Mini TO UM UNDIP Bahasa Inggris 14

81. Dosage of chemotherapy can be difficult: If the dose is too low, it will be ineffective against the tumor, whereas, at excessive doses, the toxicity (side-effects) will be intolerable to the patient. The standard method of determining chemotherapy dosage is based on calculated body surface area (BSA). The BSA is usually calculated with a mathematical formula or a nomogram, using a patient’s weight and height, rather than by direct measurement of body mass. This formula was originally derived in a 1916 study and attempted to translate medicinal doses established with laboratory animals to equivalent doses for humans. The study only included 9 human subjects. When chemotherapy was introduced in the 1950s, the BSA formula was adopted as the official standard for chemotherapy dosing for lack of a better option.

Recently, the validity of this method in calculating uniform doses has been questioned. The reason for this is that the formula only takes into accounts the individual’s weight and height. Drug absorption and clearance are influenced by multiple factors, including age, gender, metabolism, disease state, organ function, drug-to-drug interactions, genetics, and obesity, which has a major impact on the actual concentration of the drug in the patient’s bloodstream. As a result, there is high variability in the systemic chemotherapy drug concentration among patients dosed by BSA, and this variability has been demonstrated to be more than 10-fold for many drugs. In other words, if two patients receive the same dose of a given drug based on BSA, the concentration of that drug in the bloodstream of one patient may be 10 times higher or lower compared to that of the other patient. This variability is typical with many chemotherapy drugs dosed by BSA, and, as shown below, was demonstrated in a study of 14 common chemotherapy drugs.

The result of this pharmacokinetic variability among patients is that many patients do not receive the right dose to achieve optimal treatment effectiveness with minimized toxic side effects. Some patients are overdosed while others are underdosed. For example, in a randomized clinical trial, investigators found 85% of metastatic colorectal cancer patients treated with 5-fluorouracil (5-FU) did not receive the optimal therapeutic dose when dosed by the BSA standard— 68% were underdosed and 17% were overdosed.

There has been recent controversy over the use of BSA to calculate chemotherapy doses for obese patients. Because of their higher BSA, clinicians often arbitrarily reduce the dose prescribed by the BSA formula for fear of overdosing. In many cases, this can result in sub-optimal treatment.

In what course is the passage most probably given?

82. Dosage of chemotherapy can be difficult: If the dose is too low, it will be ineffective against the tumor, whereas, at excessive doses, the toxicity (side-effects) will be intolerable to the patient. The standard method of determining chemotherapy dosage is based on calculated body surface area (BSA). The BSA is usually calculated with a mathematical formula or a nomogram, using a patient’s weight and height, rather than by direct measurement of body mass. This formula was originally derived in a 1916 study and attempted to translate medicinal doses established with laboratory animals to equivalent doses for humans. The study only included 9 human subjects. When chemotherapy was introduced in the 1950s, the BSA formula was adopted as the official standard for chemotherapy dosing for lack of a better option.

Recently, the validity of this method in calculating uniform doses has been questioned. The reason for this is that the formula only takes into accounts the individual’s weight and height. Drug absorption and clearance are influenced by multiple factors, including age, gender, metabolism, disease state, organ function, drug-to-drug interactions, genetics, and obesity, which has a major impact on the actual concentration of the drug in the patient’s bloodstream. As a result, there is high variability in the systemic chemotherapy drug concentration among patients dosed by BSA, and this variability has been demonstrated to be more than 10-fold for many drugs. In other words, if two patients receive the same dose of a given drug based on BSA, the concentration of that drug in the bloodstream of one patient may be 10 times higher or lower compared to that of the other patient. This variability is typical with many chemotherapy drugs dosed by BSA, and, as shown below, was demonstrated in a study of 14 common chemotherapy drugs.

The result of this pharmacokinetic variability among patients is that many patients do not receive the right dose to achieve optimal treatment effectiveness with minimized toxic side effects. Some patients are overdosed while others are underdosed. For example, in a randomized clinical trial, investigators found 85% of metastatic colorectal cancer patients treated with 5-fluorouracil (5-FU) did not receive the optimal therapeutic dose when dosed by the BSA standard— 68% were underdosed and 17% were overdosed.

