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Match the word to its synonym level B1 CEFR. Use the vocabulary exactly adverb precisely except that aside from exist verb to be real existing adjective real, current Example: Flying cars are not practical with existing technology. existence noun reality Example: The existence of black holes has been confirmed by indirect observation. extraordinary adjective unusual feature noun important part of something Example: The Ramon Crater is a unique feature of the Negev Desert. feedback noun reaction figure noun shape Example: I can’t tell if that figure in the shadows is a man or a woman. figure out verb understand Example: I just can’t figure out how the magician did that amazing trick. financial adjective related to money Example: Her family is having financial problems so they can’t travel overseas this year. finance verb pay for Example: If I can’t get a loan from the bank, I won’t be able to finance a new apartment. finance noun money Example: An expert in finance predicts a global recession. finding/findings noun discoveries; results of a study Example: According to the findings of the police investigation, this is the gun which fired the fatal bullet. flexibility noun willingness to change flexible adjective adjusts easily Example: I’d prefer to meet on Monday morning but I can be flexible depending upon your schedule. flood noun a lot of water flood verb to cover with too much water flu noun type of sickness focus on/upon verb pay attention to Example: You should focus on your schoolwork if you want to improve your grades. focus noun attention People with attention deficit disorder lose focus easily. frequency noun how often frequent adjective very often Example: Hanah is a frequent customer and everyone at the store knows her. fresh adjective new Example: We need some fresh ideas if we’re going to solve this problem. frighten verb scare from preposition position, starting point gain verb make an increase, profit, earn Example: I have nothing to gain by choosing sides so I shall remain neutral. gain noun profit, amount earned generate verb create, make Example: Chat GPT can generate text written in any style you choose. guidance noun help, advice hopeful adjective optimistic, having a positive outlook Example: The farmers are hopeful that we will have rain this winter. hopefully adjective with luck ideal adjective best, most preferable Example: Nuclear power may not be an ideal solution to global warming, but it’s certainly worth considering. illness noun sickness, disease illustrate verb draw pictures illustration noun picture, image Example: Children’s storybooks have colorful illustrations. image noun picture, especially on film or television Example: The mother of the pop singer cried when she first saw her daughter’s image on television. in preposition within, inside, into in terms of regarding Example: That company makes a great product but they’re lacking in terms of customer service. in actual fact in truth Example: The mayor says the city is a safe place to live, but in actual fact the violent crime rate is very high. in connection with about Example: Police arrested four men in connection with the robbery. in that case if that is true Example: Billy Bob: “Traffic could be heavy tomorrow.” Peggy Sue: “In that case, we better leave early.” in the meantime while, during Example: The new computers won’t arrive until next week, but we can keep using the old ones in the meantime. initial adjective first Example: Her initial reaction to that song was negative, but over time she’s come to like it. initially adverb at first instruction noun teaching, order Example: Most new electronic devices come with a set of instructions. intelligence noun smartness Example: Since you have a degree from a good university, I assume you have sufficient intelligence to understand this problem. intelligent adjective smart Example: Joe isn’t very intelligent, but he is a kind person with a warm heart. interest noun attraction Example: Yossi has little interest in politics, whereas his wife goes to all the protests and demonstrations. interest verb to attract Example: Sports don’t really interest me, but my brother is a big basketball fan. introduce verb to show something new Example: Today in class I will introduce the basic concepts of literary analysis. invest verb to put money into something in order to earn money Example: Joe invested in cryptocurrency and lost a lot of money. investor noun one who puts money into something in order to earn money Example: Venture capitalists are investors who put money into risky start-up businesses. investment noun putting money into something in order to earn money Example: Buying real estate in Israel is a very safe investment because the value never goes down. investigate verb research, study Example: The police collected evidence to investigate the murder. investigation noun study Example: The police don’t have a suspect for the murder as the investigation isn’t finished yet. investigator