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DIRECTIONS: Complete the sentences using the words in the box. accountable dynamics initially initiative innovation instability intervention investment outlier productivity The hospital will release him from intensive care when they think he will be able to survive without the help of medical ____________________. [BLANK-1]

DIRECTIONS: Choose the best answer for each question. Goalkeepers for the Planet [A] In 2015 at the United Nations, world leaders adopted 17 Sustainable Development Goals aimed at reducing poverty, inequality, and other global problems by 2030. Such objectives have long been championed by philanthropists 1 Bill and Melinda Gates. In 2017, the Gates Foundation launched Goalkeepers, an initiative to spur action 2 and track progress toward the UN goals. Its 2018 status report says there have been “mind-blowing improvements in the human condition.” The report also calls for more investment and innovation to ensure this progress continues. [B] Susan Goldberg, editor-in-chief of National Geographic Magazine, met with Bill and Melinda Gates for a joint interview on the report, which was released to the public on September 18, 2018. [C] I’ve just read the Goalkeepers report. Why did you decide to start doing this? Melinda Gates: Because we think that the news isn’t really out there – the news that the world has made this incredible progress, this increase in lives saved, the reduction in poverty. The UN set these amazing goals for the future to help us continue to reduce poverty, and we want to make sure that we hold people accountable for that progress and really inspire the next generation of leaders who are going to take these tasks on. [D] What are you seeing in different countries? Who’s doing a great job? Bill Gates: Even a very poor country can do a good job on health, can do a good job on agriculture, on education, and that provides a lot of hope because you can copy what’s being done there. Rwanda has been a big outlier in the quality of health services. Ethiopia, on agriculture, is growing over 5 percent a year. In education, Vietnam is one we talk about because they’re so far ahead of where you’d expect given their wealth. But it’s when you get those three things together – health, education, agriculture – that eventually these countries can become self-sufficient. [E] MG: One of the things that’s also encouraging: Rwanda is a very small country [in population], Ethiopia is the second largest on the continent of Africa – but they have learned the lessons of what has helped people make progress from around the world. So they’re looking at what happened in Asia in agriculture, how did Brazil decrease the stunting 3 rate [among malnourished children] so phenomenally across a very large country with lots of poverty. [F] When you think about learning from one another, I was struck by the example from Vietnam, where you’ve got 15-year-olds who are doing as well on international tests in school as people from the United Kingdom or from the United States. What are the lessons from Vietnam that can translate across other countries? BG: It’s a really new thing to try and get into the amount of learning. The agenda for poor countries up until now has largely been to get the kids into school – and attendance rates have gone up a lot, for girls and boys. The biggest missing piece still is how much knowledge they’re gaining. A few countries, by training the teachers the right way and bringing the right material into the classroom, have really achieved learning way beyond what you might expect. [G] MG: When you look back at the UN goals that were initially set in 2000, one of the goals was to get kids into school, and that has essentially been achieved, particularly at the primary level and quite a bit at the secondary level. So it’s neat to see a goal achieved, but now with this next set of goals, it’s about how to get the depth of learning and the education right. [H] Thinking about Africa: How young it is, how many young people there are, is both a huge challenge and a great opportunity. Can you talk a little bit about that? BG: The African continent today is about a billion people out of the seven billion on Earth, and as this century goes forward, over half the young people in the entire world will be there. With those people moving into the job market, if the right investments are made – stability, education, health – Africa will have growth and innovation, far more than lots of other places. If, on the other hand, we don’t take care of the HIV crisis, then you’ll just have more people who will get infected. If you don’t have the right conditions, then the young people, particularly the men, can add to that instability. So Africa definitely hangs in the balance. 4 [I] Melinda, family planning has been one of the issues that you’re most involved in. Can you talk to me a little about that? MG: Family planning is crucial anywhere, in any community around the world, because if a woman can decide if and when to have a child, she’s going to be healthier and her child is going to be healthier. That’s one of the longest-standing pieces of global health research we have … [If parents] can space the births of those children, they can then feed them, they can educate them, the woman can work and contribute her income to the family. It changes everything in the family dynamic, and it changes the community, and ultimately you get these country-level effects where it’s good for everybody. [J] You’ve gone all over the world and seen the problems up close. If you could wave a magic wand 5 and fix just one thing, what would it be? BG: The development of children. Today more than half the kids in Africa never fully develop physically or mentally because of malnutrition, their diet, and the diseases they face. With research on the human gut microbiome, 6 we’re gaining an understanding of stunting, why they don’t grow. I’m super excited that by the end of the decade we expect to have cheap interventions so those kids will fully develop. That means all the investments you make in their education, wanting to benefit from their productivity, will work far better. So if there was just one thing, it’s the intervention to stop malnutrition. 1 A philanthropist is someone who freely gives money and help to people in need. 2 If something spurs you into action, it causes you to do something. 3 The word stunting refers to the impaired growth and development that children experience from poor nutrition and poor health. 4 If something hangs in the balance, no one is sure what will happen to it in the future. 5 A magic wand is a long thin rod that magicians or fairies wave when they perform tricks, sometimes to make a wish come true. 6 The human gut microbiome refers to the beneficial microbes that live in the human digestive system. Based on the information in paragraph J, which of the following statements is Bill Gates most likely to agree with?