There has been recent controversy over the use of BSA to calculate chemotherapy doses for obese patients. Because of their higher BSA, clinicians often arbitrarily reduce the dose prescribed by the BSA formula for fear of overdosing. In many cases, this can result in sub-optimal treatment.

What is the closest meaning of the word “derived” in line 7?

83. Dosage of chemotherapy can be difficult: If the dose is too low, it will be ineffective against the tumor, whereas, at excessive doses, the toxicity (side-effects) will be intolerable to the patient. The standard method of determining chemotherapy dosage is based on calculated body surface area (BSA). The BSA is usually calculated with a mathematical formula or a nomogram, using a patient’s weight and height, rather than by direct measurement of body mass. This formula was originally derived in a 1916 study and attempted to translate medicinal doses established with laboratory animals to equivalent doses for humans. The study only included 9 human subjects. When chemotherapy was introduced in the 1950s, the BSA formula was adopted as the official standard for chemotherapy dosing for lack of a better option.

Recently, the validity of this method in calculating uniform doses has been questioned. The reason for this is that the formula only takes into accounts the individual’s weight and height. Drug absorption and clearance are influenced by multiple factors, including age, gender, metabolism, disease state, organ function, drug-to-drug interactions, genetics, and obesity, which has a major impact on the actual concentration of the drug in the patient’s bloodstream. As a result, there is high variability in the systemic chemotherapy drug concentration among patients dosed by BSA, and this variability has been demonstrated to be more than 10-fold for many drugs. In other words, if two patients receive the same dose of a given drug based on BSA, the concentration of that drug in the bloodstream of one patient may be 10 times higher or lower compared to that of the other patient. This variability is typical with many chemotherapy drugs dosed by BSA, and, as shown below, was demonstrated in a study of 14 common chemotherapy drugs.

The result of this pharmacokinetic variability among patients is that many patients do not receive the right dose to achieve optimal treatment effectiveness with minimized toxic side effects. Some patients are overdosed while others are underdosed. For example, in a randomized clinical trial, investigators found 85% of metastatic colorectal cancer patients treated with 5-fluorouracil (5-FU) did not receive the optimal therapeutic dose when dosed by the BSA standard— 68% were underdosed and 17% were overdosed.

There has been recent controversy over the use of BSA to calculate chemotherapy doses for obese patients. Because of their higher BSA, clinicians often arbitrarily reduce the dose prescribed by the BSA formula for fear of overdosing. In many cases, this can result in sub-optimal treatment.

Which of the following is the best title of the passage?

84. Dosage of chemotherapy can be difficult: If the dose is too low, it will be ineffective against the tumor, whereas, at excessive doses, the toxicity (side-effects) will be intolerable to the patient. The standard method of determining chemotherapy dosage is based on calculated body surface area (BSA). The BSA is usually calculated with a mathematical formula or a nomogram, using a patient’s weight and height, rather than by direct measurement of body mass. This formula was originally derived in a 1916 study and attempted to translate medicinal doses established with laboratory animals to equivalent doses for humans. The study only included 9 human subjects. When chemotherapy was introduced in the 1950s, the BSA formula was adopted as the official standard for chemotherapy dosing for lack of a better option.

Recently, the validity of this method in calculating uniform doses has been questioned. The reason for this is that the formula only takes into accounts the individual’s weight and height. Drug absorption and clearance are influenced by multiple factors, including age, gender, metabolism, disease state, organ function, drug-to-drug interactions, genetics, and obesity, which has a major impact on the actual concentration of the drug in the patient’s bloodstream. As a result, there is high variability in the systemic chemotherapy drug concentration among patients dosed by BSA, and this variability has been demonstrated to be more than 10-fold for many drugs. In other words, if two patients receive the same dose of a given drug based on BSA, the concentration of that drug in the bloodstream of one patient may be 10 times higher or lower compared to that of the other patient. This variability is typical with many chemotherapy drugs dosed by BSA, and, as shown below, was demonstrated in a study of 14 common chemotherapy drugs.

The result of this pharmacokinetic variability among patients is that many patients do not receive the right dose to achieve optimal treatment effectiveness with minimized toxic side effects. Some patients are overdosed while others are underdosed. For example, in a randomized clinical trial, investigators found 85% of metastatic colorectal cancer patients treated with 5-fluorouracil (5-FU) did not receive the optimal therapeutic dose when dosed by the BSA standard— 68% were underdosed and 17% were overdosed.