noun detective Example: Detective Schmendrick is the lead investigator for the murder case. just about almost Example: I’m just about done here so I’ll be there shortly. keep on doing verb continue Example: You’re crazy if you keep on doing the same thing and expect different results. kind of type of Example: What kind of dog is that, a poodle? knowledge noun awareness Example: John failed the test due to lack of knowledge of the material. lack verb not having, missing Example: John failed the test due to lack of knowledge of the material. landscape noun the view of the land likely adjective, adverb probably Example: When we learn from our mistakes, we’re not likely to forget. limited adjective restricted Example: We should go to the store today because the sale is for a limited time only. limitation noun restriction little adjective small, not a lot Example: She always tells the truth. I have little reason to doubt her. look at verb see Example: People used to read newspapers on the train. Nowadays they just look at their phones. low adverb to a small amount or level Example: I have to charge my phone because the battery is running low. material noun documents, information Example: We have a lot of material to cover before the end of the semester. meaning noun significance mean verb to have significance or purpose means noun form of, by the use of Example: They communicate by means of radio. measure noun step Example: The teacher took measures to prevent cheating during the test mention verb to say, point out Example: The coach said the team played very well today but didn’t mention any player specifically. miss verb (1) fail to catch (2) wishing to see somebody Examples: (1) The football player kicked the ball but missed the goal. (2) Wow, it’s good to see you! I’ve missed you so much! misunderstand verb understand incorrectly Example: I’m afraid I misunderstood the instructions. Could you repeat them please? more or less approximately, somewhat, to a varying degree Example: This is more or less a religious neighborhood, though there are a few secular families. must modal verb have to naturally adverb as expected, normally nature noun (1) open air (2) character Examples: (1) We like to go hiking in nature reserves. (2) Pit bulls are aggressive by nature.

Growing up in Sioux Falls, South Dakota, a small city surrounded by endless plains, I've found unexpected echoes of home in China's smaller towns — from the warmth of locals in Huaihua, Central China's Hunan province, to the quiet charm of Yangshuo, South China's Guangxi Zhuang autonomous region. With an itch to see more of China's lesser-visited regions, I began planning a trip to the northwest with seven friends — five Americans, one Pakistani, one Zimbabwean, and one Colombian. We bought round-trip tickets from Shanghai to Yinchuan, Ningxia Hui autonomous region, for less than $120 each. From there, we planned to rent a car and drive to Xining in Qinghai, then on to Qinghai Lake, and finally to Lanzhou, Gansu. To make that possible, several of us applied for Chinese driver's licenses, a process that involved translating our US licenses into Mandarin and passing a short test on traffic laws. Within a day, we were licensed. As we piled into two rental cars in late March to begin our eight-day journey, it became clear that this wasn't just a road trip — it was the culmination of our four years in China, the Mandarin we had so diligently studied, and our ongoing effort to contribute to US-China people-to-people relations. Right away, we drew curious reactions. At the Yinchuan airport, taxi drivers offered us rides into the city, only to stare in astonishment when we told them we had rented cars. "You're driving? In China?" one driver asked, visibly surprised. It was a reaction we'd encountered multiple times during our trip, as foreign drivers are rare in China, especially in remote regions. In Yinchuan, we stocked up on snacks and adjusted to the chilly desert air. From there, we headed west, navigating wide highways framed by dramatic landscapes: arid plains, jagged mountains, and occasionally, a herd of sheep crossing the road. The vastness of the Northwest was humbling — and as someone who grew up on the wide-open prairies of South Dakota, it felt oddly familiar. One of the highlights of our trip was camping by Qinghai Lake, the largest saltwater lake in China. A few summers ago, Santiago Solano, one of my classmates from the US, cycled from Xi'an in Shaanxi to Urumqi in the Xinjiang Uygur autonomous region over the course of a month and met many kind strangers along the way. One of them was Geng San, a Tibetan lamb herder who managed a piece of land right next to Qinghai Lake and graciously invited us to camp there. "That's what China is — it's the people. The quiet generosity of an old Tibetan nomad who, years after we first met, still offered us a place to rest on his land," said Solano, who is also part of the group on this trip. But apparently, we underestimated just how cold it would be to camp next to