TEDMED 2014
Jeff Iliff: One more reason to get a good night's sleep
Jef Iliff: Razlog više za dobar san
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Mozak koristi četvrtinu energije cijelog tijela, a zauzima tek oko 2% cijele tjelesne mase. Kako ovaj jedinstveni organ prima, i još važnije, kako se rješava hranjivih tvari? Novo istraživanje pokazuje da bi san mogao imati veze s tim.
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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Trećinu svog života
provedemo spavajući,
provedemo spavajući,
00:17
but do any of us really understand what it's all about?
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ali razumije li itko od nas
o čemu se tu zapravo radi?
o čemu se tu zapravo radi?
00:20
Two thousand years ago, Galen,
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Prije dvije tisuće godina Galen,
00:22
one of the most prominent medical researchers
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jedan od najistaknutijih
istraživača medicine
istraživača medicine
00:25
of the ancient world,
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starog svijeta,
00:26
proposed that while we're awake,
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tvrdio je da dok smo budni,
00:28
our brain's motive force, its juice,
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pokretačka sila našeg mozga,
njegov sok,
njegov sok,
00:31
would flow out to all the other parts of the body,
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prelijeva se u druge dijelove tijela,
00:34
animating them but leaving the brain all dried up,
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oživljavajući ih, ali ujedno
ostavljajući mozak potpuno osušenim,
ostavljajući mozak potpuno osušenim,
00:38
and he thought that when we sleep,
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i smatrao je da se, kada spavamo,
00:40
all this moisture that filled the rest of the body
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sva ta vlaga koja je prethodno
ispunjavala naše tijelo,
ispunjavala naše tijelo,
00:42
would come rushing back,
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vraća natrag,
00:44
rehydrating the brain
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ponovo hidratizirajući mozak
00:46
and refreshing the mind.
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i osvježavajući um.
00:48
Now, that sounds completely ridiculous to us now,
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Danas nam to zvuči potpuno suludo,
00:51
but Galen was simply trying to explain
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ali Galen je jednostavno pokušao
objasniti
objasniti
00:53
something about sleep
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spavanje kao
00:54
that we all deal with every day.
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nešto što radimo svaki dan.
00:57
See, we all know based on our own experience
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Svi mi iz vlastitog iskustva znamo
00:59
that when you sleep, it clears your mind,
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da kada spavamo,
mozak postaje bistriji,
mozak postaje bistriji,
01:02
and when you don't sleep,
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a kada ne spavamo
01:03
it leaves your mind murky.
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mozak postaje mutniji.
01:06
But while we know a great deal more about sleep now
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Ali unatoč tome što danas
znamo mnogo više o spavanju
znamo mnogo više o spavanju
01:08
than when Galen was around,
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negoli u Galenovo vrijeme,
01:10
we still haven't understood why it is that sleep,
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još uvijek nismo otkrili
zašto baš spavanje,
zašto baš spavanje,
01:13
of all of our activities, has this incredible
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od svih naših aktivnosti,
ima ovakvu nevjerojatnu
ima ovakvu nevjerojatnu
01:16
restorative function for the mind.
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funkciju obnavljanja uma.
01:18
So today I want to tell you about
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Danas bih vam želio reći
nešto više
nešto više
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 bi moglo razjasniti ovo pitanje.
01:24
We've found that sleep may actually be
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Otkrili smo da bi spavanje
zapravo moglo biti
zapravo moglo biti
01:27
a kind of elegant design solution
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vrlo elegantno osmišljeno rješenje
01:30
to some of the brain's most basic needs,
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za neke od najosnovnijih
potreba mozga,
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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udovoljava visokim zahtjevima
i finesama
i finesama
01:37
that set it apart from all the other organs of the body.
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koji ga razlikuju od ostalih organa.
01:42
So almost all the biology that we observe
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Skoro sva biologija koju promatramo
01:45
can be thought of as a series of problems
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može se promišljati kao
niz problema
niz problema
01:48
and their corresponding solutions,
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i niz odgovarajućih rješenja,
01:50
and the first problem that every organ must solve
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a glavni problem koji svaki organ
mora riješiti jest
mora riješiti jest
01:53
is a continuous supply of nutrients to fuel
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konstantna opskrba svih tih stanica
01:56
all those cells of the body.
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hranjivim materijalima.
01:57
In the brain, that is especially critical;
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To je posebno važno 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 sveukupne energetske
zalihe tijela
zalihe tijela
02:05
even though the brain accounts
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iako on čini
02:07
for only about two percent of the body's mass.
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tek dva posto tjelesne mase.
