TEDMED 2014
Jeff Iliff: One more reason to get a good night's sleep
Jeff Iliff: Razlog više da se dobro naspavate
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Mozak koristi četvrtinu energije čitavog tijela, a zauzima samo oko 2 procenta čitave tjelesne mase. Kako ovaj jedinstveni organ prima, i još važnije, kako odstranjuje hranjive materije? Novo istraživanje pokazuje da to ima veze sa snom.
Jeff Iliff - Neuroscientist
Jeff Iliff is a neuroscientist who explores the unique functions of the brain. Full bio
Jeff Iliff is a neuroscientist who explores the unique functions of the brain. Full bio
Double-click the English transcript below to play the video.
00:12
Sleep.
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Spavanje.
00:14
It's something we spend about
a third of our lives doing,
a third of our lives doing,
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U tome provodimo trećinu svog života,
00:17
but do any of us really understand what it's all about?
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ali da li iko od nas zna o čemu se tu
zapravo radi?
zapravo radi?
00:20
Two thousand years ago, Galen,
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Prije 2000 godina, Galen,
00:22
one of the most prominent medical researchers
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jedan od najistaknutijih istraživača
medicine
medicine
00:25
of the ancient world,
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antičkog doba
00:26
proposed that while we're awake,
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predložio je da motivaciona snaga
našeg mozga,
našeg mozga,
00:28
our brain's motive force, its juice,
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njegovi sokovi, u budnom stanju
00:31
would flow out to all the other parts of the body,
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protiču kroz sve druge dijelove tijela
00:34
animating them but leaving the brain all dried up,
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i animiraju ih, ali time iscrpljuju mozak.
00:38
and he thought that when we sleep,
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Galen je pomislio da dok spavamo
00:40
all this moisture that filled the rest of the body
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sva ta vlažnost koja je ispunila ostatak
tijela
tijela
00:42
would come rushing back,
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naglo bi se vratila
00:44
rehydrating the brain
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i hidrirala mozak
00:46
and refreshing the mind.
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i osvježila um.
00:48
Now, that sounds completely ridiculous to us now,
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Nama to sada zvuči baš smiješno,
00:51
but Galen was simply trying to explain
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ali Galen je prosto pokušao da
objasni
objasni
00:53
something about sleep
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nešto vezano za san
00:54
that we all deal with every day.
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sa čime se susrećemo svaki dan.
00:57
See, we all know based on our own experience
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Na osnovu svog iskustva, svi znamo
00:59
that when you sleep, it clears your mind,
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da nam san razbistruje um
01:02
and when you don't sleep,
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i nedostatak istog
01:03
it leaves your mind murky.
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čini naš um mutnim.
01:06
But while we know a great deal more about sleep now
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Iako se danas zna mnogo više o snu
01:08
than when Galen was around,
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nego kad je Galen bio živ,
01:10
we still haven't understood why it is that sleep,
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još uvijek ne znamo zašto san
01:13
of all of our activities, has this incredible
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pored svih drugih aktivnosti, ima
nevjerovatnu
nevjerovatnu
01:16
restorative function for the mind.
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iscjeliteljsku moć nad našim umom.
01:18
So today I want to tell you about
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Danas želim da vam pričam
01:20
some recent research
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o nedavnom istraživanju
01:21
that may shed new light on this question.
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koje možda rasvijetli ovo pitanje.
01:24
We've found that sleep may actually be
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Otkrili smo da je san zapravo
01:27
a kind of elegant design solution
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takoreći elegantno rješenje
01:30
to some of the brain's most basic needs,
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za neke od najosnovnijih potreba mozga,
01:32
a unique way that the brain
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jedinstven način na koji mozak
01:34
meets the high demands and the narrow margins
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odgovara na velike zahtijeve i finese
01:37
that set it apart from all the other organs of the body.
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koje ga razdvajaju od ostalih organa
tijela.
tijela.
01:42
So almost all the biology that we observe
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Skoro sva biologija koju posmatramo
01:45
can be thought of as a series of problems
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može se okarakterisati kao niz
problema
problema
01:48
and their corresponding solutions,
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i odgovarajućih rješenja.