Qinghai Lake in late March. It was deathly freezing. In preparation for the trip, we had ordered two tent kits and eight sleeping bags. However, when the temperature eventually dropped to — 10 C, all of us piled into the cars and turned the heaters on. So much for camping. From Qinghai Lake, we drove to Lanzhou, where we visited many food markets and tried every type of noodle on offer. Since we are college students, we rented a gaming hotel room — something I've only ever seen in China. At night, instead of attending local parties as we had before, we stayed in the hotel and gamed late into the morning. For me, the trip was as much about the journey as it was about the destinations. Driving through Northwest China gave us a unique perspective on the region's natural beauty and its people. At gas stations, shopkeepers greeted us with curiosity and kindness, often offering recommendations for nearby attractions. At roadside carts, we sampled local specialties, grabbing a quick skewer and a mango for the road. And at every stop, we were touched by the warmth and hospitality that make traveling in China so rewarding. As an American who has lived in China for several years, I'm often asked about my experiences here. Trips like this one remind me of the similarities between the two countries, despite their differences. Just as road trips are a quintessential part of American culture, they've become my favorite way to explore China. Whether it's driving through the rolling hills of South Dakota or the deserts of Ningxia, there's something universal about the freedom and camaraderie that come with having complete control over where you end up. Written by Charlie Howes, a 22-year-old American who has lived in China since 2019. He completed his final year of high school at Beijing No 80 High School and is currently studying at New York University Shanghai. He has founded a company in China focused on facilitating US-China trade and plans to continue living in Shanghai long term. He enjoys road trips, cycling around the world, learning languages, and meeting new people.

The Pleiades, also known as the Seven Sisters, is a famous star cluster located in the constellation of Taurus. It is made up of a group of seven bright stars that are visible to the naked eye in the night sky. The stars in the Pleiades cluster are relatively young, being only about 100 million years old, which is young in astronomical terms. The Pleiades cluster has been observed and admired by cultures all around the world for thousands of years. In Greek mythology, the Pleiades were seven sisters who were pursued by the hunter Orion. To protect them, Zeus transformed them into stars, forming the star cluster we see today. Different cultures have their own stories and legends associated with the Pleiades, making it a fascinating object of study for astronomers and a source of inspiration for artists and storytellers. The Pleiades cluster is often used as a test of eyesight, as people are challenged to count how many stars they can see with the naked eye. Most people can see six or seven stars, but those with particularly sharp vision may be able to see more. The Pleiades is also a popular target for amateur astronomers with telescopes, as the cluster reveals even more stars and details when viewed through a telescope. In addition to being a beautiful sight in the night sky, the Pleiades cluster also serves a practical purpose for astronomers. By studying the stars in the Pleiades, scientists can learn more about how stars form and evolve, as well as gain insights into the structure and composition of the Milky Way galaxy. The Pleiades cluster continues to be an important object of study for astronomers, both amateur and professional, and its beauty and significance will continue to capture the imaginations of people for generations to come. Matariki is the Maori name for the Pleiades star cluster. The Pleiades is a group of stars that can be seen in the night sky, and Matariki is a special time of year when the star cluster is visible in the sky. In Maori culture, Matariki is seen as the beginning of the Maori New Year, and it is a time to celebrate and give thanks for the past year and look forward to the year ahead. So basically, Matariki is related to the Pleiades because it is a special time of year when those stars are visible in the sky and it has cultural significance for the Maori people. The Pleiades star cluster is known by different names in various cultures around the world. Here are some of the names by which the Pleiades are referred to in different countries: 1. Maori culture in New Zealand and Polynesia: Matariki 2. Greek mythology: The Seven Sisters 3. Japan: Subaru 4. Native American tribes: The Dancers or The Little Eyes 5. Inca civilization: Collca 6. Ancient Persia: Parvin 7. India: Krittika 8. Aboriginal Australians: The Seven Sisters or Djulpan These different names reflect the diverse cultural significance and interpretations of the Pleiades cluster in various societies throughout history.