02:10
So the circulatory system
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Krvotok
02:11
solves the nutrient delivery problem
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rješava problem dostave
hranjivih tvari
hranjivih tvari
02:14
by sending blood vessels to supply nutrients
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kroz krvne žile koje opskrbljuju
hranjivim tvarima
hranjivim tvarima
02:16
and oxygen to every corner of our body.
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i kisikom svaki djeličak našeg tijela.
02:20
You can actually see it in this video here.
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Možete to vidjeti u ovom videu.
02:23
Here, we're imaging blood vessels
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Ovdje smo snimili krvne žile
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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Krvne žile čine složenu mrežu
02:30
that fills the entire brain volume.
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koja pokriva cijeli mozak.
02:32
They start at the surface of the brain,
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Počinju na površini mozga
02:34
and then they dive down into the tissue itself,
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i zaranjaju u samo tkivo,
02:37
and as they spread out, they supply nutrients
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i kako se šire, opskrbljuju
hranjivim tvarima
hranjivim tvarima
02:39
and oxygen to each and every cell in the brain.
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i kisikom svaku stanicu
u mozgu zasebno.
u mozgu zasebno.
02:45
Now, just as every cell requires
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Kao što svakoj stanici trebaju
02:48
nutrients to fuel it,
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hranjive tvari za njen pogon,
02:50
every cell also produces waste as a byproduct,
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tako svaka stanica proizvodi
otpad kao nusproizvod,
otpad kao nusproizvod,
02:53
and the clearance of that waste
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i rješavanje tog otpada
02:55
is the second basic problem
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drugi je glavni problem
02:57
that each organ has to solve.
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koji svaki organ mora riješiti.
03:00
This diagram shows the body's lymphatic system,
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Ovaj dijagram pokazuje limfni
sustav u tijelu
sustav u tijelu
03:02
which has evolved to meet this need.
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koji se razvio kako bi ispunio
ovu potrebu.
ovu potrebu.
03:05
It's a second parallel network of vessels
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To je druga paralelna mreža žila
03:07
that extends throughout the body.
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koja se širi tijelom.
03:09
It takes up proteins and other waste
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Uzima proteine i drugi otpad iz
03:11
from the spaces between the cells,
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međustaničnog prostora,
03:13
it collects them, and then dumps them into the blood
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skuplja ih i ubacuje u krv
03:16
so they can be disposed of.
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kako bi se oni uklonili.
03:18
But if you look really closely at this diagram,
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Ako pažljivije promotrite
03:20
you'll see something
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ovaj dijagram, vidjet ćete nešto
03:22
that doesn't make a lot of sense.
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što nema puno smisla.
03:24
So if we were to zoom into this guy's head,
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Ukoliko bismo zumirali
glavu ovog čovjeka,
glavu ovog čovjeka,
03:27
one of the things that you would see there
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primijetili biste da
03:29
is that there are no lymphatic vessels in the brain.
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u mozgu nema limfnih žila.
03:33
But that doesn't make a lot of sense, does it?
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Ali to baš i nema previše smisla, zar ne?
03:36
I mean, the brain is this intensely active organ
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Mozak je iznimno aktivan organ
03:39
that produces a correspondingly
large amount of waste
large amount of waste
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koji proizvodi velike
količine otpada
količine otpada
03:42
that must be efficiently cleared.
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kojega se mora učinkovito riješiti.
03:44
And yet, it lacks lymphatic vessels, which means that
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A opet, tu nema limfnih žila, 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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pri rješavanju otpada,
neće funkcionirati u mozgu.
03:51
won't work in the brain.
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03:54
So how, then, does the brain solve
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Pa kako mozak rješava
03:56
its waste clearance problem?
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svoj problem rješavanja otpada?
03:58
Well, that seemingly mundane question
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Upravo je ovo naizgled
obično pitanje
obično pitanje
04:02
is where our group first jumped into this story,
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navelo našu grupu da se uključi u priču
04:05
and what we found
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i otkrili smo,
04:07
as we dove down into the brain,
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kad smo zaronili duboko u mozak,
04:09
down among the neurons and the blood vessels,
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duboko među neurone i krvne žile,
04:12
was that the brain's solution
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rješenje mozga
04:15
to the problem of waste clearance,
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za problem rješavanja otpada,
04:17
it was really unexpected.
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bilo je uistino neočekivano.
04:19
It was ingenious,
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Bilo je genijalno,
04:22
but it was also beautiful.
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ali je i lijepo.
04:25
Let me tell you about what we found.
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Ispričat ću vam što smo pronašli.