01:50
and the first problem that every organ must solve
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Prvi problem koji svaki organ mora da
riješi
riješi
01:53
is a continuous supply of nutrients to fuel
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je konstantna opskrba svih tih ćelija
01:56
all those cells of the body.
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hranjivim materijama.
01:57
In the brain, that is especially critical;
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To je posebno bitno za mozak.
02:00
its intense electrical activity uses up
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Njegova intenzivna električna aktivnost
crpi
crpi
02:02
a quarter of the body's entire energy supply,
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četvrtinu ukupne energije tijela
02:05
even though the brain accounts
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iako mozak zauzima
02:07
for only about two percent of the body's mass.
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samo oko 2 procenta tjelesne mase.
02:10
So the circulatory system
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Krvotok rješava
02:11
solves the nutrient delivery problem
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problem dostave hranjivih materija
02:14
by sending blood vessels to supply nutrients
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šaljući krvne sudove da obskrbe tim
materijama
materijama
02:16
and oxygen to every corner of our body.
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i kiseonikom svaki pedalj našeg tijela.
02:20
You can actually see it in this video here.
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To možete vidjeti na ovom snimku.
02:23
Here, we're imaging blood vessels
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Ovdje su prikazani krvni sudovi
02:24
in the brain of a living mouse.
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u mozgu živog miša.
02:27
The blood vessels form a complex network
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Krvni sudovi formiraju složenu mrežu
02:30
that fills the entire brain volume.
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koja ispunjava čitavu zapreminu mozga.
02:32
They start at the surface of the brain,
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Oni počinju na površini mozga
02:34
and then they dive down into the tissue itself,
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a onda zadiru u samo tkivo.
02:37
and as they spread out, they supply nutrients
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Dok se šire, opskrbljuju svaku moždanu
ćeliju
ćeliju
02:39
and oxygen to each and every cell in the brain.
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hranjivim materijama i kiseonikom .
02:45
Now, just as every cell requires
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Kao što svakoj ćeliji trebaju
02:48
nutrients to fuel it,
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ove materije za pogon,
02:50
every cell also produces waste as a byproduct,
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svaka ćelija proizvodi otpad
02:53
and the clearance of that waste
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i uklanjanje tog otpada
02:55
is the second basic problem
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je drugi osnovni problem koji
02:57
that each organ has to solve.
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svaki organ treba da riješi.
03:00
This diagram shows the body's lymphatic system,
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Ovaj dijagram prikazuje tjelesni limfni
sistem
sistem
03:02
which has evolved to meet this need.
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koji je evoluirao kako bi riješio
ovaj problem.
ovaj problem.
03:05
It's a second parallel network of vessels
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Ovo je drugi paralelni sistem sudova
03:07
that extends throughout the body.
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koji se prostire po cijelom tijelu.
03:09
It takes up proteins and other waste
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On sakuplja proteine i drugi otpad
03:11
from the spaces between the cells,
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iz međućelijskih dijelova
03:13
it collects them, and then dumps them into the blood
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i onda ih premiješta u krv
03:16
so they can be disposed of.
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kako bi se oni otklonili.
03:18
But if you look really closely at this diagram,
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Ako pažljivije pogledate ovaj
dijagram
dijagram
03:20
you'll see something
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primijetićete da nešto
03:22
that doesn't make a lot of sense.
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ne štima.
03:24
So if we were to zoom into this guy's head,
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Ako biste zumirali glavu ovog čovjeka
03:27
one of the things that you would see there
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ono što vidite je da
03:29
is that there are no lymphatic vessels in the brain.
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u mozgu nema limfnih sudova.
03:33
But that doesn't make a lot of sense, does it?
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Ali to nema mnogo smisla.
03:36
I mean, the brain is this intensely active organ
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Mozak je jedan izuzetno intenzivan
organ
organ
03:39
that produces a correspondingly
large amount of waste
large amount of waste
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koji shodno tome proizvodi velike
količine otpada
količine otpada
03:42
that must be efficiently cleared.
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koji se mora učinkovito otkloniti.
03:44
And yet, it lacks lymphatic vessels, which means that
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Ipak, on nema limfne sudove,
što znači da
što znači da
03:47
the approach that the rest of the body takes
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pristup koji ostatak tijela koristi
03:49
to clearing away its waste
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kako bi otklonio otpad
03:51
won't work in the brain.
