Kuchekwa kwezvitunha zvechinyakare kuri kudzikira, nepo plastination uye 3D printed (3DP) models zviri kuwana mukurumbira senzira yekudzidzisa maitiro echinyakare. Hazvisi pachena kuti simba nekusasimba kwezvishandiso zvitsva izvi chii uye kuti zvingakanganisa sei ruzivo rwekudzidza nezvemuviri wevadzidzi, izvo zvinosanganisira tsika dzevanhu dzakadai sekuremekedza, kutarisira, uye tsitsi.
Mushure mekunge chidzidzo chekuongorora chakaitwa nenzira isina kurongeka, vadzidzi 96 vakakokwa. Dhizaini inoshanda yakashandiswa kuongorora ruzivo rwekudzidza uchishandisa mamodheru emoyo ane purasitiki uye e3D (Danho 1, n=63) uye mutsipa (Danho 2, n=33). Ongororo yemusoro wenyaya yakaitwa zvichibva paongororo dzemahara mazana maviri nemakumi manomwe nemasere (zvichireva simba, kusasimba, nzvimbo dzekuvandudza) uye zvinyorwa zvemapoka akatarisana (n = 8) nezvekudzidza mamodheru uchishandisa maturusi aya.
Madingindira mana akaonekwa: kuvimbika kwakaonekwa, kunzwisisa kwakakosha uye kuomarara, mafungiro ekuremekedza nekutarisira, maitiro akawanda, uye hutungamiriri.
Kazhinji, vadzidzi vainzwa kuti mienzaniso yepurasitiki yaive yechokwadi uye nekudaro vainzwa vachiremekedzwa uye vachitarisirwa kupfuura mienzaniso ye3DP, iyo yaive nyore kushandisa uye yakakodzera kudzidza hunhu hwemuviri.
Kuongororwa kwechitunha chemunhu kwave kuri nzira yakajairika yekudzidzisa inoshandiswa mudzidzo yezvekurapa kubvira muzana remakore rechi17 [1, 2]. Zvisinei, nekuda kwekushaikwa kwekuwana, mari yakawanda yekuchengetedza chitunha [3, 4], kudzikiswa kukuru kwenguva yekudzidzira muviri [1, 5], uye kufambira mberi kwetekinoroji [3, 6], zvidzidzo zvemuviri zvinodzidziswa uchishandisa nzira dzechinyakare dzekupatsanura muviri zviri kudzikira. Izvi zvinovhura mikana mitsva yekutsvaga nzira itsva dzekudzidzisa nezvishandiso, zvakaita sema plasticine human sampuli uye 3D printed (3DP) models [6,7,8].
Chimwe nechimwe chezvishandiso izvi chine zvakanakira nezvakaipira. Zviyero zvakaputirwa zvakaomeswa, hazvina hwema, zvine musoro uye hazvina njodzi [9,10,11], zvichiita kuti zvive zvakanaka pakudzidzisa nekuita kuti vadzidzi vabatanidzwe mukudzidza nekunzwisisa maumbirwo emuviri. Zvisinei, hazvina kuomarara uye hazvichinjiki zvakanyanya [10, 12], saka zvinofungidzirwa kuti zvakaoma kushandisa uye kusvika pakuvaka kwakadzika [9]. Panyaya yemutengo, zviyero zvakaputirwa nepurasitiki zvinowanzo kudhura kutenga nekuchengetedza kupfuura zviyero zve3DP [6,7,8]. Kune rumwe rutivi, zviyero zve3DP zvinobvumira magadzirirwo akasiyana [7, 13] nemavara [6, 14] uye zvinogona kugoverwa kuzvikamu zvakati, izvo zvinobatsira vadzidzi kuona, kusiyanisa uye kurangarira zviyero zvakakosha, kunyangwe izvi zvichiita sezvisina musoro kupfuura zviyero zvakaputirwa nepurasitiki.