There has been recent controversy over the use of BSA to calculate chemotherapy doses for obese patients. Because of their higher BSA, clinicians often arbitrarily reduce the dose prescribed by the BSA formula for fear of overdosing. In many cases, this can result in sub-optimal treatment.

The word “arbitrarily” in line 35 is closest in meaning to …

85. Dosage of chemotherapy can be difficult: If the dose is too low, it will be ineffective against the tumor, whereas, at excessive doses, the toxicity (side-effects) will be intolerable to the patient. The standard method of determining chemotherapy dosage is based on calculated body surface area (BSA). The BSA is usually calculated with a mathematical formula or a nomogram, using a patient’s weight and height, rather than by direct measurement of body mass. This formula was originally derived in a 1916 study and attempted to translate medicinal doses established with laboratory animals to equivalent doses for humans. The study only included 9 human subjects. When chemotherapy was introduced in the 1950s, the BSA formula was adopted as the official standard for chemotherapy dosing for lack of a better option.

Recently, the validity of this method in calculating uniform doses has been questioned. The reason for this is that the formula only takes into accounts the individual’s weight and height. Drug absorption and clearance are influenced by multiple factors, including age, gender, metabolism, disease state, organ function, drug-to-drug interactions, genetics, and obesity, which has a major impact on the actual concentration of the drug in the patient’s bloodstream. As a result, there is high variability in the systemic chemotherapy drug concentration among patients dosed by BSA, and this variability has been demonstrated to be more than 10-fold for many drugs. In other words, if two patients receive the same dose of a given drug based on BSA, the concentration of that drug in the bloodstream of one patient may be 10 times higher or lower compared to that of the other patient. This variability is typical with many chemotherapy drugs dosed by BSA, and, as shown below, was demonstrated in a study of 14 common chemotherapy drugs.

The result of this pharmacokinetic variability among patients is that many patients do not receive the right dose to achieve optimal treatment effectiveness with minimized toxic side effects. Some patients are overdosed while others are underdosed. For example, in a randomized clinical trial, investigators found 85% of metastatic colorectal cancer patients treated with 5-fluorouracil (5-FU) did not receive the optimal therapeutic dose when dosed by the BSA standard— 68% were underdosed and 17% were overdosed.

There has been recent controversy over the use of BSA to calculate chemotherapy doses for obese patients. Because of their higher BSA, clinicians often arbitrarily reduce the dose prescribed by the BSA formula for fear of overdosing. In many cases, this can result in sub-optimal treatment.

Which of the following is NOT true according to the passage?

86. The diesel engine (also known as a compression-ignition engine) is an internal combustion engine that uses the heat of compression to initiate (ignition) and burn the fuel that has been injected into the combustion chamber. This contrasts with spark-ignition engines such as a petrol engine (gasoline engine) or gas engine (using a gaseous fuel as opposed to gasoline), which use a spark plug to ignite an air-fuel mixture.

The diesel engine has the highest thermal efficiency of any standard internal or external combustion engine due to its very high compression ratio. Low-speed diesel engines (as used in ships and other applications where overall engine weight is relatively unimportant) can have a thermal efficiency that exceeds 50%.

Diesel engines are manufactured in two-stroke and four-stroke versions. They were originally used as a more efficient replacement for stationary steam engines. Since the 1910s, they have been used in submarines and ships. Use in locomotives, trucks, heavy equipment and electric generating plants followed later. In the 1930s, they slowly began to be used in a few automobiles. Since the 1970s, the use of diesel engines in larger on-road and off-road vehicles in the USA increased. According to the British Society of Motor Manufacturing and Traders, the EU average for diesel cars account for 50% of the total sold, including 70% in France and 38% in the UK.

The world’s largest diesel engine is currently a Wärtsilä-Sulzer RTA96-C Common Rail marine diesel of about 84,420 kW (113,210 hp) @102 rpm output.

According to the passage, why does the diesel engine have the highest thermal efficiency?