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neće djelovati u mozgu.
03:54
So how, then, does the brain solve
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Kako onda mozak rješava
03:56
its waste clearance problem?
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problem odstranjivanja otpada?
03:58
Well, that seemingly mundane question
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Kod ovog naizgled svakodnevnog pitanja
04:02
is where our group first jumped into this story,
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naša prva grupa ulazi u igru.
04:05
and what we found
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Ono što smo otkrili
04:07
as we dove down into the brain,
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zaronivši dublje u mozak
04:09
down among the neurons and the blood vessels,
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dole među neurone i krvne sudove
04:12
was that the brain's solution
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bilo je da je rješenje mozga
04:15
to the problem of waste clearance,
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za odstranjivanje otpada
04:17
it was really unexpected.
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sasvim nesvakidašnje.
04:19
It was ingenious,
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Bilo je genijalno,
04:22
but it was also beautiful.
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ali i prelijepo.
04:25
Let me tell you about what we found.
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Da vam ispričam šta smo našli.
04:27
So the brain has this large pool
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Mozak ima prostor prepun
04:29
of clean, clear fluid called cerebrospinal fluid.
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čiste i bistre tečnosti koja se zove
cerebrospinalna tečnost.
cerebrospinalna tečnost.
04:33
We call it the CSF.
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Mi je zovemo CST.
04:34
The CSF fills the space that surrounds the brain,
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CST ispunjava prostor koji okružuje
mozak
mozak
04:38
and wastes from inside the brain
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i otpad iz mozga
04:39
make their way out to the CSF,
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ulazi u CST
04:42
which gets dumped, along with
the waste, into the blood.
the waste, into the blood.
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koja se zajedno s otpadnom uliva u krv.
04:45
So in that way, it sounds a lot like
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Ovo puno zvuči kao
04:46
the lymphatic system, doesn't it?
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limfni sistem, zar ne?
04:49
But what's interesting is that the fluid and the waste
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Ono što je interesantno je da tečnost
i otpad
i otpad
04:51
from inside the brain,
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iz mozga
04:53
they don't just percolate their way randomly
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ne izlaze nasumično
04:55
out to these pools of CSF.
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iz ovog prostora CST-a.
04:58
Instead, there is a specialized network of plumbing
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Naprotiv, postoji specijalizovan sistem
05:02
that organizes and facilitates this process.
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koji organizuje i podupire ovaj proces.
05:05
You can see that in these videos.
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To možete vidjeti na ovim snimcima.
05:08
Here, we're again imaging into the brain
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Ovdje ponovo imate prikaz mozga
05:11
of living mice.
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živog miša.
05:12
The frame on your left shows
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Slika lijevo prikazuje
05:14
what's happening at the brain's surface,
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šta se dešava na površini mozga
05:16
and the frame on your right shows
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a slika desno prikazuje
05:18
what's happening down below the surface of the brain
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šta se dešava ispod površine mozga
05:20
within the tissue itself.
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unutar samog tkiva.
05:21
We've labeled the blood vessels in red,
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Krvni sudovi su crvene boje
05:24
and the CSF that's surrounding the brain
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a CST koja okružuje mozak
05:26
will be in green.
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je zelene.
05:27
Now, what was surprising to us
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Ono što nas je iznenadilo je
05:29
was that the fluid on the outside of the brain,
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to da tečnost izvan mozga
05:32
it didn't stay on the outside.
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nije ostala izvan njega.
05:35
Instead, the CSF was pumped back into
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CST se vratila unutar
05:39
and through the brain
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i prošla kroz krv
05:41
along the outsides of the blood vessels,
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duž vanjskog dijela krvnih sudova.
05:44
and as it flushed down into the brain
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Dok se spuštala u mozak
05:46
along the outsides of these vessels,
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duž vanjskog dijela ovih sudova
05:48
it was actually helping to clear away,
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ona je zapravo pomagala u otklanjanju
05:51
to clean the waste from the spaces
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otpada iz
05:53
between the brain's cells.
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međućelijskog prostora.