Zvidzidzo zvakawanda zvakaongorora mhedzisiro yekudzidza/kushanda kwemhando dzakasiyana dzemidziyo yemuviri yakadai semasampuli epurasitiki, mifananidzo ye2D, zvikamu zvakanyorova, matafura eAnatomage (Anatomage Inc., San Jose, CA) uye mamodheru e3DP [11, 15, 16, 17, 18, 19, 20, 21]. Zvisinei, mhedzisiro yacho yakasiyana zvichienderana nesarudzo yechishandiso chekudzidzisa chinoshandiswa mumapoka ekudzora nekupindira, pamwe nekubva munzvimbo dzakasiyana dzemuviri [14, 22]. Semuenzaniso, kana ikashandiswa pamwe chete nematafura ekubvisa wet [11, 15] uye matafura ekuongorora muviri [20], vadzidzi vakataura nezvekugutsikana kwekudzidza kwepamusoro uye mafungiro kune masampuli epurasitiki. Saizvozvowo, kushandiswa kwemapatani epurasitiki kunoratidza mhedzisiro yakanaka yeruzivo rwevadzidzi rwechinangwa [23, 24].
Mamodheru e3DP anowanzo shandiswa kuwedzera nzira dzekudzidzisa dzechinyakare [14,17,21]. Loke et al. (2017) vakataura nezvekushandiswa kwemodheru ye3DP kunzwisisa chirwere chemwoyo chekuzvarwa nacho kuna chiremba wevana [18]. Chidzidzo ichi chakaratidza kuti boka re3DP raive nekugutsikana kwepamusoro pakudzidza, kunzwisisa zviri nani tetrad yaFallot, uye kugona kuri nani kubata varwere (kuzvibata) zvichienzaniswa neboka re2D imaging. Kudzidza maumbirwo emuti wetsinga uye maumbirwo edehenya uchishandisa mamodheru e3DP kunopa kugutsikana kwakafanana pakudzidza semifananidzo ye2D [16, 17]. Zvidzidzo izvi zvakaratidza kuti mamodheru e3DP akakwirira kupfuura mifananidzo ye2D maererano nekugutsikana kwekudzidza kunoonekwa nevadzidzi. Zvisinei, zvidzidzo zvakanyatsoenzanisa mamodheru e3DP ane zvinhu zvakawanda nemasamples epurasitiki zvakaganhurirwa. Mogali et al. (2021) vakashandisa modheru yeplastination nemamodheru ayo e3DP emwoyo nemutsipa uye vakashuma kuwedzera kwakafanana kweruzivo pakati pemapoka ekudzora neokuedza [21].
Zvisinei, humbowo hwakawanda hunodiwa kuti tinzwisise zvakadzama kuti sei ruzivo rwekudzidza kwevadzidzi ruchienderana nesarudzo yezvishandiso zvemuviri nezvikamu zvakasiyana zvemuviri nenhengo [14, 22]. Hunhu hwehunhu chinhu chinonakidza chinogona kukanganisa maonero aya. Izvi zvinoreva ruremekedzo, hanya, tsitsi netsitsi zvinotarisirwa kubva kuvadzidzi vanova vanachiremba [25, 26]. Hunhu hwehunhu hwagara huchitsvagwa mukuongororwa kwezvitunha, sezvo vadzidzi vachidzidziswa kunzwira tsitsi nekutarisira zvitunha zvakapihwa, uye nekudaro kudzidza nezvehunhu kwagara kuri nenzvimbo yakakosha [27, 28]. Zvisinei, izvi hazviwanzo kuyerwa mupurasitiki uye zvishandiso zve3DP. Kusiyana nemibvunzo yekuongorora yeLikert yakavharwa, nzira dzekuunganidza data dzakadai sekukurukurirana kwemapoka uye mibvunzo yekuongorora yakazaruka inopa nzwisiso yemhinduro dzevatori vechikamu dzakanyorwa nenzira isina kurongeka kutsanangura kukanganisa kwezvishandiso zvitsva zvekudzidza paruzivo rwavo rwekudzidza.
Saka tsvakiridzo iyi yaida kupindura kuti vadzidzi vanoona sei maumbirwo emuviri zvakasiyana pavanopihwa maturusi akarongwa (plastination) zvichienzaniswa nemifananidzo yakadhindwa ye3D kuti vadzidze maumbirwo emuviri?
