Reading 2025-12 Test 1

Sınav ayı: 2025-12

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Reading Passage 1 — A Brief History of Humans and Food

During the journey from our hunter-gatherer ancestors to the present day, there have been three seismic changes that have impacted the food we eat: the discovery of cooking, the emergence of agriculture, and the invention of methods of preserving food. The 19th-century scientist Charles Darwin thought that cooking, after language, was the greatest discovery made by man. All of us eat some raw food, such as fruit and vegetables, but the great majority of food we consume is cooked. Cooking can turn plants that are inedible into edible food by destroying toxic chemicals that plants often manufacture to protect themselves against attack by insects or other herbivorous animals. These toxic chemicals are referred to as “plant secondary compounds” because they are not directly involved in the plant’s normal growth, development, and reproduction, and are produced purely as chemical defenses. They give many of the plants we consume, such as coffee or Brussels sprouts, their bitter taste. Cooked food is often more digestible because heat breaks down tough cellulose cell walls in plants or tough connective tissue in animals. Chewing raw turnip, a plate of uncooked rice, or a raw leg of lamb is much harder work than eating the cooked equivalent. The energy expended in chewing to break down the tough material is replaced by energy from the fuel used in cooking the food, so the ratio of energy gained to energy expended by the body is greater when food is cooked. Until the development of agriculture, hunter-gatherers spent up to seven hours a day gathering food. This all began to change around 10,500 years ago with the advent of farming, which led to dramatic changes in human societies. People began to create a variety of new tools to aid survival, and in turn, populations increased in size. These changes led to the possibility of specialization of different tasks within society. Around this time, writing became more sophisticated and allowed people to maintain records of the harvest and taxes. Eventually, formalized structures of government were established as people settled in one area. The arrival of agriculture meant that, for the first time, our ancestors had more food than they could eat immediately. This, combined with the seasonality of production, led them to discover methods of preserving food: smoking, drying, adding acid by fermentation, or adding salt. These four methods all share one feature in common— they make the food a more hostile environment for bacteria that can cause it to spoil. They also tend to slow down natural chemical reactions in the food that would cause decay. Although foods today are still preserved in these ancient ways, two more recent methods of preserving food have become more common: canning and freezing. Canning was invented by a Frenchman, Nicolas Appert, in the early 19th century. He sealed food in bottles fabricated from glass and then heated them in boiling water to cook the contents. Appert’s method had great advantages over older methods of food preservation: it could be applied to a wide range of foods, and the flavor and texture were similar to freshly cooked products. His idea was soon copied by an Englishman, Peter Durand. Until this point, containers had been too heavy to be widely used, but Durand produced the first ones which were lightweight and resistant to damage. Two years later, in 1812, two Englishmen, Bryan Donkin and John Hall, started the commercial canning of food, although the real rise in popularity of canning had to wait until the invention of the can opener in 1855. Until then, cans were opened with a chisel and hammer. Canning is an extremely effective way of preserving food: one can containing meat, dating back to 1824, was opened in 1939, and the contents were still in good condition. In the 21st century, the dominance of canning as a method of food preservation has been overtaken by freezing. Chilling food to keep it fresh is an old idea. The earliest mentions of icehouses, thick-walled buildings, half underground, date back to 1700 BC in northwest Iran. In early 16th-century Italy, water was mixed with chemicals to lower its freezing point to -18 degrees Celsius. Several centuries later, frozen fish and other goods were transported by ship from Australia to England. However, the modern frozen food industry was started in the 1920s by an American, Clarence Birdseye. While on a fishing trip with the Inuit in the Canadian Arctic, Birdseye observed that rapid freezing creates smaller ice crystals and therefore causes less damage to food— a discovery he had not expected. Nevertheless, the major growth in demand for frozen food came with the arrival of freezers in ordinary people’s homes. The advantages of frozen over canned food include the fact that the flavor and consistency are often identical to the fresh product, and freezing can be used to preserve a wide variety of foods.

    Questions 1–5: TRUE/FALSE/NOT GIVEN

    Do the following statements agree with the information given in Reading Passage 1? In boxes 1–5 on your answer sheet, write TRUE if the statement agrees with the information, FALSE if the statement contradicts the information, NOT GIVEN if there is no information on this.

    1. 1

      According to Darwin, cooking was the most significant development in human history.

    2. 2

      The process of cooking gets rid of some plant poisons.

    3. 3

      Eating cooked food is more energy efficient than eating raw food.

    4. 4

      Clarence Birdseye had previously worked in the Australian food industry.