05:56
If you think about it,
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Ako razmislite o tome,
05:58
using the outsides of these blood vessels like this
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korištenje vanjskog dijela ovih sudova
06:01
is a really clever design solution,
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je jako pametno rješenje
06:04
because the brain is enclosed
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jer je mozak zatvoren
06:07
in a rigid skull
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u čvrstu lobanju
06:08
and it's packed full of cells,
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i prepun je ćelija
06:10
so there is no extra space inside it
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tako da u njemu nema dodatnog
prostora
prostora
06:13
for a whole second set of vessels
like the lymphatic system.
like the lymphatic system.
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za čitav set sudova jednog
limfnog sistema.
limfnog sistema.
06:17
Yet the blood vessels,
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Ipak, krvni sudovi
06:18
they extend from the surface of the brain
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se protežu sa površine mozga
06:20
down to reach every single cell in the brain,
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do svake žive ćelije mozga
06:23
which means that fluid
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što znači da tečnost
06:24
that's traveling along the outsides of these vessels
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koja putuje duž vanjskog dijela krvnih
sudova
sudova
06:27
can gain easy access to the entire brain's volume,
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može dobiti pristup cijelokupnoj
zapremini mozga,
zapremini mozga,
06:31
so it's actually this really clever way
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tako da je ovo jako pametan način
za prekvalifikaciju jednog seta sudova,
06:33
to repurpose one set of vessels, the blood vessels,
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06:37
to take over and replace the function
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krvnih sudova, koji preuzimaju funkciju
06:40
of a second set of vessels, the lymphatic vessels,
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drugog seta sudova, limfnih sudova
06:43
to make it so you don't need them.
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kako bi se pobrinuli da ih ne trebamo.
06:45
And what's amazing is that no other organ
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Ono što je zapanjujuće je da nijedan
drugi organ
drugi organ
06:48
takes quite this approach
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ne koristi ovaj pristup
06:49
to clearing away the waste from between its cells.
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kako bi otklonio međućelijski otpad.
06:52
This is a solution that is entirely unique to the brain.
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Ovo rješenje je karakteristično samo
za mozak.
za mozak.
06:58
But our most surprising finding
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Ali najiznenađujuće otkriće
07:00
was that all of this,
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je da se sve ovo
07:03
everything I just told you about,
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što sam vam rekao
07:05
with all this fluid rushing through the brain,
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o ovoj tečnosti koja ide kroz mozak
07:08
it's only happening in the sleeping brain.
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samo se dešava u stanju sna.
07:12
Here, the video on the left
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Snimak lijevo
07:14
shows how much of the CSF is moving
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pokazuje koliko se CST kreće
07:16
through the brain of a living mouse while it's awake.
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kroz mozak miša koji je budan.
07:20
It's almost nothing.
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Skoro pa ništa.
07:22
Yet in the same animal,
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Ali u istoj životinji
07:23
if we wait just a little while until it's gone to sleep,
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ako samo malo sačekamo da zaspi
07:26
what we see is that the CSF
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ono što vidimo je da CST
07:29
is rushing through the brain,
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poput bujice ide kroz mozak.
07:31
and we discovered that at the same time
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Otkrili smo i da u isto vrijeme
07:34
when the brain goes to sleep,
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kada mozak zaspi
07:36
the brain cells themselves seem to shrink,
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moždane ćelije se, čini se, smanje
07:39
opening up spaces in between them,
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i daju malo međuprostora,
07:41
allowing fluid to rush through
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što omogućava tečnosti da jurne
07:43
and allowing waste to be cleared out.
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i time očisti otpad.
07:46
So it seems that Galen may actually have been
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Izgleda da je Galen zapravo
07:48
sort of on the right track when he wrote about
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bio na pravom putu kada je pisao o
07:51
fluid rushing through the brain
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tečnosti koja šiklja kroz mozak
07:53
when sleep came on.
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kada spavamo.
07:55
Our own research, now it's 2,000 years later,
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Naše istraživanje, 2000 godina poslije,
07:58
suggests that what's happening is that
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upućuje na to da
08:00
when the brain is awake
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kada je mozak budan
08:03
and is at its most busy,
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i najzauzetiji
08:05
it puts off clearing away the waste
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on odgađa odstranjivanje otpada
08:07
from the spaces between its cells until later,
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iz međućelijskog prostora
08:10
and then, when it goes to sleep
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i onda kada zaspi
08:12
and doesn't have to be as busy,
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i nije toliko zauzet
08:14
it shifts into a kind of cleaning mode
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prebacuje se u stanje čišćenja
08:17
to clear away the waste
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i odstranjuje otpad
08:19
from the spaces between its cells,
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iz međućelijskog prostora,
08:20
the waste that's accumulated throughout the day.