Kuti vapindure mibvunzo iri pamusoro apa, vadzidzi vane mukana wekuwana, kuunganidza uye kugovana ruzivo rwemuviri kuburikidza nekudyidzana kwechikwata uye kushanda pamwe chete. Pfungwa iyi inowirirana zvakanaka nedzidziso ye constructivist, iyo vanhu kana mapoka evanhu vanogadzira uye vanogovana ruzivo rwavo [29]. Kutaurirana kwakadaro (semuenzaniso, pakati pevezera, pakati pevadzidzi nevadzidzisi) kunokanganisa kugutsikana kwekudzidza [30, 31]. Panguva imwe chete, ruzivo rwekudzidza rwevadzidzi ruchakanganiswawo nezvinhu zvakaita sekureruka kwekudzidza, nharaunda, nzira dzekudzidzisa, uye zviri mukosi [32]. Mushure mezvo, hunhu uhu hunogona kukanganisa kudzidza kwevadzidzi uye kugona kwavo misoro inovafadza [33, 34]. Izvi zvinogona kunge zvine chekuita nemaonero edzidziso e pragmatic epistemology, uko kukohwa kwekutanga kana kuumbwa kweruzivo rwemunhu, njere, uye zvitendero zvinogona kusarudza nzira inotevera yekuita [35]. Nzira ye pragmatic inorongwa nokungwarira kuti ione misoro yakaoma uye kutevedzana kwayo kuburikidza nekubvunzurudzwa neongororo, zvichiteverwa nekuongorora dingindira [36].
Mienzaniso yemutumbi inowanzoonekwa sevadzidzisi vakanyarara, sezvo ichionekwa sezvipo zvakakosha zvekubatsira sainzi nevanhu, zvichikurudzira ruremekedzo nekutenda kubva kuvadzidzi kune vanovapa [37, 38]. Zvidzidzo zvekare zvakashuma mamakisi akafanana kana akakwirira pakati peboka remutumbi/plastination neboka re3DP [21, 39], asi hazvina kujeka kana vadzidzi vaine ruzivo rwakafanana rwekudzidza, kusanganisira humanistic values, pakati pemapoka maviri aya. Kuti uwane rumwe ruzivo, chidzidzo ichi chinoshandisa musimboti we pragmatism [36] kuongorora ruzivo rwekudzidza uye hunhu hwe3DP models (ruvara nekugadzirwa) uye kuzvienzanisa ne plastinated samples zvichibva pamhinduro dzevadzidzi.
Maonero evadzidzi anogona kukanganisa sarudzo dzevadzidzisi pakusarudza maturusi akakodzera emuviri zvichibva pane zvinoshanda uye zvisingabatsiri pakudzidzisa muviri. Ruzivo urwu runogonawo kubatsira vadzidzisi kuona zvinodiwa nevadzidzi uye kushandisa maturusi akakodzera ekuongorora kuti vavandudze ruzivo rwavo rwekudzidza.
Chidzidzo ichi chekuongorora zvinhu chakanangana nekutsvaga izvo vadzidzi vanoona sechiitiko chakakosha chekudzidza vachishandisa sampuli dzemwoyo nemutsipa dzakagadzirwa nepurasitiki zvichienzaniswa ne3DP. Sekureva kweongororo yekutanga yakaitwa naMogali et al. muna 2018, vadzidzi vakaona sampuli dzakagadzirwa nepurasitiki sedziri dzechokwadi kupfuura 3DP [7]. Saka ngatifungei kuti:
Zvichienderana nekuti mapurasitiki akagadzirwa kubva kuzvitunha zvechokwadi, vadzidzi vaitarisirwa kuona mapurasitiki zvakanaka kupfuura mamodheru e3DP maererano nekuvimbika uye kukosha kwehunhu.
Chidzidzo ichi chemhando yepamusoro chakabatana nezvidzidzo zviviri zvekare zvehuwandu [21, 40] nekuti data rakapihwa muzvidzidzo zvese zvitatu rakaunganidzwa panguva imwe chete kubva mumuenzaniso mumwe chete wevadzidzi vakatora chikamu. Chinyorwa chekutanga chakaratidza zviyero zvakafanana zvechinangwa (zvibodzwa zvebvunzo) pakati pemapoka eplastination ne3DP [21], uye chinyorwa chechipiri chakashandisa ongororo yezvinhu kugadzira chishandiso chakasimbiswa nepfungwa (zvinhu zvina, zvinhu gumi nepfumbamwe) kuyera zvivakwa zvedzidzo zvakaita sekugutsikana kwekudzidza, kuzvibata, hunhu hwevanhu, uye miganho yekudzidza [40]. Chidzidzo ichi chakaongorora hurukuro dzemhando yepamusoro dzemapoka akazaruka uye akatarisana kuti vaone kuti vadzidzi vanoona sei zvakakosha pavanodzidza anatomy vachishandisa sampuli dzakapendwa uye modhi dzakadhindwa dze3D. Saka, chidzidzo ichi chakasiyana nezvinyorwa zviviri zvakapfuura maererano nezvinangwa/mibvunzo yekutsvagisa, data, uye nzira dzekuongorora kuti vawane nzwisiso yemhinduro yevadzidzi yemhando yepamusoro (makomendi emahara pamwe nehurukuro yeboka rekutarisa) pakushandiswa kwezvishandiso zve3DP zvichienzaniswa nesamples dzakapendwa. Izvi zvinoreva kuti chidzidzo chiripo chinogadzirisa mubvunzo wekutsvagisa wakasiyana pane zvinyorwa zviviri zvakapfuura [21, 40].