DIRECTIONS: Choose the best answer for each question. Innovations to Revolutionize the Future of Medicine [A] I would never have met Harriett were it not for our mutual friend, Linda. I’m a physician in Northern California; Harriett’s a communications executive in New York City. Linda co-founded an online personal genomics company, to which Harriett and I each sent our genetic information for analysis. [B] Linda introduced us after she saw that Harriett and I had something in common: a rare type of DNA, which meant we were distantly related. It turns out that we also share that genealogy with a prehistoric celebrity: Otzi the Iceman, whose 5,300-year-old frozen corpse was discovered in the Alps in 1991. For fun, I even started a Facebook group for people with the same DNA variant as Otzi and Harriett and me. [C] I tell this story to make a point. Harriett and I met over a feat of science – mass-market, low-cost gene analysis – that once was unimaginable and now is commonplace. The convergence of digital technologies and social platforms made it possible for us to learn our genotypes and share what we found out with the online universe. [D] Since then, we’ve seen an explosion of tech-driven innovations that have the potential to reshape many aspects of health and medicine. All around us, technologies from artificial intelligence (AI) to personal genomics and robotics are advancing rapidly, giving form to the future of medicine. Rise of the Wearables [E] Just a decade after the first Fitbit initially launched the “wearables” revolution, health tracking devices are ubiquitous. Most are used to measure and document fitness activities. In the future, these sensing technologies will be central to disease prevention, diagnosis, and therapy. They’ll measure health objectively, detect changes that may indicate a developing condition, and relay patients’ data to their doctors. [F] Flexible, electronic medical tattoos and stick-on sensors can measure a person’s heartbeat, breathing rate, and blood sugar levels, and then transmit the results via Bluetooth. It is a mobile form of vital sign tracking, but at a level once found only in an intensive care unit. [G] Hearing aids or earbuds with embedded sensors will not only amplify sound but also track heart rate and movement. Such smart earpieces also could also be integrated with a digital coach to cheer on a runner, or a guide to lend assistance to dementia patients. [H] Smart contact lenses in the future will be packed with thousands of sensors, and designed to identify early indicators of cancer and other conditions. Lenses now in development may someday measure blood sugar values in tears, to help diabetics manage diet and medications. [I] Implantable devices may include a radio-frequency ID chip under the skin that holds a patient’s medical records, or a sensor that could continuously monitor blood chemistry. Devices that are swallowed in capsules will perform tasks within the digestive system, from delivering treatment to identifying foreign objects. [J] And if we want to collect health data when no one’s wearing a device? Engineers at MIT have modified a WiFi-like box so it can capture vital signs and sleep patterns of several people in the same residence. AI, Machine Learning, and the “Virtualist” [K] The widening array of digital tools paired with AI technology almost certainly will boost the accuracy and speed of a doctor’s diagnosis. This will improve disease detection at early stages and raise the odds of successful treatment or cure. Apps and sensors can enable a phone to check for irregular heartbeats; software and a microphone can equip it to “listen” to a cough and diagnose pneumonia. To improve treatment of hypertension – a leading risk factor associated with early death – sensors now in development would take continuous blood pressure readings. [L] Machine learning can also help improve diagnoses. Google researchers fed more than a quarter-million scans of patients’ eyes into computers that could recognize patterns – and the technology “learned” to spot which patterns predict a patient has high blood pressure or is at increased risk for heart attack or stroke. In some comparisons, digital tools produced more accurate analyses than their human counterparts. [M] In the United States, the days of doctors routinely making house calls are long gone. Soon to follow: Private Skype-like interactions between patient and doctor, taking place online. Patients’ vital signs will be obtained and shared with the doctor via a range of wearable devices. [N] The time it usually takes for medical appointments – including travel and waiting room time – will plummet, replaced by telemedicine visits with a new type of doctor, the “virtualist.” In the future, most patients will have medical appointments in the comfort of their own homes. [O] The conventional prescriptions in your future could be given out by an ATM-like robot, remotely controlled by a provider to ensure the right doses at the right times. Or your doctor could consult your genetics test to determine the most appropriate drugs for your specific gene profile. [P] If you’re not meeting in person with your doctor, could a robot serve as well as a human? Soon they may be answering calls. A chatbot nurse will ask about your symptoms and use data from your wearable devices and the crowdsourced health records of others like you. Should your complaint be psychological more than physical, you can seek counseling from a virtual therapist programmed to converse as a human would, offer self-help guidance, and lend a sympathetic ear. [Q] It’s great to benefit from all this technological progress, but it’s just as important to spread it. In 2016, an estimated 3.6 million people in low- and middle-income countries died because they lacked access to healthcare. And even more people in those countries – an estimated five million – died because they got poor-quality care. We can change that, starting today, by sharing the wealth of new medical technologies and other health and wellness resources. In the second sentence of paragraph K, what does it refer to?