    5. 5

      Birdseye’s trip with the Inuit confirmed what he already believed about rapid freezing.

    Questions 6–13: Note Completion

    Complete the notes below. Choose ONE WORD ONLY from the passage for each answer.

    The Development of Agriculture and Food Preservation The changes agriculture brought about were: • the development of equipment and larger 6 ______ • the ability to keep 7 ______ as writing developed • the setting up of organised government Food preservation • early methods of food preservation included: smoking, drying and combining food with acid or 8 ______ • canning – Nicolas Appert put food into containers made of 9 ______ – Appert’s method resulted in preserved food that had the same taste and 10 ______ as fresh food – Peter Durand introduced cans which had the advantage of being 11 ______ and hard to break – In 1855, the metal can opener replaced the 12 ______ which had been used with a hammer to open cans – some food was still found to be edible after more than a hundred years, e.g. an old can of 13 ______ • freezing
    1. 6

      the development of equipment and larger 6 ______

    2. 7

      the ability to keep 7 ______ as writing developed

    3. 8

      early methods of food preservation included: smoking, drying and combining food with acid or 8 ______

    4. 9

      Nicolas Appert put food into containers made of 9 ______

    5. 10

      Appert’s method resulted in preserved food that had the same taste and 10 ______ as fresh food

    6. 11

      Peter Durand introduced cans which had the advantage of being 11 ______ and hard to break

    7. 12

      In 1855, the metal can opener replaced the 12 ______ which had been used with a hammer to open cans

    8. 13

      some food was still found to be edible after more than a hundred years, e.g. an old can of 13 ______

    Reading Passage 2 — Solving the problem of waste disposal

    With the amount of rubbish being produced around the world increasing, Mark Rowe asks whether a new generation of incineration plants can help to solve the problem. A For many years, burning rubbish has been portrayed as the lazy option when it comes to dealing with the problem of waste disposal, since it sends toxic fumes into the air and appears to support a consumerist, throwaway society. Norway, however, appears to be burning its way through a sizeable chunk of Europe’s municipal waste, using the heat created by this process to warm and power homes in many of its cities. Norway isn’t alone: Germany, Sweden, Belgium and the Netherlands all burn significant quantities of rubbish, and across Europe there are 420 plants burning municipal waste. With Europe dumping 150 million tonnes of rubbish into landfill* every year, there would seem to be a limitless supply. B Those who support burning waste say that a new generation of incinerators has made it a more attractive option. Filters and scrubbing mechanisms now capture harmful substances such as mercury, hydrochloric acid and heavy metals. According to Ted Michaels, president of the US-based Energy Recovery Centre, ‘There has been constant evolution in combustion engineering and emissions-control technology, and the output from these facilities is now minuscule.’ Above all, however, supporters say that incineration is the only way of preventing the long-term impacts of landfill. In ten years’ time, says the World Bank, humans will be generating 2.2 billion tonnes of solid waste per year. Advocates see incineration as a practical way to deal swiftly with an immediate problem. C Levels of waste generation vary hugely around the world. ‘It’s a problem for the developed nations,’ says Joergen Fenhann, a senior scientist working with the UN Environment Programme in Denmark. ‘The more you develop, the more you produce, buy and throw away.’ But the growth of incineration hasn’t been universally welcomed. Lars Haltbrekken, chairman of Friends of the Earth in Norway, is concerned that incineration plants appear to generate demand for their services. ‘The problem in Norway,’ he explains, ‘is that we have built too many waste-burning factories. So we’ve ended up importing waste from other countries. If you look at this in a very small perspective, it is, of course, better for the climate to burn rubbish from the UK rather than leave it in landfill there,’ he continues. ‘But in a broader perspective, it’s a lazy way of getting rid of waste; you don’t stimulate the goals of reducing, reusing and recycling.’ D Incineration is also at odds with EU policy, which promotes a ‘recycling hierarchy’: ideally, we simply produce less waste in the first place; failing that, we reuse objects more; the next step is recycling; only then should we consider incineration, while dumping in landfill is the last resort. Dealing with the problem of waste disposal involves tracing the whole process that took the material from its inception to landfill. We used to call this the ‘cradle to grave’ life cycle; now, the talk is of ‘cradle to cradle’ and an even more comprehensive concept known as ‘zero waste’. ‘The philosophy of cradle to cradle is about designing products that are actually good for the environment at the end of their life,’ says Joan Marc Simon, European spokesman for the environmental movement GAIA. ‘You design a bottle that contains no toxins, is fully recyclable and requires the minimum amount of energy to be produced.’ As Simon points out, however, without the right mechanisms in place ‘nothing guarantees that this bottle will end up being properly collected and treated in the appropriate recycling facility’. E Tim Burns, policy manager at Keep Britain Tidy, says, ‘In the UK alone, people waste £10 billion of food every year. You can argue about composting that, or not buying it in the first place — if you do that, then that’s money the retailers don’t get, so it’s not always clear-cut.’ The implications of zero waste are that we’re going to have to take a good long look at those well-stocked supermarket shelves, too. ‘Supermarkets keep their shelves stocked even when demand isn’t there, which means they have to pay to dispose of a lot of food,’ says Burns. ‘But that cost is less to them than the cost in brand damage of having empty shelves.’ F Recent history and changes in trends in recycling suggest that we should be prepared for unexpected developments. ‘If someone back in the 1980s had suggested what waste would be like now, they would be completely wrong,’ says Richard Fisher, a PhD researcher at Cranfield University. ‘Consumerism has developed at a pace we never expected. Nobody would have said there would be so much electronic waste. But recycling has grown, too — ten years ago nobody would have predicted today’s levels of recycling.’ But he points out that the need to reduce waste is still a difficult message to sell to consumers. He suggests that what people are really concerned about is their loved ones and the future they face. ‘Perhaps we can align the environmental message to these deep-seated values,’ he says. ‘We need to look at whether it’s business that drives consumers or the other way around. You need government to play a leadership role, whereas countries such as the UK seem to be stepping away from the environment in pursuit of short-term economic goals. *landfill: a method of disposing of waste material by burying it