Short Story: Making Good Choices Last month, I made an important decision. I asked my parents if I could get some **pocket money**. I wanted to learn how to make **independent choices** and use the money **to buy for myself**. They agreed to give me some on a **weekly basis**. I was very happy! One day, at school, we had a **final** exam. I was very **worried**. I tried to **concentrate**, but I **can hardly** sit still when I'm nervous. My best friend, Jake, is always **fun loving**, and he didn’t **stay for long** in the classroom after the test started. He wanted to **pass notes**, but I said no. I didn’t want to **get caught**. The teacher said, “**Turn over** your papers now.” I looked at the test and felt **scared**. “What if I **lose** all my marks?” I thought. “I will look **stupid**.” I tried to **look straight into my eyes** in the small mirror on my pencil case and said, “You can do this.” Then, I started to **find** some answers and felt a little better. After school, we walked on the **sidewalk** and saw a big **crowd** of students talking about the test. Jake laughed and said, “Let’s buy some ice cream with your **pocket money**!” But I said no. “I want to save it **to buy for myself** something special.” When I got home, I helped my mom **wash up** the dishes. She smiled and said, “You made good choices today.” That night, I dreamed I was a **slave** in a boring office, working all day. But when I woke up, I laughed. I wasn’t a **slave**. I was just a kid learning to make smart choices. I **decided** to study more and use my **pocket money** wisely. I wanted to be **independent**, make good choices, and maybe be the **first** in my family to buy something big with saved money.

[t comes from the GREEK name "Epilepsia" which means "taking hold of or seizing". - It is a disorder characterized by: recurrent seizures. SEIZURES R ectment transient attacks of: R epresent: R esult from: ASSOCIATED WITH: somatic, psychic, or, autonomic clinical featmes. clinical features of abnormally hyperexcitable cortical neurons. paroxvsmal and excessive electrical neuronal discharges. EEG changes & may be disturbance of consciousness. same causes of convulsions 1. Idiopathic epile~ • It is the commonest cause. no cause can be detected ( 65 % ) • It may be associated with positive family history in some cases. • It starts in the l st & 2nd decades in the form of: -- Grand ma! epilepsy. Petit mal epilepsy. Myoclonic epilepsy. Atonic seizures. 2. Secondary epilepsy A. Local causes in the brain: l. Congenital: 2. Traumatic: cerebral palsy. a cause can be detected cerebral contusion or laceration. 3. Inflammatory: 4. Neoplastic: 5. Degenerative: 6. Vascular: encephalitis, brain tumours. mening1t1s, presenile dementia. brain abscess. stroke (especially hemon-hagic), hypertensive encephalopathy. B. General causes with secondary effects on the brain: I. Toxic: 2. Iatrogenic: 3. Metabolic: 4. Endocrinal: 5. Organ failure: 6. Heart disease: 7. Nutritional: - Alcohol, cocaine, lead. - Lidocaine, INH. - j glucose & ! glucose. - Hypoparathyroidism. - Hepatic failme. - Adam's Stoke's attacks. - Pellagra. - Botulism, tetanus. - Ambilhar, Amphetamine, Aminophylline. - j Ca & ! Ca. - Hype1thyroid crisis. - Renal failure. - Fallot's tetralogy. - j Na & ! Na. - Vitamin B6 deficiency. 8. Physical: 9. HYSTERICAL. - High fevers. - Heat stroke. 