DIRECTIONS: Choose the best answer for each question. Goalkeepers for the Planet [A] In 2015 at the United Nations, world leaders adopted 17 Sustainable Development Goals aimed at reducing poverty, inequality, and other global problems by 2030. Such objectives have long been championed by philanthropists 1 Bill and Melinda Gates. In 2017, the Gates Foundation launched Goalkeepers, an initiative to spur action 2 and track progress toward the UN goals. Its 2018 status report says there have been “mind-blowing improvements in the human condition.” The report also calls for more investment and innovation to ensure this progress continues. [B] Susan Goldberg, editor-in-chief of National Geographic Magazine, met with Bill and Melinda Gates for a joint interview on the report, which was released to the public on September 18, 2018. [C] I’ve just read the Goalkeepers report. Why did you decide to start doing this? Melinda Gates: Because we think that the news isn’t really out there – the news that the world has made this incredible progress, this increase in lives saved, the reduction in poverty. The UN set these amazing goals for the future to help us continue to reduce poverty, and we want to make sure that we hold people accountable for that progress and really inspire the next generation of leaders who are going to take these tasks on. [D] What are you seeing in different countries? Who’s doing a great job? Bill Gates: Even a very poor country can do a good job on health, can do a good job on agriculture, on education, and that provides a lot of hope because you can copy what’s being done there. Rwanda has been a big outlier in the quality of health services. Ethiopia, on agriculture, is growing over 5 percent a year. In education, Vietnam is one we talk about because they’re so far ahead of where you’d expect given their wealth. But it’s when you get those three things together – health, education, agriculture – that eventually these countries can become self-sufficient. [E] MG: One of the things that’s also encouraging: Rwanda is a very small country [in population], Ethiopia is the second largest on the continent of Africa – but they have learned the lessons of what has helped people make progress from around the world. So they’re looking at what happened in Asia in agriculture, how did Brazil decrease the stunting 3 rate [among malnourished children] so phenomenally across a very large country with lots of poverty. [F] When you think about learning from one another, I was struck by the example from Vietnam, where you’ve got 15-year-olds who are doing as well on international tests in school as people from the United Kingdom or from the United States. What are the lessons from Vietnam that can translate across other countries? BG: It’s a really new thing to try and get into the amount of learning. The agenda for poor countries up until now has largely been to get the kids into school – and attendance rates have gone up a lot, for girls and boys. The biggest missing piece still is how much knowledge they’re gaining. A few countries, by training the teachers the right way and bringing the right material into the classroom, have really achieved learning way beyond what you might expect. [G] MG: When you look back at the UN goals that were initially set in 2000, one of the goals was to get kids into school, and that has essentially been achieved, particularly at the primary level and quite a bit at the secondary level. So it’s neat to see a goal achieved, but now with this next set of goals, it’s about how to get the depth of learning and the education right. [H] Thinking about Africa: How young it is, how many young people there are, is both a huge challenge and a great opportunity. Can you talk a little bit about that? BG: The African continent today is about a billion people out of the seven billion on Earth, and as this century goes forward, over half the young people in the entire world will be there. With those people moving into the job market, if the right investments are made – stability, education, health – Africa will have growth and innovation, far more than lots of other places. If, on the other hand, we don’t take care of the HIV crisis, then you’ll just have more people who will get infected. If you don’t have the right conditions, then the young people, particularly the men, can add to that instability. So Africa definitely hangs in the balance. 4 [I] Melinda, family planning has been one of the issues that you’re most involved in. Can you talk to me a little about that? MG: Family planning is crucial anywhere, in any community around the world, because if a woman can decide if and when to have a child, she’s going to be healthier and her child is going to be healthier. That’s one of the longest-standing pieces of global health research we have … [If parents] can space the births of those children, they can then feed them, they can educate them, the woman can work and contribute her income to the family. It changes everything in the family dynamic, and it changes the community, and ultimately you get these country-level effects where it’s good for everybody. [J] You’ve gone all over the world and seen the problems up close. If you could wave a magic wand 5 and fix just one thing, what would it be? BG: The development of children. Today more than half the kids in Africa never fully develop physically or mentally because of malnutrition, their diet, and the diseases they face. With research on the human gut microbiome, 6 we’re gaining an understanding of stunting, why they don’t grow. I’m super excited that by the end of the decade we expect to have cheap interventions so those kids will fully develop. That means all the investments you make in their education, wanting to benefit from their productivity, will work far better. So if there was just one thing, it’s the intervention to stop malnutrition. 1 A philanthropist is someone who freely gives money and help to people in need. 2 If something spurs you into action, it causes you to do something. 3 The word stunting refers to the impaired growth and development that children experience from poor nutrition and poor health. 4 If something hangs in the balance, no one is sure what will happen to it in the future. 5 A magic wand is a long thin rod that magicians or fairies wave when they perform tricks, sometimes to make a wish come true. 6 The human gut microbiome refers to the beneficial microbes that live in the human digestive system. In the first sentence of paragraph H, what does it refer to?