      Questions 14–19: Matching Headings

      Reading Passage 2 has six paragraphs, A–F. Choose the correct heading for each paragraph from the list of headings below.

      List of headings i New terminology reflecting changing attitudes to waste disposal ii Fundamental changes in behaviour in the past and future iii Ways of rewarding the public for recycling iv A surprising approach to waste disposal by several countries v Difficult choices for individuals and businesses vi Arguments against incineration from a country that uses it vii A number of justifications for the use of incineration
      1. 14

        Paragraph A

      2. 15

        Paragraph B

      3. 16

        Paragraph C

      4. 17

        Paragraph D

      5. 18

        Paragraph E

      6. 19

        Paragraph F

      Questions 20–23: Matching

      Look at the following people (Questions 20–23) and the list of opinions below. Match each person with the correct opinion, A–G.

      List of Opinions A. Incineration does not encourage responsible attitudes to waste disposal. B. Recycling can sometimes create serious problems for the future. C. Greater consumerism leads to higher levels of waste. D. Proper systems are needed for the recycling of environmentally-friendly products. E. Landfill is better for the environment than incineration. F. Incineration of waste is now relatively harmless to the environment. G. Efforts to reduce waste may affect profits for some types of companies.
      1. 20

        Ted Michaels

      2. 21

        Joergen Fenhann

      3. 22

        Joan Marc Simon

      4. 23

        Tim Burns

      Questions 24–26: Summary Completion

      Complete the summary below. Choose ONE WORD ONLY from the passage for each answer.

      What recent history tells us about recycling Richard Fisher, a researcher from Cranfield University, points out that the pace of consumerism has increased more quickly than was predicted in the 1980s. There has, for example, been unexpected growth in waste from 24 ________ products. He suggests that the need to protect the environment should be linked to basic values, and adds that it might be better if consumers had more influence over 25 ________ and more direction was provided by 26 ________.
      1. 24

        There has, for example, been unexpected growth in waste from 24 ________ products.

      2. 25

        He suggests that the need to protect the environment should be linked to basic values, and adds that it might be better if consumers had more influence over 25 ________

      3. 26

        and more direction was provided by 26 ________.