Pachikoro chemunyori, magadzirirwo emuviri anobatanidzwa muzvidzidzo zvehurongwa hwemuviri zvakaita secardiopulmonary, endocrinology, musculoskeletal, nezvimwewo, mumakore maviri ekutanga echirongwa chemakore mashanu cheBachelor of Medicine neBachelor of Surgery (MBBS). Zviyero zvakaputsika, mapurasitiki, mifananidzo yekurapa, uye mamodeli e3D chaiwo anowanzo shandiswa panzvimbo pekuyedza kana kunyorova magadzirirwo emuviri kutsigira maitiro ezvemuviri. Zvidzidzo zveboka zvinotsiva hurukuro dzechinyakare dzinodzidziswa nekutarisa pakushandiswa kweruzivo rwakawanikwa. Pakupera kwemodule yega yega yesystem, tora bvunzo yekudzidzira yemuviri yepamhepo inosanganisira mhinduro makumi maviri dzakanakisa (SBAs) dzinofukidza maitiro emuviri, kufungidzira, uye histology. Pakazara, bvunzo shanu dzekugadzira dzakaitwa panguva yekuyedza (nhatu mugore rekutanga uye mbiri mugore rechipiri). Ongororo yakazara yakanyorwa yeGore 1 ne2 inosanganisira mapepa maviri, imwe neimwe ine maSBA zana nemakumi maviri. Magadzirirwo emuviri anova chikamu cheongororo idzi uye hurongwa hwekuongorora hunosarudza huwandu hwemibvunzo yemuviri inofanira kuverengerwa.
Kuti pave nekuwedzera huwandu hwevadzidzi nemuenzaniso, mamodheru emukati e3DP akavakirwa pazvienzaniso zveplastina akadzidzwa kuti adzidzise uye adzidze maumbirwo emuviri. Izvi zvinopa mukana wekuona kukosha kwedzidzo yemamodheru matsva e3DP zvichienzaniswa nemamodheru eplastina asati aiswa muchirongwa cheanatomy.
Muchidzidzo ichi, computed tomography (CT) (64-slice Somatom Definition Flash CT scanner, Siemens Healthcare, Erlangen, Germany) yakaitwa pamamodeli epurasitiki emoyo (moyo mumwe chete nemoyo mumwe muchikamu chakachinjika) uye musoro nemutsipa (mumwe wose nemusoro mumwe wepakati pemutsipa) (Mufananidzo 1). Mifananidzo yeDigital Imaging and Communications in Medicine (DICOM) yakatorwa ndokuiswa mu3D Slicer (shanduro 4.8.1 na4.10.2, Harvard Medical School, Boston, Massachusetts) kuti igovaniswe nerudzi rwakaita semhasuru, tsinga, tsinga, nemapfupa. Mafaira akapatsanurwa akaiswa muMaterialize Magics (Version 22, Materialize NV, Leuven, Belgium) kuti abvise magokora eruzha, uye mamodeli akadhindwa akachengetwa muSTL format, ayo akazoendeswa kuObjet 500 Connex3 Polyjet printer (Stratasys, Eden Prairie, MN) kuti vagadzire mamodeli e3D anatomical. Maresini anogadziriswa ne photopolymer uye ma elastomers anoonekera (VeroYellow, VeroMagenta naTangoPlus) anoomesa jira nejira pasi pesimba remwaranzi yeUV, zvichipa chimiro chega chega magadzirirwo neruvara rwacho.
Zvishandiso zvekudzidza nezveanatomy zvakashandiswa muchidzidzo ichi. Kuruboshwe: Mutsipa; kurudyi: zvakaputirwa uye moyo wakadhindwa ne3D.