DIRECTIONS: Choose the best answer for each question. Innovations to Revolutionize the Future of Medicine [A] I would never have met Harriett were it not for our mutual friend, Linda. I’m a physician in Northern California; Harriett’s a communications executive in New York City. Linda co-founded an online personal genomics company, to which Harriett and I each sent our genetic information for analysis. [B] Linda introduced us after she saw that Harriett and I had something in common: a rare type of DNA, which meant we were distantly related. It turns out that we also share that genealogy with a prehistoric celebrity: Otzi the Iceman, whose 5,300-year-old frozen corpse was discovered in the Alps in 1991. For fun, I even started a Facebook group for people with the same DNA variant as Otzi and Harriett and me. [C] I tell this story to make a point. Harriett and I met over a feat of science – mass-market, low-cost gene analysis – that once was unimaginable and now is commonplace. The convergence of digital technologies and social platforms made it possible for us to learn our genotypes and share what we found out with the online universe. [D] Since then, we’ve seen an explosion of tech-driven innovations that have the potential to reshape many aspects of health and medicine. All around us, technologies from artificial intelligence (AI) to personal genomics and robotics are advancing rapidly, giving form to the future of medicine. Rise of the Wearables [E] Just a decade after the first Fitbit initially launched the “wearables” revolution, health tracking devices are ubiquitous. Most are used to measure and document fitness activities. In the future, these sensing technologies will be central to disease prevention, diagnosis, and therapy. They’ll measure health objectively, detect changes that may indicate a developing condition, and relay patients’ data to their doctors. [F] Flexible, electronic medical tattoos and stick-on sensors can measure a person’s heartbeat, breathing rate, and blood sugar levels, and then transmit the results via Bluetooth. It is a mobile form of vital sign tracking, but at a level once found only in an intensive care unit. [G] Hearing aids or earbuds with embedded sensors will not only amplify sound but also track heart rate and movement. Such smart earpieces also could also be integrated with a digital coach to cheer on a runner, or a guide to lend assistance to dementia patients. [H] Smart contact lenses in the future will be packed with thousands of sensors, and designed to identify early indicators of cancer and other conditions. Lenses now in development may someday measure blood sugar values in tears, to help diabetics manage diet and medications. [I] Implantable devices may include a radio-frequency ID chip under the skin that holds a patient’s medical records, or a sensor that could continuously monitor blood chemistry. Devices that are swallowed in capsules will perform tasks within the digestive system, from delivering treatment to identifying foreign objects. [J] And if we want to collect health data when no one’s wearing a device? Engineers at MIT have modified a WiFi-like box so it can capture vital signs and sleep patterns of several people in the same residence. AI, Machine Learning, and the “Virtualist” [K] The widening array of digital tools paired with AI technology almost certainly will boost the accuracy and speed of a doctor’s diagnosis. This will improve disease detection at early stages and raise the odds of successful treatment or cure. Apps and sensors can enable a phone to check for irregular heartbeats; software and a microphone can equip it to “listen” to a cough and diagnose pneumonia. To improve treatment of hypertension – a leading risk factor associated with early death – sensors now in development would take continuous blood pressure readings. [L] Machine learning can also help improve diagnoses. Google researchers fed more than a quarter-million scans of patients’ eyes into computers that could recognize patterns – and the technology “learned” to spot which patterns predict a patient has high blood pressure or is at increased risk for heart attack or stroke. In some comparisons, digital tools produced more accurate analyses than their human counterparts. [M] In the United States, the days of doctors routinely making house calls are long gone. Soon to follow: Private Skype-like interactions between patient and doctor, taking place online. Patients’ vital signs will be obtained and shared with the doctor via a range of wearable devices. [N] The time it usually takes for medical appointments – including travel and waiting room time – will plummet, replaced by telemedicine visits with a new type of doctor, the “virtualist.” In the future, most patients will have medical appointments in the comfort of their own homes. [O] The conventional prescriptions in your future could be given out by an ATM-like robot, remotely controlled by a provider to ensure the right doses at the right times. Or your doctor could consult your genetics test to determine the most appropriate drugs for your specific gene profile. [P] If you’re not meeting in person with your doctor, could a robot serve as well as a human? Soon they may be answering calls. A chatbot nurse will ask about your symptoms and use data from your wearable devices and the crowdsourced health records of others like you. Should your complaint be psychological more than physical, you can seek counseling from a virtual therapist programmed to converse as a human would, offer self-help guidance, and lend a sympathetic ear. [Q] It’s great to benefit from all this technological progress, but it’s just as important to spread it. In 2016, an estimated 3.6 million people in low- and middle-income countries died because they lacked access to healthcare. And even more people in those countries – an estimated five million – died because they got poor-quality care. We can change that, starting today, by sharing the wealth of new medical technologies and other health and wellness resources. The following sentence would be best placed at the end of which paragraph? Such devices can also be equipped with tiny cameras that enable a doctor to see inside their patients’ bodies.

