शैडोइंग अभ्यास: Artificial Liver Program: Mayo Clinic Radio - वीडियो के साथ अंग्रेजी बोलना सीखें
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Welcome back to Mayo Clinic Radio.
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I'm Dr. Tom Shives.
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And I'm Tracy McRae.
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Tracy, every year, 40 ,000 people die of liver disease in the U .S.
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And the only proven therapy for end -stage liver disease is still a liver transplant.
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Unfortunately, there aren't enough organs to go around for those who need them.
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In fact, there are more than 150 ,000 people who are on the waiting list for a donor liver.
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Now, hopefully, treatment for liver disease is about to change for the better.
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Research at Mayo Clinic is focusing on new regenerative liver therapies to help repair diseased livers
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and improve the treatment options for liver disease patients.
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Here to discuss is Dr. Scott Nyberg, a transplant surgeon at Mayo Clinic.
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Dr. Nyberg is the director of the liver program at the Mayo Clinic Center for Regenerative Medicine
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and head of Mayo Clinic's artificial liver program.
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Welcome to the program, Dr. Nyberg.
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It's nice to meet you.
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It's great to be here, Tracy and Tom.
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Thank you for having me.
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Yeah, you bet.
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You have been studying the liver and liver disease for a long time, long enough to get all those titles, right?
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I started back in the early 80s, probably.
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I was both a chemical engineer and then a biomedical engineer.
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Had a mentor who said with that engineering background, why don't you build a liver dialysis machine?
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I asked him, how should I do that?
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That was in 1989, and he said, you figure it out.
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You're the engineer.
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So I've been working on this for almost 30 years.
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Well, I want to learn a lot more about the artificial liver program, but before we go there, we should probably just set the table.
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What is liver disease?
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What causes liver disease?
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I mean, there are many causes.
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They can range from Tylenol overdose, a common drug like Tylenol, alcohol.
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People are familiar with that, along with genetic causes.
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In the United States, I would say obesity is becoming a number one cause.
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Overweight contributes to a disease called NASH.
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It had been hepatitis C.
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Now there are pretty effective treatments for hepatitis C, so we're seeing a decrease.
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But the number one cause would be NASH, followed by alcohol, and then these others.
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Now explain NASH to us.
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And you mentioned that obesity is becoming a more common cause of liver disease.
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How does obesity cause liver disease?
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And I suspect that NASH is the answer.
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Right.
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It's not fully understood as far as the mechanisms, but there has been this association with as Americans and people around the world become heavier,
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there's more liver disease.
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If a pathologist looks at a biopsy of a NASH liver, it looks similar to an alcoholic liver, so it's probably a nutritional problem.
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Where too many calories cause an inflammatory response and do this over a long period of time,
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there becomes scarring and eventually cirrhosis and the manifestations of end -stage liver disease.
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And cirrhosis is pretty much just scarring of the liver.
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Advanced scarring to a point where the liver isn't able to regenerate.
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Fortunately, a healthy liver, if we cut it in half, will grow back to a full size within a couple of weeks.
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That's a normal response, but due to the scarring of fibrosis and cirrhosis,
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that regenerative response is impaired and the only real treatment for those end -stage livers is a liver transplant currently.
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Does NASH stand for something?
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Non -alcoholic steatohepatitis.
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So it looks pathologically like alcoholic liver injury,
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but it's non -alcoholic related presumably to diet and weight.
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How long can people live with liver disease before they need a transplant?
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well we have a scoring system now
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that was developed here at mayo called the meld score initially
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it was called the mayo end -stage liver disease score to
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predict how long people would survive what's their likelihood of being alive in two months
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it's been adopted nationally for organ allocation
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because it's very good at predicting the name was changed they took mayo out of the name
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and now it's just the model for end -stage liver disease so that's probably the best predictor.
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And in transplant, we use that score to determine who has highest priority.
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So it ranges from zero to 40, where if you have a score of 40, it's unlikely you're going to survive more than a few weeks.
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What can make if a patient is not eligible for transplant?
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I mean, there's being on the list means that you're eligible, but why would patients not be eligible for transplant?
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I mean, there's a variety of reasons.
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If you're an alcoholic that continues to drink
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and haven't recovered you wouldn't be eligible
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that wouldn't be a wise use of an organ
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if you have a disease that may involve other organs that's not corrected by a liver transplant
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or if you have a cancer that's spread outside of the liver that we wouldn't be able to help you and
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transplant an immunosuppressive patient you could actually shorten their life and that
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so there are a number
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you can be too old though we don't have a cutoff as far as age goes
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so you're still doing a lot of liver transplant right and
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and a fair number of those are from deceased donors
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but also you're using live donors yeah here at mayo
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we have a large living donor program one of the largest in the united states
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which means we do over 20 per year of the 130 liver transplants that we do.
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So that's a living donor, a family member, our friend who donates half of their liver.
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Two weeks later, the liver has regenerated, did you say, to its normal size?