Pamusoro pezvo, ascending aorta ne coronary system zvakasarudzwa kubva mumodhi yemoyo wese, uye ma base scaffolds akavakwa kuti abatanidzwe nemodhi (vhezheni 22, Materialize NV, Leuven, Belgium). Modhi iyi yakadhindwa paRaise3D Pro2 printer (Raise3D Technologies, Irvine, CA) uchishandisa thermoplastic polyurethane (TPU) filament. Kuti iratidze tsinga dzemodhi iyi, zvinhu zvakadhindwa zveTPU support zvakafanira kubviswa uye tsinga dzeropa dzakapendwa nered acrylic.
Vadzidzi veBachelor of Medicine vegore rekutanga paLee Kong Chiang Faculty of Medicine mugore redzidzo ra2020-2021 (n = 163, varume 94 nevakadzi 69) vakagamuchira tsamba yekutumira email kuti vatore chikamu muchidzidzo ichi sechiito chekuzvipira. Kuedza kwacho kwakaitwa muzvikamu zviviri, kutanga nekuchekwa kwemoyo uye ipapo nekuchekwa kwemutsipa. Pane nguva yekugeza kwemavhiki matanhatu pakati pezvikamu zviviri kuderedza migumisiro yakasara. Muzvikamu zvose, vadzidzi vakanga vasingaoni misoro yekudzidza uye mabasa eboka. Vanhu vasingapfuuri vatanhatu muboka. Vadzidzi vakagamuchira samples dzakagadzirwa nepurasitiki muchikamu chekutanga vakagamuchira mamodheru e3DP muchikamu chechipiri. Pachikamu chimwe nechimwe, mapoka ese ari maviri anogamuchira hurukuro yekutanga (maminetsi makumi matatu) kubva kune wechitatu (mudzidzisi mukuru) zvichiteverwa nekudzidza wega (maminetsi makumi mashanu) vachishandisa maturusi ekudzidza wega uye mapepa ekushandisa.
Rondedzero yeCOREQ (Comprehensive Criteria for Qualitative Research Reporting) inoshandiswa kutungamira tsvakurudzo yequalitative.
Vadzidzi vakapa mhinduro pamusoro pezvidzidzo zvekutsvaga kuburikidza neongororo yaisanganisira mibvunzo mitatu yakasununguka pamusoro pesimba ravo, kushaya simba, uye mikana yekukura. Vose vakapindura makumi mapfumbamwe nematanhatu vakapa mhinduro dzemahara. Ipapo vadzidzi vasere vanozvipira (n = 8) vakapinda muboka rekutarisa. Kubvunzurudza kwakaitwa paAnatomy Training Center (kwakaitwa kuyedza) uye kwakaitwa neInvestigator 4 (Ph.D.), mudzidzisi wechirume asiri weanatomy ane ruzivo rwemakore anopfuura gumi rwekubatsira TBL, asi asina kubatanidzwa mukudzidziswa kwechikwata chekudzidza. Vadzidzi vaisaziva hunhu hwevaongorori (kana boka rekutsvaga) vasati vatanga kudzidza, asi fomu rekubvumidza rakavazivisa chinangwa chechidzidzo. Muongorori 4 chete nevadzidzi ndivo vakatora chikamu muboka rekutarisa. Muongorori akatsanangura boka rekutarisa kuvadzidzi ndokuvabvunza kana vachida kutora chikamu. Vakagovana ruzivo rwavo rwekudzidza 3D printing neplastination uye vaifara zvikuru. Murayiridzi akabvunza mibvunzo mitanhatu inotungamira kukurudzira vadzidzi kuti vashande kuburikidza (Zvimwe Zvinyorwa 1). Mienzaniso inosanganisira kukurukura nezvezvinhu zvemidziyo yemuviri zvinokurudzira kudzidza nekudzidza, uye basa rekunzwisisa tsitsi mukushanda nemuenzaniso wakadaro. "Ungatsanangura sei ruzivo rwako rwekudzidza nezvemuviri uchishandisa mienzaniso yeplastinated uye makopi akadhindwa e3D?" ndiwo waiva mubvunzo wekutanga wekubvunzurudzwa. Mibvunzo yese yakavhurika, ichibvumira vashandisi kupindura mibvunzo vakasununguka pasina nzvimbo dzakarerekera, zvichibvumira data idzva kuwanikwa uye matambudziko ekukundwa nezvishandiso zvekudzidza. Vatori vechikamu havana kugamuchira kunyorwa kwemashoko kana kuongororwa kwemhedzisiro. Hunhu hwekuzvipira hwekudzidza hwakadzivirira kuzadza data. Hurukuro yese yakatepwa kuti iongororwe.