DIRECTIONS: Choose the best answer for each question. Innovations to Revolutionize the Future of Medicine [A] I would never have met Harriett were it not for our mutual friend, Linda. I’m a physician in Northern California; Harriett’s a communications executive in New York City. Linda co-founded an online personal genomics company, to which Harriett and I each sent our genetic information for analysis. [B] Linda introduced us after she saw that Harriett and I had something in common: a rare type of DNA, which meant we were distantly related. It turns out that we also share that genealogy with a prehistoric celebrity: Otzi the Iceman, whose 5,300-year-old frozen corpse was discovered in the Alps in 1991. For fun, I even started a Facebook group for people with the same DNA variant as Otzi and Harriett and me. [C] I tell this story to make a point. Harriett and I met over a feat of science – mass-market, low-cost gene analysis – that once was unimaginable and now is commonplace. The convergence of digital technologies and social platforms made it possible for us to learn our genotypes and share what we found out with the online universe. [D] Since then, we’ve seen an explosion of tech-driven innovations that have the potential to reshape many aspects of health and medicine. All around us, technologies from artificial intelligence (AI) to personal genomics and robotics are advancing rapidly, giving form to the future of medicine. Rise of the Wearables [E] Just a decade after the first Fitbit initially launched the “wearables” revolution, health tracking devices are ubiquitous. Most are used to measure and document fitness activities. In the future, these sensing technologies will be central to disease prevention, diagnosis, and therapy. They’ll measure health objectively, detect changes that may indicate a developing condition, and relay patients’ data to their doctors. [F] Flexible, electronic medical tattoos and stick-on sensors can measure a person’s heartbeat, breathing rate, and blood sugar levels, and then transmit the results via Bluetooth. It is a mobile form of vital sign tracking, but at a level once found only in an intensive care unit. [G] Hearing aids or earbuds with embedded sensors will not only amplify sound but also track heart rate and movement. Such smart earpieces also could also be integrated with a digital coach to cheer on a runner, or a guide to lend assistance to dementia patients. [H] Smart contact lenses in the future will be packed with thousands of sensors, and designed to identify early indicators of cancer and other conditions. Lenses now in development may someday measure blood sugar values in tears, to help diabetics manage diet and medications. [I] Implantable devices may include a radio-frequency ID chip under the skin that holds a patient’s medical records, or a sensor that could continuously monitor blood chemistry. Devices that are swallowed in capsules will perform tasks within the digestive system, from delivering treatment to identifying foreign objects. [J] And if we want to collect health data when no one’s wearing a device? Engineers at MIT have modified a WiFi-like box so it can capture vital signs and sleep patterns of several people in the same residence. AI, Machine Learning, and the “Virtualist” [K] The widening array of digital tools paired with AI technology almost certainly will boost the accuracy and speed of a doctor’s diagnosis. This will improve disease detection at early stages and raise the odds of successful treatment or cure. Apps and sensors can enable a phone to check for irregular heartbeats; software and a microphone can equip it to “listen” to a cough and diagnose pneumonia. To improve treatment of hypertension – a leading risk factor associated with early death – sensors now in development would take continuous blood pressure readings. [L] Machine learning can also help improve diagnoses. Google researchers fed more than a quarter-million scans of patients’ eyes into computers that could recognize patterns – and the technology “learned” to spot which patterns predict a patient has high blood pressure or is at increased risk for heart attack or stroke. In some comparisons, digital tools produced more accurate analyses than their human counterparts. [M] In the United States, the days of doctors routinely making house calls are long gone. Soon to follow: Private Skype-like interactions between patient and doctor, taking place online. Patients’ vital signs will be obtained and shared with the doctor via a range of wearable devices. [N] The time it usually takes for medical appointments – including travel and waiting room time – will plummet, replaced by telemedicine visits with a new type of doctor, the “virtualist.” In the future, most patients will have medical appointments in the comfort of their own homes. [O] The conventional prescriptions in your future could be given out by an ATM-like robot, remotely controlled by a provider to ensure the right doses at the right times. Or your doctor could consult your genetics test to determine the most appropriate drugs for your specific gene profile. [P] If you’re not meeting in person with your doctor, could a robot serve as well as a human? Soon they may be answering calls. A chatbot nurse will ask about your symptoms and use data from your wearable devices and the crowdsourced health records of others like you. Should your complaint be psychological more than physical, you can seek counseling from a virtual therapist programmed to converse as a human would, offer self-help guidance, and lend a sympathetic ear. [Q] It’s great to benefit from all this technological progress, but it’s just as important to spread it. In 2016, an estimated 3.6 million people in low- and middle-income countries died because they lacked access to healthcare. And even more people in those countries – an estimated five million – died because they got poor-quality care. We can change that, starting today, by sharing the wealth of new medical technologies and other health and wellness resources. In paragraph B, who is the Facebook group for?