87. The diesel engine (also known as a compression-ignition engine) is an internal combustion engine that uses the heat of compression to initiate (ignition) and burn the fuel that has been injected into the combustion chamber. This contrasts with spark-ignition engines such as a petrol engine (gasoline engine) or gas engine (using a gaseous fuel as opposed to gasoline), which use a spark plug to ignite an air-fuel mixture.

The diesel engine has the highest thermal efficiency of any standard internal or external combustion engine due to its very high compression ratio. Low-speed diesel engines (as used in ships and other applications where overall engine weight is relatively unimportant) can have a thermal efficiency that exceeds 50%.

Diesel engines are manufactured in two-stroke and four-stroke versions. They were originally used as a more efficient replacement for stationary steam engines. Since the 1910s, they have been used in submarines and ships. Use in locomotives, trucks, heavy equipment and electric generating plants followed later. In the 1930s, they slowly began to be used in a few automobiles. Since the 1970s, the use of diesel engines in larger on-road and off-road vehicles in the USA increased. According to the British Society of Motor Manufacturing and Traders, the EU average for diesel cars account for 50% of the total sold, including 70% in France and 38% in the UK.

The world’s largest diesel engine is currently a Wärtsilä-Sulzer RTA96-C Common Rail marine diesel of about 84,420 kW (113,210 hp) @102 rpm output.

Which of the following probably the subject of the following paragraph?

88. The diesel engine (also known as a compression-ignition engine) is an internal combustion engine that uses the heat of compression to initiate (ignition) and burn the fuel that has been injected into the combustion chamber. This contrasts with spark-ignition engines such as a petrol engine (gasoline engine) or gas engine (using a gaseous fuel as opposed to gasoline), which use a spark plug to ignite an air-fuel mixture.

The diesel engine has the highest thermal efficiency of any standard internal or external combustion engine due to its very high compression ratio. Low-speed diesel engines (as used in ships and other applications where overall engine weight is relatively unimportant) can have a thermal efficiency that exceeds 50%.

Diesel engines are manufactured in two-stroke and four-stroke versions. They were originally used as a more efficient replacement for stationary steam engines. Since the 1910s, they have been used in submarines and ships. Use in locomotives, trucks, heavy equipment and electric generating plants followed later. In the 1930s, they slowly began to be used in a few automobiles. Since the 1970s, the use of diesel engines in larger on-road and off-road vehicles in the USA increased. According to the British Society of Motor Manufacturing and Traders, the EU average for diesel cars account for 50% of the total sold, including 70% in France and 38% in the UK.

The world’s largest diesel engine is currently a Wärtsilä-Sulzer RTA96-C Common Rail marine diesel of about 84,420 kW (113,210 hp) @102 rpm output.

The word “ignition” in line 2 is closest in meaning to …

89. The diesel engine (also known as a compression-ignition engine) is an internal combustion engine that uses the heat of compression to initiate (ignition) and burn the fuel that has been injected into the combustion chamber. This contrasts with spark-ignition engines such as a petrol engine (gasoline engine) or gas engine (using a gaseous fuel as opposed to gasoline), which use a spark plug to ignite an air-fuel mixture.

The diesel engine has the highest thermal efficiency of any standard internal or external combustion engine due to its very high compression ratio. Low-speed diesel engines (as used in ships and other applications where overall engine weight is relatively unimportant) can have a thermal efficiency that exceeds 50%.

Diesel engines are manufactured in two-stroke and four-stroke versions. They were originally used as a more efficient replacement for stationary steam engines. Since the 1910s, they have been used in submarines and ships. Use in locomotives, trucks, heavy equipment and electric generating plants followed later. In the 1930s, they slowly began to be used in a few automobiles. Since the 1970s, the use of diesel engines in larger on-road and off-road vehicles in the USA increased. According to the British Society of Motor Manufacturing and Traders, the EU average for diesel cars account for 50% of the total sold, including 70% in France and 38% in the UK.

The world’s largest diesel engine is currently a Wärtsilä-Sulzer RTA96-C Common Rail marine diesel of about 84,420 kW (113,210 hp) @102 rpm output.