136 137 CLINICAL PICTURE 1. GENERALISED SEIZURES " Excessive electrical discharges from cortical neurons in BOTH hemispheres simultaneously " I. II. 1. Grand Mal Epile~: 1. Pre-ictal stage "attacks of tonic-clonic convulsions " (aura) It is a warning sign of a coming attack. It may be: • Somatic: • Psychic: • Autonomic: 2. Ictal stage Myoclonus, Hallucinations. Tachycardia, (seizure) Sudden loss of consciousness: Parasthesias. Sweating. for seconds to minutes. -- Tonic phase (few seconds) o The UL & LL: o o o o The HEAD: The JAWS: CYANOSIS: are extended. is retracted to one side & the eye balls rolled up. are firmly clenched, with biting of the TONGUE. due to impaired respiration. There may be incontinence of urine. Clonic phase (few minutes) o The UL & LL: o The HEAD: 3. Post-ictal stage - It may be: • Somatic: • Psychic: • Autonomic: Drug of choice: contract & relax repeatedly & rapidly. jerks forcibly. (sequelae) Todd's paralysis(< 24 hours, due to neuronal exhaustion). Confusion. Vomiting. Carbamazepine (Tegretol) or Phenytoin (Epanutin) Petit Mal Epilepsy: "attacks of loss of consciousness " " Absence " It starts in childhood & improves at puberty & usually disappears at the age of 20. 2. It is NOT PRECEEDED by aura & NOT FOLLOWED by sequelae. 3. It is usually PRECIPITATED by: hyperventilation 4. It is characterized by: or photic stimulation. sudden loss of consciousness of short duration (few seconds). 5. It may be associated with: • High frequency ( 50 attacks / day). • Falling to the ground without warning. • Jerky movements of the head & UL Drug of choice: (myoclonic petit mal). Valproate (Depakine) or Succinimide (Zarontin) 137 138 Ill. M oclonic Seizures: "attacks of involuntary clonic movements " - It is characterized by: sudden, jerky, shock-like INVOLUNTARY muscle contraction. • The jerks are bilateral contractions, mainly of the shoulders and arms. • However, some patients repmtjerking in the lower limbs, trunk, or head. - It may be of 2 types: - Occurs singly • Simple: • As a pait of: I Drug of choice: IV. Atonic seizures: (no loss of consciousness). - Grand mal epilepsy (aura). - Petit mal epilepsy. Valproate (Depakine) or Clonazepam (Rivotril) I - Transient attacks of brief loss of postural tone, often resulting in falls and injuries. 2. PARTIAL SEIZURES "Excessive electrical discharges from cmtical neurons in a ce1tain area in ONE hemisphere" A. Simple seizures: " No disturbance in consciousness " - The CP depends on the site of the hyperexcitable neurones in the cerebral cortex, whether in: "Motor area or Senso,y areas". 1. Motor fits: • Focal fits: • Motor jacksonian fits: 2. General Sensory fits: • Focal fits: • Sensory jacksonian fits: 3. Special Senso1y fits: • Visual hallucinations: • Auditory hallucinations: • Olfactory hallucinations: B. Complex seizures: - SITE: movement of part of a limb or the whole limb. movement of one side of the body (see before). parasthesia of part of a limb or the whole limb. parasthesia of one side of the body (see before). irritation of the visual sensory area. irritation of the auditory sensory area. initation of the uncus. " disturbance in consciousness " The hyperexcitable neurons are in the Temporal lobe "Temporal lobe epilepsy". - DURATION: The seizure lasts few seconds to few minutes. - The seizure starts with A ura, followed by A bsence, Automatism, Amnesia: 1. 2. 3. 4. A ura: A bsence: Automatism: A mnesia: Olfactory hallucinations, Deja-vu phenomenon, Sensation of fear. Absent patient with staring eyes (with no response to conversation). Involuntary Purposeless acts: motor ( eg, lip smacking, chewing) or verbal. No recalling of the seizure. 138 139 3. PARTIAL SEIZURES ~ GENERALISED SEIZURES " Partial seizures may spread to involve the whole brain .