DIRECTIONS: Choose the best answer for each question. Innovations to Revolutionize the Future of Medicine [A] I would never have met Harriett were it not for our mutual friend, Linda. I’m a physician in Northern California; Harriett’s a communications executive in New York City. Linda co-founded an online personal genomics company, to which Harriett and I each sent our genetic information for analysis. [B] Linda introduced us after she saw that Harriett and I had something in common: a rare type of DNA, which meant we were distantly related. It turns out that we also share that genealogy with a prehistoric celebrity: Otzi the Iceman, whose 5,300-year-old frozen corpse was discovered in the Alps in 1991. For fun, I even started a Facebook group for people with the same DNA variant as Otzi and Harriett and me. [C] I tell this story to make a point. Harriett and I met over a feat of science – mass-market, low-cost gene analysis – that once was unimaginable and now is commonplace. The convergence of digital technologies and social platforms made it possible for us to learn our genotypes and share what we found out with the online universe. [D] Since then, we’ve seen an explosion of tech-driven innovations that have the potential to reshape many aspects of health and medicine. All around us, technologies from artificial intelligence (AI) to personal genomics and robotics are advancing rapidly, giving form to the future of medicine. Rise of the Wearables [E] Just a decade after the first Fitbit initially launched the “wearables” revolution, health tracking devices are ubiquitous. Most are used to measure and document fitness activities. In the future, these sensing technologies will be central to disease prevention, diagnosis, and therapy. They’ll measure health objectively, detect changes that may indicate a developing condition, and relay patients’ data to their doctors. [F] Flexible, electronic medical tattoos and stick-on sensors can measure a person’s heartbeat, breathing rate, and blood sugar levels, and then transmit the results via Bluetooth. It is a mobile form of vital sign tracking, but at a level once found only in an intensive care unit. [G] Hearing aids or earbuds with embedded sensors will not only amplify sound but also track heart rate and movement. Such smart earpieces also could also be integrated with a digital coach to cheer on a runner, or a guide to lend assistance to dementia patients. [H] Smart contact lenses in the future will be packed with thousands of sensors, and designed to identify early indicators of cancer and other conditions. Lenses now in development may someday measure blood sugar values in tears, to help diabetics manage diet and medications. [I] Implantable devices may include a radio-frequency ID chip under the skin that holds a patient’s medical records, or a sensor that could continuously monitor blood chemistry. Devices that are swallowed in capsules will perform tasks within the digestive system, from delivering treatment to identifying foreign objects. [J] And if we want to collect health data when no one’s wearing a device? Engineers at MIT have modified a WiFi-like box so it can capture vital signs and sleep patterns of several people in the same residence. AI, Machine Learning, and the “Virtualist” [K] The widening array of digital tools paired with AI technology almost certainly will boost the accuracy and speed of a doctor’s diagnosis. This will improve disease detection at early stages and raise the odds of successful treatment or cure. Apps and sensors can enable a phone to check for irregular heartbeats; software and a microphone can equip it to “listen” to a cough and diagnose pneumonia. To improve treatment of hypertension – a leading risk factor associated with early death – sensors now in development would take continuous blood pressure readings. [L] Machine learning can also help improve diagnoses. Google researchers fed more than a quarter-million scans of patients’ eyes into computers that could recognize patterns – and the technology “learned” to spot which patterns predict a patient has high blood pressure or is at increased risk for heart attack or stroke. In some comparisons, digital tools produced more accurate analyses than their human counterparts. [M] In the United States, the days of doctors routinely making house calls are long gone. Soon to follow: Private Skype-like interactions between patient and doctor, taking place online. Patients’ vital signs will be obtained and shared with the doctor via a range of wearable devices. [N] The time it usually takes for medical appointments – including travel and waiting room time – will plummet, replaced by telemedicine visits with a new type of doctor, the “virtualist.” In the future, most patients will have medical appointments in the comfort of their own homes. [O] The conventional prescriptions in your future could be given out by an ATM-like robot, remotely controlled by a provider to ensure the right doses at the right times. Or your doctor could consult your genetics test to determine the most appropriate drugs for your specific gene profile. [P] If you’re not meeting in person with your doctor, could a robot serve as well as a human? Soon they may be answering calls. A chatbot nurse will ask about your symptoms and use data from your wearable devices and the crowdsourced health records of others like you. Should your complaint be psychological more than physical, you can seek counseling from a virtual therapist programmed to converse as a human would, offer self-help guidance, and lend a sympathetic ear. [Q] It’s great to benefit from all this technological progress, but it’s just as important to spread it. In 2016, an estimated 3.6 million people in low- and middle-income countries died because they lacked access to healthcare. And even more people in those countries – an estimated five million – died because they got poor-quality care. We can change that, starting today, by sharing the wealth of new medical technologies and other health and wellness resources. What kind of figurative language is used in the following sentence from paragraph D? We’ve seen an explosion of tech-driven innovations.