04:27
So the brain has this large pool
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Mozak ima veliki bazen
04:29
of clean, clear fluid called cerebrospinal fluid.
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bistre tekućine nazvane
"cerebrospinalna tekućina".
"cerebrospinalna tekućina".
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,
okružuje 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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izlazi 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 s otpadom izbacuje u krv.
04:45
So in that way, it sounds a lot like
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Podsjeća na
04:46
the lymphatic system, doesn't it?
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limfni sustav, zar ne?
04:49
But what's interesting is that the fluid and the waste
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Ali zanimjivo je da se
tekućina i otpad
tekućina 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 filtriraju nasumično
04:55
out to these pools of CSF.
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u bazene CST, već
04:58
Instead, there is a specialized network of plumbing
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postoji vodoinstalacijski sustav
05:02
that organizes and facilitates this process.
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koji organizira i olakšava ovaj proces.
05:05
You can see that in these videos.
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Možete to vidjeti u ovim videima.
05:08
Here, we're again imaging into the brain
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Ovdje ponovno skeniramo
mozak
mozak
05:11
of living mice.
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živog miša.
05:12
The frame on your left shows
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Isječak s vaše lijeve strane pokazuje
05:14
what's happening at the brain's surface,
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što se događa na
površini mozga,
površini mozga,
05:16
and the frame on your right shows
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a ovaj s desne pokazuje
05:18
what's happening down below the surface of the brain
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što se događa 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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Označili smo krvne žile crvenom bojom,
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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jest zelene boje.
05:27
Now, what was surprising to us
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I ono što je nas iznenadilo
05:29
was that the fluid on the outside of the brain,
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jest da tekućina koja se
nalazi izvan mozga,
nalazi izvan mozga,
05:32
it didn't stay on the outside.
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nije ostala vani,
05:35
Instead, the CSF was pumped back into
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već je CST ispumpana natrag u
05:39
and through the brain
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i kroz mozak
05:41
along the outsides of the blood vessels,
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uz rub krvnih žila.
05:44
and as it flushed down into the brain
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I dok se tekućina spuštala kroz mozak
05:46
along the outsides of these vessels,
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uz rubove žila,
05:48
it was actually helping to clear away,
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pomagala je u čišćenju
05:51
to clean the waste from the spaces
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otpada iz međustaničnog
05:53
between the brain's cells.
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prostora mozga.
05:56
If you think about it,
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Ako malo razmislite o tome,
05:58
using the outsides of these blood vessels like this
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koristeći vanjski rub krvnih žila
na ovaj način
na ovaj način
06:01
is a really clever design solution,
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zaista je pametno osmišljeno 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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unutar tvrde lubanje,
06:08
and it's packed full of cells,
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a prepun je stanica,
06:10
so there is no extra space inside it
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tako da tu nema viška prostora
06:13
for a whole second set of vessels
like the lymphatic system.
like the lymphatic system.
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za cijeli paralelni sustav žila
kao što je limfni sustav.
kao što je limfni sustav.
06:17
Yet the blood vessels,
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No krvne žile se ipak
06:18
they extend from the surface of the brain
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šire od površine mozga
06:20
down to reach every single cell in the brain,
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i dopiru do svake stanice u mozgu,
06:23
which means that fluid
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što znači da tekućina
06:24
that's traveling along the outsides of these vessels
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koja putuje uz rub žila
06:27
can gain easy access to the entire brain's volume,
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ima lak pristup cijelom mozgu,
06:31
so it's actually this really clever way
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pa je to vrlo pametan način
06:33
to repurpose one set of vessels, the blood vessels,
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prenamjene jednog sustava žila,
krvnih žila,
krvnih žila,
06:37
to take over and replace the function
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kako bi preuzeo i zamijenio funkciju
06:40
of a second set of vessels, the lymphatic vessels,
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drugog sustava žila, limfnih žila,
06:43
to make it so you don't need them.
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kako ih ne bismo uopće trebali.
06:45
And what's amazing is that no other organ
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Čudesno je to što nijedan
drugi organ
drugi organ
06:48
takes quite this approach
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nema ovakav pristup
06:49
to clearing away the waste from between its cells.
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čišćenju međustaničnog otpada.
06:52
This is a solution that is entirely unique to the brain.
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To je rješenje karakteristično za mozak,
06:58
But our most surprising finding
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ali naše otkriće koje nas je
najviše iznenadilo
najviše iznenadilo
07:00
was that all of this,
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bilo je da sve ovo,
07:03
everything I just told you about,
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sve ovo što sam vam ispričao
07:05
with all this fluid rushing through the brain,
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o tekućini koja ispire mozak,
07:08
it's only happening in the sleeping brain.