Kurekodhwa kweboka rekutarisa (maminetsi makumi matatu nemashanu) kwakanyorwa sezvakunoitwa uye kwakabviswa pamunhu (ma pseudonyms akashandiswa). Pamusoro pezvo, mibvunzo yemibvunzo yakavhurika yakaunganidzwa. Zvinyorwa zveboka rekutarisa uye mibvunzo yekuongorora zvakapinzwa muMicrosoft Excel spreadsheet (Microsoft Corporation, Redmond, WA) kuti data rionekwe uye riunganidzwe kuti rionekwe kana paine mhinduro dzakafanana kana dzakafanana kana mhinduro itsva [41]. Izvi zvinoitwa kuburikidza nekuongorora kwedzidziso [41, 42]. Mhinduro dzemudzidzi wega wega dzinowedzerwa kuhuwandu hwemhinduro. Izvi zvinoreva kuti mhinduro dzine mitsara yakawanda dzichabatwa seimwe. Mhinduro dzine nil, hapana kana hapana kana kuti hapana ma comment tag hadzizoteererwi. Vaongorori vatatu (muongorori wechikadzi ane Ph.D., muongorori wechikadzi ane master's degree, uye mubatsiri wechirume ane bachelor's degree muinjiniya uye makore 1-3 eruzivo rwekutsvagisa mudzidzo yezvekurapa) vakazvimiririra vakanyora data risina kurongeka. Vagadziri vemapurogiramu vatatu vanoshandisa ma drawing pads chaiwo kuti varonge zvinyorwa zve post-it zvichibva pakufanana uye kusiyana. Zvidzidzo zvakawanda zvakaitwa kuti makodhi arongwe uye aitwe mumapoka kuburikidza nekuziva maitiro akarongwa uye anodzokororwa, apo makodhi akarongwa kuti aone misoro midiki (hunhu hwakasiyana kana hwakajairika senge hunhu hwakanaka nehusina kunaka hwezvishandiso zvekudzidza) izvo zvakazogadzira dingindira guru [41]. Kuti vabvumirane, muongorori wechirume matanhatu (Ph.D.) ane makore gumi nemashanu eruzivo mukudzidzisa anatomi akabvumidza zvidzidzo zvekupedzisira.
Zvichienderana neChiziviso cheHelsinki, Bhodhi reInstitutional Review reNanyang Technological University (IRB) (2019-09-024) rakaongorora nzira yekudzidza iyi ndokuwana mvumo inodiwa. Vatori vechikamu vakapa mvumo uye vakaziviswa nezvekodzero yavo yekurega kutora chikamu chero nguva.
Vadzidzi vekurapa vegore rekutanga makumi mapfumbamwe nevatanhatu vakapa mvumo yakazara, ruzivo rwevanhu rwakaita sekuti murume kana mukadzi nezera, uye vakataura kuti havana kudzidziswa zvemuviri. Chikamu chekutanga (moyo) nechikamu chechipiri (kuchekwa kwemutsipa) zvaisanganisira vatori vechikamu makumi matanhatu nematatu (varume makumi matatu nematatu nevakadzi makumi matatu) uye vatori vechikamu makumi matatu nematatu (varume gumi nevasere nevakadzi gumi nevashanu), zvichiteerana. Zera ravo raive pakati pemakore gumi nemasere kusvika makumi maviri nerimwe (avhareji ± kutsauka kwakajairwa: makore 19.3 ± 0.9). Vadzidzi vese makumi mapfumbamwe nematanhatu vakapindura mibvunzo (hapana kusiya chikoro), uye vadzidzi vasere vakatora chikamu mumapoka ekutarisa. Kwaive nemashoko akavhurika mazana maviri nemakumi manomwe nemasere pamusoro pezvakanakira, zvakaipa, uye zvinodiwa pakuvandudza. Pakanga pasina kusawirirana pakati pedata rakaongororwa nemushumo wezvakawanikwa.