DIRECTIONS: Choose the best answer for each question. Goalkeepers for the Planet [A] In 2015 at the United Nations, world leaders adopted 17 Sustainable Development Goals aimed at reducing poverty, inequality, and other global problems by 2030. Such objectives have long been championed by philanthropists 1 Bill and Melinda Gates. In 2017, the Gates Foundation launched Goalkeepers, an initiative to spur action 2 and track progress toward the UN goals. Its 2018 status report says there have been “mind-blowing improvements in the human condition.” The report also calls for more investment and innovation to ensure this progress continues. [B] Susan Goldberg, editor-in-chief of National Geographic Magazine, met with Bill and Melinda Gates for a joint interview on the report, which was released to the public on September 18, 2018. [C] I’ve just read the Goalkeepers report. Why did you decide to start doing this? Melinda Gates: Because we think that the news isn’t really out there – the news that the world has made this incredible progress, this increase in lives saved, the reduction in poverty. The UN set these amazing goals for the future to help us continue to reduce poverty, and we want to make sure that we hold people accountable for that progress and really inspire the next generation of leaders who are going to take these tasks on. [D] What are you seeing in different countries? Who’s doing a great job? Bill Gates: Even a very poor country can do a good job on health, can do a good job on agriculture, on education, and that provides a lot of hope because you can copy what’s being done there. Rwanda has been a big outlier in the quality of health services. Ethiopia, on agriculture, is growing over 5 percent a year. In education, Vietnam is one we talk about because they’re so far ahead of where you’d expect given their wealth. But it’s when you get those three things together – health, education, agriculture – that eventually these countries can become self-sufficient. [E] MG: One of the things that’s also encouraging: Rwanda is a very small country [in population], Ethiopia is the second largest on the continent of Africa – but they have learned the lessons of what has helped people make progress from around the world. So they’re looking at what happened in Asia in agriculture, how did Brazil decrease the stunting 3 rate [among malnourished children] so phenomenally across a very large country with lots of poverty. [F] When you think about learning from one another, I was struck by the example from Vietnam, where you’ve got 15-year-olds who are doing as well on international tests in school as people from the United Kingdom or from the United States. What are the lessons from Vietnam that can translate across other countries? BG: It’s a really new thing to try and get into the amount of learning. The agenda for poor countries up until now has largely been to get the kids into school – and attendance rates have gone up a lot, for girls and boys. The biggest missing piece still is how much knowledge they’re gaining. A few countries, by training the teachers the right way and bringing the right material into the classroom, have really achieved learning way beyond what you might expect. [G] MG: When you look back at the UN goals that were initially set in 2000, one of the goals was to get kids into school, and that has essentially been achieved, particularly at the primary level and quite a bit at the secondary level. So it’s neat to see a goal achieved, but now with this next set of goals, it’s about how to get the depth of learning and the education right. [H] Thinking about Africa: How young it is, how many young people there are, is both a huge challenge and a great opportunity. Can you talk a little bit about that? BG: The African continent today is about a billion people out of the seven billion on Earth, and as this century goes forward, over half the young people in the entire world will be there. With those people moving into the job market, if the right investments are made – stability, education, health – Africa will have growth and innovation, far more than lots of other places. If, on the other hand, we don’t take care of the HIV crisis, then you’ll just have more people who will get infected. If you don’t have the right conditions, then the young people, particularly the men, can add to that instability. So Africa definitely hangs in the balance. 4 [I] Melinda, family planning has been one of the issues that you’re most involved in. Can you talk to me a little about that? MG: Family planning is crucial anywhere, in any community around the world, because if a woman can decide if and when to have a child, she’s going to be healthier and her child is going to be healthier. That’s one of the longest-standing pieces of global health research we have … [If parents] can space the births of those children, they can then feed them, they can educate them, the woman can work and contribute her income to the family. It changes everything in the family dynamic, and it changes the community, and ultimately you get these country-level effects where it’s good for everybody. [J] You’ve gone all over the world and seen the problems up close. If you could wave a magic wand 5 and fix just one thing, what would it be? BG: The development of children. Today more than half the kids in Africa never fully develop physically or mentally because of malnutrition, their diet, and the diseases they face. With research on the human gut microbiome, 6 we’re gaining an understanding of stunting, why they don’t grow. I’m super excited that by the end of the decade we expect to have cheap interventions so those kids will fully develop. That means all the investments you make in their education, wanting to benefit from their productivity, will work far better. So if there was just one thing, it’s the intervention to stop malnutrition. 1 A philanthropist is someone who freely gives money and help to people in need. 2 If something spurs you into action, it causes you to do something. 3 The word stunting refers to the impaired growth and development that children experience from poor nutrition and poor health. 4 If something hangs in the balance, no one is sure what will happen to it in the future. 5 A magic wand is a long thin rod that magicians or fairies wave when they perform tricks, sometimes to make a wish come true. 6 The human gut microbiome refers to the beneficial microbes that live in the human digestive system. What is the purpose of paragraph C?