- secondarily generalised seizures " . HY-sterical epilepsY • Usually: • The cause: • Incidence: young neurotic Sj2 . psychological & there is no organic lesion. usually occurs in the presence of people. • It is associated with: • EEG: • It is not associated with: normal. • Missed ttt. • Menses. • Alkalosis. anxiety, palpitaion & hyperventilation. tongue biting or incontinence of urine. • Alcohol use & Drug abuse ( e.g. cocaine ). • S timulation by photons & Hyperventilation. • S leep deprivation & Stress & sudden withdrawal of antiepileptic drngs. INVESTIGATIONS 1. EEG: • It is the most specific test for epilepsy because it records the electrical activity of the brain. • It shows specific pattern: 2. LOCAL INVESTIGATIONS: "Epilepsy waves". "CT & MRI of the brain" • To identify or exclude a LOCAL CAUSE of seizures in the brain. 3. GENERAL INVESTIGATIONS: "Laboratory investigations" • To search for a GENERAL CAUSE of seizures, e.g. blood glucose. 139 140 TREATMENT A. General Measures: 1. 2. Moderation of the patient's physical activity. A void the precipitating factors ( Alcohol, hyperventilation, photic stimulation ...... ). 3. A ketogenic diet is encouraged because it will induce acidosis: - Acidosis is beneficial as it raises the threshold of stimulation of the brain cells. B. Specific Treatment: 2. 1. Treatment of the cause in secondary epilepsy. Anti-epileptic drugs: a) Always sta1t with one drug, then add another drug if there is no response. b) Always stop the drugs ONLY if: • The patient stays free of symptoms for at least 2 years. • The patient has a normal EEG. 3. Side effects of Anti-epileptic drugs: I . Skin rash. 2. 3. Bone marrow depression. Ataxia. Drug 1. Barbiturates (Pbenonobarbitone) 2. Hydantoin (Epanutin) 3. Carbamazepine 4. Clonazepam 5. Valproate 6. Succinamide ANTI-EPILEPTIC DRUGS NEW ANTI-EPILEPTIC DRUGS - These drugs are new dtugs that may be used in resistant seizures. 1. Lamotrigine: 200 - 400 mg/ day. 2. Felbamate: 3. Gabapentin: 400- 800 mg/ day. 600 - 1200 mg/ day. \ " General rules for use ": Dose 100-600 mg I day 100-600 mg / day 200-600 mg I day 2-6 mg I day 500-1500 mg I day 500-1000 mg / day Best indicated - Broad spectrum. - Not for petit mal. - Grand mal. - Motor Jacksonian fits. - Grand mal. - Motor Jacksonian fits. - Complex seizures. - Not for petit ma!. - Myoclonic. - Grand mat. - Broad spectrum. - Petit mat. 140 141 STATUS EPILEPTICUS DEFINITION - A medical emergency: 1. Repeated attacks of generalized convulsions, with lack of recove,y of consciousness, 2. Persistent attack of seizure lasting for at least 30 minutes. OR, - If the convulsions are not stopped rapidly, coma deepens & death may occur due to: heart failure or respiratory failure or brain damage or hyperpyrexia. - The most common causes are: sudden withdrawal of anti-epileptic drugs & stroke. TREATMENT A. General Measures: l. Take care of: " ABC " • Place the patient on the ground, to guard against falling from bed. • Mouth gag & 02 inhalation ( endo-tracheal intubation may be needed). • Record the vital signs regularly. 2. Take a sample of: - Venous blood: for the level of: - A.tierial blood: for the level of: 3. a nti-epileptic drugs, a lcohol. pH, p0 2, pC02, HC0 3. Give cerebral dehydrating measures: e.g. Frusemide, cone. Mannitol, Dexamethazone. B. Specific Treatment: - Phenytoin with diazepam (or clonazepam) immediately: 1. Phenytoin: 2. Diazepam: Clonazepam: seizures recur: 15 mg I Kg slow infusion. 5 mg slowly IV, to be repeated after 5 minutes if seizures recur: maximum dose: 20 mg. OR: 2 mg slowly IV, to be repeated after 5 minutes if maximum dose: 6 mg. - If seizures persist after 20 min. of Phenytoin & diazepam: 3. PHENOBARBITONE: - In resistant cases: 200 mg infusion. 4. GENERAL ANAESTHESIA: may be used.

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