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otpad koji se nakuplja tokom dana.
08:22
So it's actually a little bit like how you or I,
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To je nekako kao kad vi ili ja
08:25
we put off our household chores during the work week
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odgađamo naše kućanske poslove
u toku radne sedmice
u toku radne sedmice
08:28
when we don't have time to get to it,
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kada nemamo puno vremena
08:29
and then we play catch up on all
the cleaning that we have to do
the cleaning that we have to do
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i onda kada dođe vikend
08:33
when the weekend rolls around.
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trudimo se da sve nadoknadimo.
08:35
Now, I've just talked a lot about waste clearance,
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Puno sam pričao o odstranjivanju
otpada
otpada
08:39
but I haven't been very specific
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ali nisam bio konkretan
08:40
about the kinds of waste
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u vezi sa tipovima otpada
08:42
that the brain needs to be clearing
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koje mozak treba da odstrani
08:44
during sleep in order to stay healthy.
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tokom sna kako bi ostao zdrav.
08:46
The waste product that these recent studies
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Štetni proizvod na koji se
08:48
focused most on is amyloid-beta,
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recentne studije mahom fokusiraju
je amiloid-beta.
je amiloid-beta.
08:50
which is a protein that's made
in the brain all the time.
in the brain all the time.
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To je protein koji se konstantno proizvodi
u mozgu.
u mozgu.
08:54
My brain's making amyloid-beta right now,
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Moj mozak upravo proizvodi
amiloid-betu
amiloid-betu
08:55
and so is yours.
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a i vaš.
08:58
But in patients with Alzheimer's disease,
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Ali kog oboljelih od Alchajmerove
09:00
amyloid-beta builds up and aggregates
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amiloid-beta se nakuplja
09:02
in the spaces between the brain's cells,
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2013
u međućelijskom prostoru
09:04
instead of being cleared away
like it's supposed to be,
like it's supposed to be,
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umjesto da se otklanja
09:08
and it's this buildup of amyloid-beta
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2010
i smatra se da su upravo ove nakupine
09:10
that's thought to be one of the key steps
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amiloid-bete jedan od ključnih koraka
09:12
in the development of that terrible disease.
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u razvitku ove strašne bolesti.
09:15
So we measured how fast amyloid-beta is cleared
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Izmjerili smo koliko brzo se amiloid-beta
otklanja
otklanja
09:18
from the brain when it's awake
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iz mozga u budnom stanju
09:19
versus when it's asleep,
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a koliko u snu.
09:21
and we found that indeed,
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Otkrili smo da, zaista,
09:23
the clearance of amyloid-beta
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otklanjanje amiloid-bete
09:25
is much more rapid from the sleeping brain.
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je mnogo brže u mozgu koji spava.
09:29
So if sleep, then,
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Ako je spavanje
09:31
is part of the brain's solution
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dio rješenja mozga
09:33
to the problem of waste clearance,
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2010
za problem otklanjanja otpada
09:35
then this may dramatically change how we think
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onda će ovo itekako promijeniti
naše razmišljanje
naše razmišljanje
09:37
about the relationship between sleep,
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o vezi između sna,
09:40
amyloid-beta, and Alzheimer's disease.
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amiloid-bete i Alchajmerove bolesti.
09:43
A series of recent clinical studies
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Niz skorašnjih kliničkih studija
09:45
suggest that among patients
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upućuje da među pacijentima
09:47
who haven't yet developed Alzheimer's disease,
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koji još uvijek nisu
dobili Alchajmerovu
dobili Alchajmerovu
09:50
worsening sleep quality and sleep duration
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pogoršano spavanje i njegovo trajanje
09:53
are associated with a greater amount
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su povezani sa većom količinom
09:55
of amyloid-beta building up in the brain,
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nakupina amiloid-bete u mozgu.