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Probably two weeks in the donor, we do CAT scans to measure the volume.
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And they're within 90 % of the original volume within two weeks.
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So it's very rapid.
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In my lab, we have a number of animal models studying regeneration
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and we see this very quickly also all right what's new
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and regenerative medicine
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and artificial liver well here at mayo the the biggest problem in transplant is the shortage of organs
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so the things we do in regenerative medicine are to address
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that shortage of organs one option is a liver dialysis machine to allow the the liver to regenerate
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and hopefully avoid a liver transplant so that would be
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that would save the liver it could be used for someone else
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and avoid big surgery
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and all the immunosuppression lifelong immunosuppression for a patient that'd be a patient maybe with a tylenol overdose
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we also have a special pig that we've developed a genetically engineered pig
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and the goal there is to grow transplantable human livers in this pig sounds science fiction
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but in my lab we recently had a pig named eddie who beautiful a little piggy
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if you look at my instagram site
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you'll see a picture of eddie who essentially was created by a stem cell transplant into a day four embryo
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and this is sort of the future i see of organ production
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and then we're also
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so this is hopefully someday eddie's liver can be transplanted into a human eddie will eddie
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and pigs like eddie will be incubators to grow human livers.
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The concept would be to take a cell, reprogram it into a cell from a patient liver disease, reprogram it into a stem cell,
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fuse it with an embryo, and then grow a liver from that human stem cell.
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Whoa.
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I got to sit down.
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Oh, I am sitting down.
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Good.
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That's good.
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How are you using the patient's own liver cell?
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Is that what you're saying when you take a cell to help?
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In this case, you could even take a blood sample, like a white blood cell from just a blood sample.
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The Nobel Prize for Medicine about four years ago was a way to reprogram cells, adult cells, to become stem cells.
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And the theory would be that you could use those stem cells to grow livers.
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Well, hopefully you and Eddie will get the Nobel Prize next year.
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I think we're still a little ways off.
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eddie and pigs like eddie the other option that we're working with a local company is to take
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livers decellularize them and then repopulate them with cells from a patient
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so again you could avoid the need for immunosuppression
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so these would be a tissue engineered liver
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that would be identical to the patient so they wouldn't need an anti -rejection drug after the transplant
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If it works using your own cells, you shouldn't need to.
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We had a paper recently published in one of the science journals, Science Translational Medicine, showing that this concept would work in pigs,
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and it's a matter of scaling it up to humans.
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It's all really exciting.
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Thanks so much for being with us.
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Thank you very much.
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An update on the treatment of liver disease with Dr. Scott Nyberg,
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transplant surgeon and director of the liver program at the Mayo Clinic Center for Regenerative Medicine
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and head of Mayo Clinic's artificial liver program.
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Thanks, Dr. Nyberg.
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Yeah, thank you, Tom, Tracy.
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इस पाठ की शब्दावली और बोलने के सुझाव
यह स्पीकिंग पाठ वीडियो “Artificial Liver Program: Mayo Clinic Radio” पर आधारित है। सबसे ज़्यादा दोहराए गए शब्द ये हैं: liver, disease, transplant, cell, mayo। इस वीडियो में शैडोइंग के लिए 136 वाक्य और 1533 शब्द हैं। बोला गया हिस्सा 9:08 लंबा है। वक्ता लगभग 168 शब्द प्रति मिनट की स्वाभाविक गति से बोलता है, जो रोज़मर्रा की बातचीत के करीब है। केवल 76% शब्द अंग्रेज़ी के 3,000 सबसे आम शब्दों में से हैं, इसलिए शब्दावली कठिन है।
इस वीडियो की मुख्य शब्दावली
वीडियो के 15 सीखने लायक शब्द, उच्चारण और अर्थ के साथ:
| शब्द | उच्चारण | अर्थ |
|---|---|---|
| transplant क्रिया | /tɹænzˈplænt/ | रोपना |
| organ संज्ञा | /ˈɔːɡən/ | अंग, ऑर्गन |
| liver संज्ञा | /ˈlɪvɚ/ | कलेजा, जिगर |
| donor संज्ञा | /ˈdəʊnə/ | दानी, दाता |
| alcoholic संज्ञा | /ˌæl.kəˈhɔ.lɪk/ | पियक्कड़, शराबी |
| artificial विशेषण | /ˌɑː.tɪˈfɪʃ.əl/ | कृत्रिम |
| scar संज्ञा | /skɑɹ/ | दाग़, निशान |
| pig संज्ञा | /ˈpɪɡ/ | सूअर |
| obesity संज्ञा | /ə(ʊ)ˈbiːsɪti/ | मोटापा |
| surgeon संज्ञा | /ˈsɝd͡ʒən/ | शल्यचिकित्सक, जर्राह |
| shortage संज्ञा | /ˈʃɔː(ɹ)tɪd͡ʒ/ | कमी, अभाव |
| hepatitis संज्ञा | /ˌhɛpəˈtaɪ̯tɪs/ | हेपेटाइटिस |
| fiction संज्ञा | /ˈfɪkʃən/ | काल्पनिक |
| priority संज्ञा | /pɹaɪˈɒɹɪti/ | अग्रिमता, प्राथमिकता |
| genetic विशेषण | /d͡ʒəˈnɛt.ɪk/ | अनुवांशिक |
वीडियो में आने वाली फ़्रेज़ल वर्ब
| शब्द | अर्थ |
|---|---|
| sit down क्रिया | बैठना |
दोहराने लायक वाक्य
वीडियो के छोटे, पूरे वाक्य जिन्हें आप रोज़ की बातचीत में इस्तेमाल कर सकते हैं:
- It's nice to meet you.