The word “they” in line 13 refers to …

90. The diesel engine (also known as a compression-ignition engine) is an internal combustion engine that uses the heat of compression to initiate (ignition) and burn the fuel that has been injected into the combustion chamber. This contrasts with spark-ignition engines such as a petrol engine (gasoline engine) or gas engine (using a gaseous fuel as opposed to gasoline), which use a spark plug to ignite an air-fuel mixture.

The diesel engine has the highest thermal efficiency of any standard internal or external combustion engine due to its very high compression ratio. Low-speed diesel engines (as used in ships and other applications where overall engine weight is relatively unimportant) can have a thermal efficiency that exceeds 50%.

Diesel engines are manufactured in two-stroke and four-stroke versions. They were originally used as a more efficient replacement for stationary steam engines. Since the 1910s, they have been used in submarines and ships. Use in locomotives, trucks, heavy equipment and electric generating plants followed later. In the 1930s, they slowly began to be used in a few automobiles. Since the 1970s, the use of diesel engines in larger on-road and off-road vehicles in the USA increased. According to the British Society of Motor Manufacturing and Traders, the EU average for diesel cars account for 50% of the total sold, including 70% in France and 38% in the UK.

The world’s largest diesel engine is currently a Wärtsilä-Sulzer RTA96-C Common Rail marine diesel of about 84,420 kW (113,210 hp) @102 rpm output.

The phrase “account for” in line 19 could be replaced by …

91. Ann Arbor, MI – Robotic Industries Association (RIA) today announced that Wolf Robotics … (91) … recertification as part of the RIA Certified Robot Integrator program. Wolf Robotics achieved their initial certification … (92) … April 2012 by completing a rigorous process, which includes an on-site audit, and … (93) … of key personnel among other important criteria. The certification program … (94) … to provide robot integrators with a way to benchmark against industry best practices and allows robot users to develop a baseline for … (95) … robot integrators. RIA currently has over 20 Certified Robot Integrators and requires each of them to be recertified every two years.

Choose the correct answer for blank (91).

92. Ann Arbor, MI – Robotic Industries Association (RIA) today announced that Wolf Robotics … (91) … recertification as part of the RIA Certified Robot Integrator program. Wolf Robotics achieved their initial certification … (92) … April 2012 by completing a rigorous process, which includes an on-site audit, and … (93) … of key personnel among other important criteria. The certification program … (94) … to provide robot integrators with a way to benchmark against industry best practices and allows robot users to develop a baseline for … (95) … robot integrators. RIA currently has over 20 Certified Robot Integrators and requires each of them to be recertified every two years.

Choose the correct answer for blank (92).

93. Ann Arbor, MI – Robotic Industries Association (RIA) today announced that Wolf Robotics … (91) … recertification as part of the RIA Certified Robot Integrator program. Wolf Robotics achieved their initial certification … (92) … April 2012 by completing a rigorous process, which includes an on-site audit, and … (93) … of key personnel among other important criteria. The certification program … (94) … to provide robot integrators with a way to benchmark against industry best practices and allows robot users to develop a baseline for … (95) … robot integrators. RIA currently has over 20 Certified Robot Integrators and requires each of them to be recertified every two years.

Choose the correct answer for blank (93).

94. Ann Arbor, MI – Robotic Industries Association (RIA) today announced that Wolf Robotics … (91) … recertification as part of the RIA Certified Robot Integrator program. Wolf Robotics achieved their initial certification … (92) … April 2012 by completing a rigorous process, which includes an on-site audit, and … (93) … of key personnel among other important criteria. The certification program … (94) … to provide robot integrators with a way to benchmark against industry best practices and allows robot users to develop a baseline for … (95) … robot integrators. RIA currently has over 20 Certified Robot Integrators and requires each of them to be recertified every two years.

Choose the correct answer for blank (94).

95. Ann Arbor, MI – Robotic Industries Association (RIA) today announced that Wolf Robotics … (91) … recertification as part of the RIA Certified Robot Integrator program. Wolf Robotics achieved their initial certification … (92) … April 2012 by completing a rigorous process, which includes an on-site audit, and … (93) … of key personnel among other important criteria. The certification program … (94) … to provide robot integrators with a way to benchmark against industry best practices and allows robot users to develop a baseline for … (95) … robot integrators. RIA currently has over 20 Certified Robot Integrators and requires each of them to be recertified every two years.

Choose the correct answer for blank (95).