      Reading Passage 3 — Clinical Trials

      A. The benefits of vitamins to our well-being are now familiar to most; however, when the link between diets lacking in citrus fruits and the development of the affliction ‘scurvy’ in sailors was first discovered by James Lind in 1747, the concept of vitamins was yet to be discovered. Scurvy, which causes softening of the gums, oral bleeding and, in extreme cases, tooth loss, is now known to present as a result of lack of Vitamin C in the diet. Additional symptoms include depression, liver spots on the skin – particularly arms and legs – loss of colour in the face and partial immobility; high incidence of the ailment aboard ships took an enormous toll on the crew’s ability to complete essential tasks while at sea. B. Suggestions that citrus fruit may lower the incidence or indeed prevent scurvy had been made as early as 1600. It was Lind, however, who would conduct the first clinical trial by studying the effect within scientific experimental parameters. However, while the correlation between consuming citrus fruit and avoidance of scurvy was established, the preventative properties were attributed to the presence of acids in the fruit and not what would later be identified as vitamin content. C. Lind’s subjects for his trial consisted of twelve sailors already exhibiting symptoms of scurvy. These individuals were split into six groups; each pair common diet. Pair 1 were rationed a daily quart of cider, pair 2 elixirs of vitriol, pair 3 a given quantity of vinegar, pair 4 seawater, pair 5 oranges and a lemon and pair 6 barley water. Despite the trial having to be aborted after day five, when supplies of fruit were depleted, the findings of the interventional study showed that only the control group who were given fruit supplements showed any significant improvement in their condition (one had, in fact, recovered to the extent that he was fit enough to return to work). The immediate impact on sailors’ health and incidence of scurvy on board ship was, however, limited as Lind and other physicians remained convinced that the curative effect was acid-based. Therefore, while the consumption of citrus fruit was recommended, it was often replaced by cheaper acid supplements. The preventative Qualities of citrus fruit against scurvy were not truly recognized until 1800, though throughout the latter part of the 1700s, lemon juice was increasingly administered as a cure for sailors already afflicted. D. Nowadays, the implementation of findings discovered in clinical trials into mainstream medicine remains an arduous and lengthy process and the clinical trials themselves represent only a small stage of the process of developing a new drug from the research stage to launch in the marketplace. On average, for every thousand drugs conceived, only one of the thousand actually makes it to the stage of the clinical trial, other projects being abandoned for a variety of reasons. Stages that need to be fulfilled prior to a clinical trial – where the treatment is actually tested on human subjects – include discovery, purification, characterization and laboratory testing. E. A new pharmaceutical for the treatment of a disease such as cancer typically takes a period of 6 years or more before reaching the stage of a clinical trial. Since legislation requires subjects participating in such trials to be monitored for a considerable period of time so that side-effects and benefits can be assessed correctly, a further eight years typically passes between the stage of a drug entering clinical trial and being approved for general use. One of the greatest barriers to clinical trial procedures is the availability of subjects willing to participate, Criteria for selection is rigorous and trials where subjects are required to be suffering from the disease in question, experience tremendous recruitment difficulties as individuals already vulnerable due to the effects of their condition, are often reluctant to potentially put their health at higher levels of risk. F. Clinical trials are conducted in line with a strict protocol and the stages of a trial are generally defined by five distinct phases. A drug that is deemed safe and effective enough to reach the end of stage three is most often, at that point, approved for use in mainstream medicine. Phase 0 involves a first-in-human trial (usually conducted using a small population often to fifteen subjects) with the purpose of ascertaining that the drug’s effect is, in fact, the same as predicted in pre-clinical studies. If no concerns have raised, the drug then enters Phase 1 of trial where a modest selection (usually between twenty and eighty subjects) of usually healthy volunteers, is exposed to the drug. However, for HIV and cancer drugs, this stage is conducted using patients suffering from the condition in question. There are two main variations of Phase I testing, these being SAD (single ascending dose) and MAD (multiple ascending doses). The former involves a single administration of a drug at a pre-determined level to one group of subjects, and the second involves the administration of a pre-determined sequence of dosages. G. Phases 0 and 1 have geared towards establishing the safety of pharmaceutical and once this has been confirmed, drugs pass into Phase II testing where, while safety continues to be monitored, the drug’s effectiveness is also assessed using a larger group of subjects, ranging from twenty up to three hundred. In some trials, Phase II has regarded as involving two sub-stages, in that Phase 11(a) may be concerned with establishing optimum dosage levels and Phase 11(b) to evaluate effectiveness. Phase III is the most expensive, time-consuming and complex stage of the trial process, often involving as many as 3000 patients. At this stage, a new drug’s effectiveness is rigorously tested and compared to that of the best of the existing alternatives already approved and in common use. Where research indicates that a pharmaceutical has passed all requirements of Phases 0, I, II and III, submissions to relevant regulatory and licensing bodies have then made. H. The final phase of clinical testing, Phase IV, is conducted over a lengthy period of time post-launch for general usage. This stage is, in essence, a safety net which involves continuous monitoring of the drug, its properties and side-effects through which any long term adverse reactions, which remained undetected in the pre-launch clinical testing time frame can be discovered. Identification of harmful effects at this stage, on occasion, has led to the withdrawal of a drug from the market; for example, as was the case with cerivastatin, a cholesterol-lowering drug. which had later found to have an adverse effect on muscle reaction which, on occasion, had fatal consequences.