DIRECTIONS: Complete the sentences using the words in the box. artificial ascend contemplate delicate devoid of plummet scheme stamina successive tackle If the company’s CEO is found to be involved in illegal activity, its stock price is sure to ____________________. [BLANK-1]

DIRECTIONS: Choose the best answer for each question. How Jimmy Chin Filmed Alex Honnold’s Death-Defying Free Solo Honnold planned to climb Yosemite’s El Capitan without a rope. Chin would film it. But first they had to figure out how to talk about it. [A] When you are Jimmy Chin, you make a long list of rules for filming your friend Alex Honnold’s historic attempt to climb Yosemite’s El Capitan without using any ropes. First you will hire a team of world-class climber-cinematographers to rappel beside him as he ascends the nearly 3,000-foot granite face. No one is allowed to whisper, sneeze, drop a lens cap, dislodge a pebble – any of which might create the distraction that sends him plummeting to his death. Most important, no one is allowed to talk to Honnold about the epic climb, at least not directly. This is to avoid putting any pressure on him but also to keep from upsetting his precisely calibrated mind-set, a mixture of acute concentration, bulletproof confidence, and deep Zen calm. Instead of using the term “free soloing,” which means climbing without ropes or safety gear, you use his preferred euphemism – “scrambling.” [B] You follow these rules knowing that any notion of rules is contradictory to the very idea of free soloing, because in this ruthlessly unforgiving sport there really aren’t any rules, at least no written ones. That’s much of the point. Climbing without ropes is decidedly against all the rules, especially the rules of mountain safety, not to mention human logic. [C] Some veteran climbers say there is no if a free soloist falls – only when. You can think of many who have fallen to their deaths, some you knew personally. And suddenly there it is: the vividly horrifying image of your friend flailing into the void. [D] But wait. That’s exactly what you’re not supposed to picture when your buddy is trying to do what some experts say is the most daring ascent ever attempted – what Honnold’s friend and fellow elite climber Tommy Caldwell called “the moon landing of free soloing.” [E] Such thoughts looped in Chin’s mind for more than a year as he and Elizabeth Chai Vasarhelyi, his wife and filmmaking partner, documented Honnold’s efforts to make climbing history. (Spoiler alert: He makes it.) The film, aptly titled Free Solo, was released in theaters. [F] “To film a climber with both the physical and mental ability Alex has, combined with the desire to take on something so ambitious and scary,” Chin says, “it’s the project of a lifetime, no doubt.” [G] Chin, 45, and Honnold, 33, first climbed together in 2009 as part of an expedition to Borneo to explore Low’s Gully, one of the world’s deepest slot canyons. Honnold had recently burst onto the climbing scene with a series of headline-grabbing free solos, including Yosemite’s Half Dome. Chin remembers being struck by Honnold’s boyish face and large brown eyes, which would inevitably earn him the nickname Bambi. [H] But Honnold’s youthful appearance belies his most exceptional gift – an uncanny ability to control his fear and focus on perfectly executing the task at hand (never mind that the task is reaching for a fingertip of rock while clinging to a cliff 1,000 feet up). It’s a gift that Chin shares in some measure. Three years before meeting Honnold, he climbed Mount Everest and skied down its icy, nearly vertical face. [I] After Borneo, the men started climbing together regularly, with Chin filming some of Honnold’s free solos. “We built up a lot of trust,” says Chin. “He trusted me to safely film him, and I trusted him to climb only what he felt good about and not to feel compelled to do rad stuff for the camera.” [J] Meanwhile Honnold had been privately contemplating what it would take to free solo El Cap. “After Half Dome it seemed like the next obvious thing,” Honnold says. “At the end of each season, I’d think I’d be ready to do it the next year, but then I’d look up at it and think, ‘Whoa, that’s still too scary.'” [K] Finally, in late 2015, Honnold told Chin and Vasarhelyi he was ready, and they agreed to work together in secret on a film about the climb. “It was very important that the film would be about Alex’s process,” Chin says. “Whether it ended with him summiting El Cap or deciding not to go for it didn’t matter. It was always about how do you even think about doing something so mind-bending.” [L] Honnold chose a route called Freerider, one that often takes skilled climbers using ropes multiple days to ascend. He set about perfecting a hand-by-hand, foot-by-foot choreography up the famous cliff. Meanwhile Chin hired a crew of hard-core Yosemite climbers and began planning the extensive logistics. [M] Each practice session required many hours of preparation. Chin and the crew would speed climb an easy route up the east side of El Cap ahead of Honnold, lugging hundreds of pounds of cameras, ropes, and gear. Then they’d rappel down Freerider and use a type of hand winch to keep pace with him as he climbed. “We all got in the best shape of our lives,” Chin says. But at the end of each marathon day, the mental loop of what-ifs would play: “Not a day went by that I didn’t think about the worst.” [N] Around 5 p.m. on June 2, 2017, feeling that he was at his peak, Honnold asked Chin if the team could be ready to shoot the next day. “I think I’ll go scrambling,” he said. Chin nodded, acting like it was no big deal: “My mind was racing with all the things we needed to put in place before it got dark, but I didn’t want to upset his mind-set, so I hung out with him for a while.” Finally Chin told Honnold he’d see him in the morning and walked slowly until he was out of his friend’s line of sight. [O] Then Chin ran like hell. He jumped on the crew’s walkie-talkie channel and, using Honnold’s code name, alerted the team to what was about to happen. “Bambi is going for it! Repeat: Bambi is going for it!” What is the main purpose of the passage?