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to se događa samo dok mozak spava.
07:12
Here, the video on the left
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Ovdje, video s lijeve strane
07:14
shows how much of the CSF is moving
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pokazuje kretanje CST-a
07:16
through the brain of a living mouse while it's awake.
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kroz mozak budnog živog miša.
07:20
It's almost nothing.
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Skoro ništa.
07:22
Yet in the same animal,
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A ipak kod iste životinje,
07:23
if we wait just a little while until it's gone to sleep,
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ako pričekamo samo malo
dok ne ode spavati,
dok ne ode spavati,
07:26
what we see is that the CSF
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vidimo da CST
07:29
is rushing through the brain,
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juri kroz mozak,
07:31
and we discovered that at the same time
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a otkrili smo da
07:34
when the brain goes to sleep,
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kad mozak ide spavati
07:36
the brain cells themselves seem to shrink,
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ujedno se smanjuju moždane stanice
07:39
opening up spaces in between them,
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povećavajući prostore između njih
07:41
allowing fluid to rush through
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dozvoljavajući tekućini da protekne njima
07:43
and allowing waste to be cleared out.
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i tako očisti otpad.
07:46
So it seems that Galen may actually have been
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Stoga se čini da je Galen možda čak
07:48
sort of on the right track when he wrote about
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bio na pravom tragu pišući o
07:51
fluid rushing through the brain
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tekućini koja juri mozgom
07:53
when sleep came on.
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kada zaspemo.
07:55
Our own research, now it's 2,000 years later,
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Naše istraživanje, 2000 godina kasnije,
07:58
suggests that what's happening is that
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pretpostavlja da
08:00
when the brain is awake
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mozak u budnom i
08:03
and is at its most busy,
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najaktivnijem stanju
08:05
it puts off clearing away the waste
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odgađaa čišćenje otpada
08:07
from the spaces between its cells until later,
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iz međustaničnih prostora za kasnije,
08:10
and then, when it goes to sleep
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a kada ode spavati
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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kako bi očistio otpad
08:19
from the spaces between its cells,
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iz međustaničnih prostora,
08:20
the waste that's accumulated throughout the day.
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otpad koji se nakupio tijekom dana.
08:22
So it's actually a little bit like how you or I,
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Na neki je način nalik tome kako vi ili ja
08:25
we put off our household chores during the work week
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odgađamo kućanske poslove tijekom
radnih dana kada se
radnih dana kada se
08:28
when we don't have time to get to it,
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ne stignemo njima baviti
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 sve to čišćenje pokušavamo
nadoknaditi
nadoknaditi
08:33
when the weekend rolls around.
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preko vikenda.
08:35
Now, I've just talked a lot about waste clearance,
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Puno sam pričao o čišćenju otpada,
08:39
but I haven't been very specific
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ali nisam baš precizno rekao
08:40
about the kinds of waste
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kakav to otpad
08:42
that the brain needs to be clearing
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mozak treba očistiti
08:44
during sleep in order to stay healthy.
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za vrijeme spavanja kako bi ostao zdrav.
08:46
The waste product that these recent studies
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Nusproizvod na koji se nova
08:48
focused most on is amyloid-beta,
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istraživanja najviše usredotočuju je
amyloid-beta,
amyloid-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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protein koji se u mozgu neprestano stvara.
08:54
My brain's making amyloid-beta right now,
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Moj ga mozak proizvodi upravo sada,
08:55
and so is yours.
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baš kao i vaš.
08:58
But in patients with Alzheimer's disease,
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Ali kod oboljelih od Alzheimera,
09:00
amyloid-beta builds up and aggregates
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amyloid-beta nakuplja se
09:02
in the spaces between the brain's cells,
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2013
u prostorima između stanica mozga,
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 čisti na način na koji
bi trebao,
bi trebao,
09:08
and it's this buildup of amyloid-beta
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2010
a baš je to nakupljanje amyloid-bete
09:10
that's thought to be one of the key steps
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navodno jedan od ključnih koraka
09:12
in the development of that terrible disease.
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u razvijanju ove strašne bolesti.
09:15
So we measured how fast amyloid-beta is cleared
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Stoga smo izmjerili koliko se brzo
amyloid-beta čisti
amyloid-beta čisti
09:18
from the brain when it's awake
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iz mozga u stanju budnosti
09:19
versus when it's asleep,
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1778
i u stanju spavanja
09:21
and we found that indeed,
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i otkrili smo da je
09:23
the clearance of amyloid-beta
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čišćenje amyloid-bete
09:25
is much more rapid from the sleeping brain.