        Questions 27–31: Short Answer

        Choose NO MORE THAN TWO WORDS from the passage for each answer.

        1. 27

          Although James Lind is credited with the first clinical trial, the actual cause of scurvy was ………………. at that time.

        2. 28

          In advanced cases of scurvy suffers may experience………………. along with numerous other symptoms.

        3. 29

          Fruit adds had mistakenly heralded as having………………. in incidents of scurvy prior to the identification of vitamins.

        4. 30

          Lind’s subjects for the first clinical trial were seamen who were at the time of ………………. the condition in question.

        5. 31

          All groups in Lind’s experiment were given a………………. along with specific rations which had varied for each control group.

        Questions 32–35: Multiple Choice

        Choose the correct letter A, B, C or D.

        1. 32

          The first clinical trial had conducted for only 5 days because

          • A. that period of time was the planned protocol.
          • B. the subjects in the relevant control group had already recovered.
          • C. resources fundamental to the experiment had used up.
          • D. those taking part in the trial were too sick to continue.
        2. 33

          The impact of findings from the trial had not used to full potential because

          • A. Lind failed to recommend the consumption of citrus fruit.
          • B. ineffective substitutes had often made available.
          • C. other physicians were unconvinced by his evidence.
          • D. the trial was not conducted over a long enough period to be valid.
        3. 34

          One of the greatest hindrances to clinical testing today is

          • A. low volunteer rates.
          • B. the poor success rate.
          • C. the strict protocol.
          • D. shortage of laboratory staff.
        4. 35

          Clinical testing for HIV and cancer drugs differs from usual procedures because

          • A. the clinical trial phase is much longer.
          • B. the MAD instead of the SAD approach has used during Phase I.
          • C. subjects exhibiting no symptoms of the illness are not used.
          • D. effectiveness is more rigorously tested than safety.

        Questions 36–40: Summary Completion

        Choose ONE WORD ONLY from the passage for each answer.

        Phases of Clinical Testing 10-15 subjects tested to confirm assumptions made in the 36 ______ stages were accurate. • 2 different approaches may be used. One involving one-off exposure to the drug the other involving a 37 ______ May involve two sub-stages to establish 38 ______ quantities and usefulness. The most 39 ______, protracted and costly of all stages. Submissions made post-testing at this stage of all is agreeable. • Precautionary monitoring continues post-launch. Any serious issues uncovered can, on occasion, result in 40 ______
        1. 36

          10-15 subjects tested to confirm assumptions made in the 36 ______ stages were accurate.

        2. 37

          One involving one-off exposure to the drug the other involving a 37 ______

        3. 38

          May involve two sub-stages to establish 38 ______ quantities and usefulness.

        4. 39

          The most 39 ______, protracted and costly of all stages.

        5. 40

          Any serious issues uncovered can, on occasion, result in 40 ______

        Cevap anahtarını göster

        Cevap anahtarı

        1. 1. FALSE

          This is FALSE because Darwin thought cooking was the greatest discovery after language, not the most significant overall: 'Darwin thought that cooking, after language, was the greatest discovery made by man.'

        2. 2. TRUE

          This is TRUE because cooking destroys toxic chemicals in plants: 'Cooking can turn plants that are inedible into edible food by destroying toxic chemicals that plants often manufacture.'

        3. 3. TRUE

          This is TRUE because cooked food gives more energy than raw food: 'the ratio of energy gained to energy expended by the body is greater when food is cooked.'

        4. 4. NOT GIVEN

          NOT GIVEN because there is no information about Birdseye working in the Australian food industry.

        5. 5. FALSE

          This is FALSE because Birdseye discovered something he had not expected: 'a discovery he had not expected.'

        6. 6. populations

          The answer is 'populations' because the passage says, 'populations increased in size' after the advent of farming and new tools.

        7. 7. records

          The answer is 'records' because writing allowed people to 'maintain records of the harvest and taxes.'

        8. 8. salt

          The answer is 'salt' because early methods included 'smoking, drying, adding acid by fermentation, or adding salt.'

        9. 9. glass

          The answer is 'glass' because Appert 'sealed food in bottles fabricated from glass.'

        10. 10. texture

          The answer is 'texture' because Appert's method kept 'the flavor and texture... similar to freshly cooked products.'