09:58
and while it's important to point out
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Važno je istaknuti da, iako
10:00
that these studies don't prove
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ove studije ne dokazuju
10:01
that lack of sleep or poor sleep
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da nedostatak ili loš san
10:04
cause Alzheimer's disease,
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uzrokuju Alchajmerovu,
10:06
they do suggest that the failure of the brain
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2610
one upućuju da neuspjeh mozga
10:09
to keep its house clean
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da očisti kuću
10:10
by clearing away waste like amyloid-beta
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uklanjajući otpad poput
amiloid-bete
amiloid-bete
10:13
may contribute to the development
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1902
može doprinijeti razvitku
10:15
of conditions like Alzheimer's.
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bolesti poput Alchajmerove.
10:19
So what this new research tells us, then,
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Ono što nam ovo istraživanje
govori
govori
10:21
is that the one thing that all of you
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je da jedna stvar koju ste svi
10:23
already knew about sleep,
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već znali o snu,
10:24
that even Galen understood about sleep,
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koju je čak i Galen shvatio,
10:27
that it refreshes and clears the mind,
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da osvježava i razbistruje um,
10:30
may actually be a big part
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je možda glavni razlog
10:32
of what sleep is all about.
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što san postoji.
10:34
See, you and I, we go to sleep
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Vi i ja, mi idemo na spavanje
10:36
every single night,
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svako veče,
10:37
but our brains, they never rest.
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ali naš mozak se nikada ne odmara.
10:40
While our body is still
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1834
Dok naše tijelo miruje
10:42
and our mind is off walking in dreams somewhere,
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i naš um hoda u snovima,
10:45
the elegant machinery of the brain
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elegantna mašinerija našeg mozga
10:47
is quietly hard at work
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1980
marljivo radi svoj posao,
10:49
cleaning and maintaining
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čisti i održava
10:51
this unimaginably complex machine.
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ovu nevjerovatno složenu mašinu.
10:54
Like our housework,
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1041
Kao i kućanski posao,
10:55
it's a dirty and a thankless job,
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to je prljav i nezahvalan posao,
10:58
but it's also important.
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ali je isto jako bitan.
11:00
In your house, if you stop cleaning your kitchen
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2403
Ako prestanete da čistite kuhinju
11:02
for a month,
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na jedan mjesec
11:04
your home will become completely unlivable
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vaša kuća vrlo brzo neće imati
11:07
very quickly.
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uslove za život.
11:08
But in the brain, the consequences
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Ali u mozgu, posljedice neuspjeha
11:10
of falling behind may be much greater
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mogu biti mnogo ozbiljnije
11:13
than the embarrassment of dirty countertops,
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od nelagode uzrokovane
prašnjavim kredencima,
prašnjavim kredencima,
11:16
because when it comes to cleaning the brain,
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2564
jer kada je u pitanju mozak
11:19
it is the very health and function
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zdravlje i funkcija
11:21
of the mind and the body that's at stake,
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uma i tijela je na kocki
11:24
which is why understanding these
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i zbog toga, shvatanje ovih
11:26
very basic housekeeping functions of the brain today
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osnovnih funkcija čišćenja našeg mozga
danas
danas
11:30
may be critical for preventing and treating
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možda je od presudne važnosti
za prevenciju i liječenje
za prevenciju i liječenje
11:33
diseases of the mind tomorrow.
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bolesti uma sutra.
11:36
Thank you.
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Hvala.
11:38
(Applause)
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ABOUT THE SPEAKER
Jeff Iliff - NeuroscientistJeff Iliff is a neuroscientist who explores the unique functions of the brain.
Why you should listen
Neuroscientist Jeff Iliff 's research follows two main paths. The first is the exploration of how the brain’s support cells, called glia, contribute to maintaining the proper environment for neuronal function and how their failure in conditions like vascular dementia, stroke, and traumatic brain injury leads to neurodegeneration. The second seeks to define the basic cellular mechanisms by which brain blood flow is coordinated up and down the vascular tree. Now an Assistant Professor of Anesthesiology and Perioperative Medicine at Oregon Health & Science University, Jeff was a part of a University of Rochester Medical Center team that discovered a brain cleansing system, which they dubbed the “glymphatic system.”
More profile about the speakerJeff Iliff | Speaker | TED.com