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ustinu brže za vrijeme spavanja.
09:29
So if sleep, then,
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Stoga, ako je spavanje
09:31
is part of the brain's solution
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1958
jedna metoda mozga za
09:33
to the problem of waste clearance,
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2010
čišćenje otpada,
09:35
then this may dramatically change how we think
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to može dramatično promijeniti naš način
09:37
about the relationship between sleep,
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razmišljanja o odnosu između sna,
09:40
amyloid-beta, and Alzheimer's disease.
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amyloid-bete i Alzheimera.
09:43
A series of recent clinical studies
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1958
Niz novih kliničkih studija
09:45
suggest that among patients
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navodi da kod pacijenata
09:47
who haven't yet developed Alzheimer's disease,
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koji još nisu razvili Alzheimerovu bolest,
09:50
worsening sleep quality and sleep duration
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3066
pogoršanje u kvaliteti sna i
njegovoj dužini
njegovoj dužini
09:53
are associated with a greater amount
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2018
povezani su s većom količinom
09:55
of amyloid-beta building up in the brain,
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2812
nakupina amyloid-bete u mozgu,
09:58
and while it's important to point out
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i iako je važno napomenuti
10:00
that these studies don't prove
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da ove studije ne dokazuju
10:01
that lack of sleep or poor sleep
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da manjak sna ili loš san
10:04
cause Alzheimer's disease,
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uzrokuju Alzheimerovu bolest,
10:06
they do suggest that the failure of the brain
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2610
one sugeriraju da nemogućnost mozga
10:09
to keep its house clean
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1912
da održi svoj životni prostor čistim,
10:10
by clearing away waste like amyloid-beta
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čisteći ga od otpada poput amyloid-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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3617
poremećaja poput Alzheimera.
10:19
So what this new research tells us, then,
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1905
Ovo novo israživanje govori nam
10:21
is that the one thing that all of you
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da bi sve ono što smo svi mi
10:23
already knew about sleep,
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već znali o spavanju,
10:24
that even Galen understood about sleep,
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2653
ono što je čak i Galen shvaćao,
10:27
that it refreshes and clears the mind,
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da ono osvježava i pročišćava um,
10:30
may actually be a big part
251
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mogao biti glavni
10:32
of what sleep is all about.
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razlog postojanja sna.
10:34
See, you and I, we go to sleep
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Vi i ja idemo spavati
10:36
every single night,
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svake noći,
10:37
but our brains, they never rest.
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ali naši mozgovi nikad ne odmaraju.
10:40
While our body is still
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1834
Dok je naše tijelo u mirovanju,
10:42
and our mind is off walking in dreams somewhere,
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3071
a naš um šeće po snovima,
10:45
the elegant machinery of the brain
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1676
mozak kao uglađen stroj
10:47
is quietly hard at work
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1980
tiho, ali naporno
10:49
cleaning and maintaining
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2193
čisti i održava
10:51
this unimaginably complex machine.
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2835
taj nezamislivo kompleksni stroj.
10:54
Like our housework,
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1041
Poput kućanskih poslova,
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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2255
ali je i važan posao.
11:00
In your house, if you stop cleaning your kitchen
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Ako prestanemo čistiti
11:02
for a month,
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kuhinju na mjesec dana,
11:04
your home will become completely unlivable
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naš će cijeli dom vrlo brzo postati
11:07
very quickly.
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neprikladan za život.
11:08
But in the brain, the consequences
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U mozgu posljedice
11:10
of falling behind may be much greater
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2931
odgađanja čišćenja mogu biti mnogo veće
11:13
than the embarrassment of dirty countertops,
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od neugode koju će kod nas izazvati
prljavi šankovi
prljavi šankovi
11:16
because when it comes to cleaning the brain,
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2564
jer kad se radi o čišćenju mozga,
11:19
it is the very health and function
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tada je na kocki zdravlje i funkcija
11:21
of the mind and the body that's at stake,
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2945
uma i tijela
11:24
which is why understanding these
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i zato je ključno danas razumjeti
11:26
very basic housekeeping functions of the brain today
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ove osnovne održavajuće funkcije mozga
11:30
may be critical for preventing and treating
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koje bi mogle biti ključne u prevenciji
i liječenju
i liječenju
11:33
diseases of the mind tomorrow.
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bolesti uma sutra.
11:36
Thank you.
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Hvala vam!
11:38
(Applause)
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(Pljesak. )
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