian economy has undergone major systemic changes in the past thirty years. The impact of the reform is felt by every Hungarian citizen. The influence of the Hungarian experience, however, does not stop at the borders of this small Eastern European country. Reform is a notion used widely by many parties and political movements all over the world. The modernization of a highly bureaucratic regulation of the economy with the aid of computers is not “reform.”

: This report describes the design of the Impulse architecture and shows how an Impulse memory system can be used in a variety of ways to improve the performance of data-intensive applications. The Impulse design does not require any modification to processor, cache, or bus designs - all novel hardware functionality resides at the memory controller. As a result, Impulse optimizations can be adopted in conventional systems without major system changes. Impulse can be used to: (1) dynamically create superpages cheaply, (2) dynamically recolor physical pages, to perform strided fetches, (3) perform gathers and scatters through indirection vectors, and (4) dynamically gather cache lines from randomly dispersed data. Impulse improved the performance of six DARPA Data Intensive System (DIS) program Stressmarks from 1 .25X to 16X (or 470X in the case of in-place CornerTurn, which was unusually well-suited for Impulse). Impulse sped up the twenty-two programs in the benchmark suite by a geometric mean of 2.4X on 2002-class hardware, and 3.3X on 2007-class hardware. In addition to its applicability for data-intensive applications, Impulse can also be used by the OS for dynamic superpage creation, which is useful for arbitrary applications.

Looking back on the experience of transition, based on the case study of Slovenia, this article argues that the transformation of the labour market was a major area of transition. It therefore focuses on the topic of the relationship between output, employment, unemployment and inactivity of labour in a transition country. The transition period is from 1980 to 2006. The averages for the whole period 1980–2006 conceal too much. The whole transition period is divided into two sub-periods: the period of the transition crisis and the period of transitional rehabilitation. The thesis is that there were important differences between the two sub-periods as far as the labour market is concerned. Okun's relationships about the responses of employment and unemployment to output changes are valid during both sub-periods. Empirical estimates of the Beveridge relationship and job-matching function do not differ significantly for the first period compared with the second. The conclusion would be that the labour market responded normally during the transition and that the official statistical data do not reflect major systemic changes that the labour market has supposedly experienced during transition.

If the consonants of Older Scots present us with a relatively uncomplicated orthographic system, the Older Scots vowels are a different matter. The geographical and chronological variations we find among different accents of Scots are largely a matter of differing vowel sounds: vowels change more than consonants do, over space and time. In this chapter, we consider why vowels are generally less stable than consonants, sketch out the major systemic changes in the vowel system over the Older Scots period, and explore how the variable and changing systems of pronunciation mapped onto the Older Scots vowel graphemes. The most thorough discussion of this topic is in Aitken and Macafee (2002), and this chapter largely offers a synopsis of the much more extensive descriptions found there. A briefer account is given in Smith (2012: 29–33). Other relevant studies that have informed the content of this chapter include Aitken (1977), Johnston (1997a), Lass (1999) and Macafee and Aitken (consonant

Occupational therapy's core values and founding beliefs reflect a commitment to the attainment of a self-directed life that enables full community participation. The reality that this desired outcome remains unattainable for millions of persons with disabilities due to the institutional bias of current public policies cannot be ignored. The Supreme Court's landmark Olmstead decision provides a judicial mechanism to right this fundamental injustice. The executive branch's response to the Olmstead decision, the New Freedom Initiative (NFI), offers the potential to finally end the societal segregation of persons with disabilities. Occupational therapy practitioners share a moral collective responsibility to advocate for the major systemic changes that will be needed to fully implement the NFI and achieve the promise of the Olmstead decision. By joining with the disability rights movement, occupational therapy practitioners can become effective activists to help persons with disabilities attain full participation in life.

Hypervelocity Wind Tunnel No. 9, located at the White Oak, MD site of the Arnold Engineering Development Complex (AEDC), has long been recognized as a unique world class ground-test facility. The facility was developed in the early 1970s to provide critical low-altitude, high Mach number data in support of the Navy's reentry development programs. Since its inception, Tunnel 9 has maintained a leading role in hypersonic ground testing by continually expanding its operational capabilities to match the needs of current and projected programs, maintaining data quality, and understanding customer requirements. Tunnel 9 started with a unique design built around a state-of-the-art supply heater that provided a clean, high-pressure, high-temperature nitrogen supply. Initial operation of Tunnel 9 realized a Mach 10 and 14 aerodynamic simulation capability. Additional Mach 7 and 8 high Reynolds number capabilities were subsequently developed. Each upgrade to Tunnel 9 during the past 40 years of operation has been in response to various sponsors or hypersonic basic research requirements. These capability enhancements have helped maintain Tunnel 9's position as a core DoD hypersonic test and evaluation (T&E) ground-test facility, which has been identified as a leading facility in all major hypersonic facility studies. Recent improvements and modernization over the past 10 years have focused on test article measurements and have significantly changed the types, quantity, and quality of test data that are readily acquired in a Tunnel 9 test entry. Recent advancements include major system changes such as a completely new control room and high-speed data system to entirely new measurement capabilities such as global heattransfer measurements using Temperature Sensitive paint technology. These along with other incremental improvements have allowed Tunnel 9 to provide new insights into the physics associated with complex hypersonic flows.

BackgroundOnline postal self-sampling (OPSS) allows service users to screen for sexually transmitted infections (STIs) by ordering a self-sampling kit online, taking their own samples, returning them to a laboratory for testing, and receiving their results remotely. OPSS availability and use has increased in both the United Kingdom and globally the past decade but has been adopted in different regions of England at different times, with different models of delivery. It is not known why certain models were decided on or how implementation strategies have influenced outcomes, including the sustainability of OPSS in sexual health service delivery.ObjectiveThis study aims to evaluate the implementation of OPSS in 3 case study areas of England, with a focus on the sustainability of implementation and the relationship between implementation strategies and outcomes.MethodsQualitative data collection methods were used: interviews with staff and stakeholders involved in the implementation and delivery of OPSS, analysis of local implementation and national policy documents, and observations in sexual health clinics. Analysis of interviews and observations was undertaken using qualitative implementation science frameworks, including normalization process theory, the Consolidated Framework for Implementation Research, and the major system change framework. Documentary sources were used primarily to map processes over time and triangulate against interview and observational evidence.ResultsAcross the 3 case study areas, 60 staff and stakeholders were interviewed, 12 observations were conducted, and data from 86 documents were collated. Rather than being a discrete digital health intervention, we found that OPSS was part of—or occurred parallel to—major system changes in all areas. These changes were driven by budgetary pressures in all areas, but there was variation in other objectives used to rationalize the decision to adopt. The financial context and organizational relationships in each area determined the implementation strategies available to decision makers, how these strategies were enacted, and, in turn, led to different outcomes at different time points. OPSS implementation was not a one-off outcome but an ongoing process in response to changes in context, which in turn affected how staff perceived and engaged with OPSS. The COVID-19 pandemic had profound but divergent effects on OPSS implementation in each area, accelerating it in some contexts and reversing it in others.ConclusionsIn this multisite case study, OPSS implementation was part of systems change to address a wider problem of insufficient funding to deliver sexual health care. Decisions about implementing OPSS were made before sufficient evidence was available to effectively guide the process. The resultant unintended consequences need acknowledgment to enable future commissioners and sexual health services to optimize sexual health service provision.International Registered Report Identifier (IRRID)RR2-10.1136/bmjopen-2022-067170

Multi-omics analysis of the effects of dietary changes and probiotics on diet-induced obesity