- I asked him, how should I do that?
- I mean, there's a variety of reasons.
- How are you using the patient's own liver cell?
- Is that what you're saying when you take a cell to help?
इस वीडियो का व्याकरण
वक्ता जिन संरचनाओं का सबसे अधिक प्रयोग करता है, वीडियो के असली शब्दों के साथ:
| संरचना | वीडियो में |
|---|---|
| Present perfect continuous have/has been + -ing — पहले शुरू हुआ काम जो अब भी जारी है | have been studying · I've been working |
| Passive voice be + past participle — ज़ोर इस पर कि क्या होता है, न कि कौन करता है | is impaired · was developed · was called |
| Present perfect have/has + past participle — बीता हुआ काम जिसका असर अभी भी है | has been · it's been adopted · haven't recovered |
| Relative clauses who / which + उपवाक्य — व्यक्ति या वस्तु के बारे में अतिरिक्त जानकारी | those who need · people who are · friend who donates |
ध्यान देने योग्य उच्चारण
वक्ता 28 बार संक्षिप्त रूपों का प्रयोग करता है, जैसे you're, we're, wouldn't। इन्हें वैसे ही छोटा बोलें जैसा आप सुनते हैं।
- “sh” और “zh” की ध्वनियाँ: artificial /ˌɑː.tɪˈfɪʃ.əl/, shortage /ˈʃɔː(ɹ)tɪd͡ʒ/, fiction /ˈfɪkʃən/, essentially /ɪˈsɛnʃəli/, tissue /ˈtɪʃ.(j)u/
- लंबे शब्द — बलाघात सही रखें: alcoholic /ˌæl.kəˈhɔ.lɪk/, eligible /ˈɛl.ɪ.d͡ʒɪ.bəl/, artificial /ˌɑː.tɪˈfɪʃ.əl/, obesity /ə(ʊ)ˈbiːsɪti/, hepatitis /ˌhɛpəˈtaɪ̯tɪs/
हिंदी भाषियों के लिए मुश्किल ध्वनियाँ:
- /v/ और /w/ का फ़र्क़ — /v/ में ऊपर के दाँत निचले होंठ को छूते हैं, /w/ में होंठ गोल होते हैं: liver /ˈlɪvɚ/, overdose /ˈəʊvə(ɹ)ˌdəʊs/, recover /ɹɪˈkʌvɚ/, involve /ɪnˈvɑlv/, whoa /woʊ/
- /z/ — इसे “ज” (/dʒ/) न बनाएँ: transplant /tɹænzˈplænt/, mechanism /ˈmɛk.ə.nɪ.zəm/, presumably /pɹɪˈzuːməbli/, fuse /fjuːz/, decellularize /diːˈsɛljələɹaɪz/
- शब्द की शुरुआत में s + व्यंजन — पहले “इ” न जोड़ें: stem /stɛm/, scar /skɑɹ/, scan /skæn/
इस वीडियो से अभ्यास कैसे करें
- पहले बिना बोले पूरा वीडियो एक बार सुनें और जो शब्द नहीं आते उन्हें लिख लें।
- 0.75× गति से शुरू करें, एक-एक वाक्य की शैडोइंग करें, और सहज लगने पर सामान्य गति पर लौटें।
- अपनी आवाज़ रिकॉर्ड करें और मूल से तुलना करें, ख़ासकर transplant, organ, liver जैसे शब्दों पर ध्यान दें।
शैडोइंग तकनीक क्या है?
शैडोइंग (Shadowing) एक विज्ञान-समर्थित भाषा सीखने की तकनीक है जो मूल रूप से पेशेवर दुभाषिया प्रशिक्षण के लिए विकसित की गई थी। विधि सरल लेकिन शक्तिशाली है: आप मूल अंग्रेज़ी ऑडियो सुनते हैं और तुरंत इसे ज़ोर से दोहराते हैं — जैसे वक्ता की छाया 1-2 सेकंड की देरी से। शोध से पता चलता है कि यह उच्चारण सटीकता, स्वर, लय, जुड़ी हुई ध्वनियाँ, सुनने की समझ और बोलने की प्रवाहशीलता में काफ़ी सुधार करता है।