        11. 11. lightweight

          The answer is 'lightweight' because Durand made cans 'which were lightweight and resistant to damage.'

        12. 12. chisel

          The answer is 'chisel' because cans were opened 'with a chisel and hammer' before the can opener.

        13. 13. meat

          The answer is 'meat' because 'one can containing meat, dating back to 1824, was opened in 1939, and the contents were still in good condition.'

        14. 14. iv

          The answer is 'iv' because Paragraph A is about the discovery of vitamins and scurvy, matching 'Discovery of the link between diet and disease.'

        15. 15. vii

          The answer is 'vii' because Paragraph B describes Lind's clinical trial, matching 'The first clinical trial.'

        16. 16. vi

          The answer is 'vi' because Paragraph C explains the details and results of Lind's experiment, matching 'Details of the experiment and its results.'

        17. 17. i

          The answer is 'i' because Paragraph D discusses the process and stages before clinical trials, matching 'The stages before clinical trials.'

        18. 18. v

          The answer is 'v' because Paragraph E talks about the time and difficulties before a drug is approved, matching 'The time and challenges before approval.'

        19. 19. ii

          The answer is 'ii' because Paragraph F describes the phases of clinical trials, matching 'The phases of clinical trials.'

        20. 20. F

          The answer is 'F' because Ted Michaels is quoted in Paragraph B: 'According to Ted Michaels, president of the US-based Energy Recovery Centre...'

        21. 21. C

          The answer is 'C' because Joergen Fenhann is mentioned in Paragraph C: 'It's a problem for the developed nations,' says Joergen Fenhann...'

        22. 22. D

          The answer is 'D' because Joan Marc Simon is quoted in Paragraph D: 'says Joan Marc Simon, European spokesman for the environmental movement GAIA.'

        23. 23. G

          The answer is 'G' because Tim Burns is quoted in Paragraph E: 'Tim Burns, policy manager at Keep Britain Tidy, says...'

        24. 24. electronic

          The answer is 'electronic' because the passage says, 'Nobody would have said there would be so much electronic waste.'

        25. 25. business

          The answer is 'business' because the passage says, 'We need to look at whether it's business that drives consumers or the other way around.'

        26. 26. government

          The answer is 'government' because the passage says, 'You need government to play a leadership role.'

        27. 27. undiscovered / to be discovered

          The answer is 'undiscovered / to be discovered' because the passage says, 'the concept of vitamins was yet to be discovered.'

        28. 28. tooth loss

          The answer is 'tooth loss' because the passage says, 'in extreme cases, tooth loss.'

        29. 29. preventative properties

          The answer is 'preventative properties' because the passage says, 'the preventative properties were attributed to the presence of acids in the fruit.'

        30. 30. exhibiting symptoms

          The answer is 'exhibiting symptoms' because Lind's subjects were 'twelve sailors already exhibiting symptoms of scurvy.'

        31. 31. common diet

          The answer is 'common diet' because 'each pair [had a] common diet.'

        32. 32. C

          The answer is C because the trial stopped after five days 'when supplies of fruit were depleted,' meaning resources were used up. Option B is tempting but the passage clearly says the reason was running out of fruit, not recovery.

        33. 33. B

          The answer is B because 'the curative effect was acid-based... it was often replaced by cheaper acid supplements,' so ineffective substitutes were used. Option C is tempting, but the main reason was the use of substitutes, not just disbelief.

        34. 34. A

          The answer is A because 'One of the greatest barriers to clinical trial procedures is the availability of subjects willing to participate,' meaning low volunteer rates. Option B is tempting, but the passage focuses on recruitment, not success rate.

        35. 35. C

          The answer is C because for HIV and cancer drugs, 'this stage is conducted using patients suffering from the condition,' so healthy subjects are not used. Option B is tempting, but the passage does not say MAD is always used for these drugs.

        36. 36. pre-clinical

          The answer is 'pre-clinical' because Phase 0 is to confirm assumptions made in the 'pre-clinical studies.'

        37. 37. sequence

          The answer is 'sequence' because MAD involves 'the administration of a pre-determined sequence of dosages.'

        38. 38. optimum

          The answer is 'optimum' because Phase II(a) is 'concerned with establishing optimum dosage levels.'

        39. 39. complex

          The answer is 'complex' because Phase III is described as 'the most expensive, time-consuming and complex stage of the trial process.'

        40. 40. withdrawal

          The answer is 'withdrawal' because 'Identification of harmful effects at this stage, on occasion, has led to the withdrawal of a drug from the market.'