Muhurukuro dzemapoka ekutarisa uye mhinduro dzeongororo, misoro mina yakabuda: kuvimbika kwemaonero, kunzwisisa kwakakosha uye kuomarara, mafungiro ekuremekedza nekutarisira, maitiro akawanda, uye hutungamiriri (Mufananidzo 2). Musoro wega wega unotsanangurwa zvakadzama pazasi.
Madingindira mana aya—chokwadi chinoonekwa, kunzwisisa kwakakosha uye kuoma, ruremekedzo nehanya, uye kufarira nzira dzekudzidza—zvakavakirwa pakuongorora dingindira remibvunzo yeongororo yakavhurika uye hurukuro dzemapoka akatarisana. Zvinhu zviri mumabhokisi ebhuruu neyero zvinomiririra hunhu hwemuenzaniso wakapetwa uye modhi ye3DP, zvichiteerana. 3DP = 3D kudhinda
Vadzidzi vaifunga kuti sampuli dzakagadzirwa nepurasitiki dzaive dzechokwadi, dzaive nemavara echisikigo airatidza zvitunha chaizvo, uye dzaive neruzivo rwakajeka rwemuviri kupfuura 3DP models. Semuenzaniso, kurongeka kwemhasuru kwakanyanya kuonekwa musampuli dzakagadzirwa nepurasitiki zvichienzaniswa ne3DP models. Musiyano uyu unoratidzwa muchirevo chiri pazasi.
"...zvakadzama uye zvakarurama, sekunge zvakabva kumunhu chaiye (mutori wechikamu weC17; ongororo yepurasitiki yakasununguka)."
Vadzidzi vakacherechedza kuti zvishandiso zve3DP zvaibatsira pakudzidza hunhu hwemuviri uye kuongorora zvinhu zvikuru zvemacroscopic, nepo sampuli dzakagadzirwa nepurasitiki dzaive dzakanakira kuwedzera ruzivo rwavo nekunzwisisa maumbirwo akaomarara emuviri nenzvimbo. Vadzidzi vakafunga kuti kunyangwe zvishandiso zvese zvaive zvakafanana, vaishaya ruzivo rwakakosha pavaishanda nemamodeli e3DP zvichienzaniswa nemasampuli akaumbwa nepurasitiki. Izvi zvinotsanangurwa muchirevo chiri pazasi.
"...paiva nematambudziko akaita se... zvinhu zvidiki zvakaita sefossa ovale... kazhinji modhi ye3D yemoyo inogona kushandiswa... yemutsipa, pamwe ndichadzidza modhi yeplastination nechivimbo (mutori wechikamu PA1; 3DP, hurukuro yeboka rekutarisa").
"...zvimiro zvakakura zvinogona kuonekwa... zvakadzama, mienzaniso ye3DP inobatsira pakudzidza, semuenzaniso, zvimiro zvakakomba (uye) zvinhu zvikuru, zviri nyore kuziva senge tsandanyama nenhengo ... pamwe (kune) vanhu vangave vasina mukana wekuwana mienzaniso yeplastinated (mutori wechikamu wePA3; 3DP, hurukuro yeboka rekutarisa)".
Vadzidzi vakaratidza ruremekedzo nehanya zvakanyanya nemuenzaniso wepurasitiki, asi vainetsekawo nekuparadzwa kwechivako nekuda kwekusasimba kwacho uye kushaya kuchinjika. Kusiyana neizvi, vadzidzi vakawedzera ruzivo rwavo rwekushanda nekuona kuti mamodheru e3DP anogona kudzokororwa kana akakuvara.
"... tinowanzo chenjererawo maitiro epurasitiki (mutori wechikamu chePA2; purasitiki, hurukuro yeboka rekutarisa)".
"...pazviyero zvepurasitiki, zvakaita se...chimwe chinhu chakachengetedzwa kwenguva yakareba. Kana ndikachikuvadza... Ndinofunga tinoziva kuti chinoita sekukuvadzwa kwakakomba nekuti chine nhoroondo (mutori wechikamu wePA3; purasitiki, hurukuro yeboka rekutarisa)."
"Mamodheru akadhindwa ne3D anogona kugadzirwa nekukurumidza uye zviri nyore ... zvichiita kuti mamodheru e3D asvike kuvanhu vakawanda uye zvichiita kuti kudzidza kuve nyore pasina kugovaniswa kwemasamples (I38 contributor; 3DP, ongororo yemahara yemagwaro)."
"...nemamodeli e3D tinogona kutamba zvishoma tisinganetseki nezvekuakuvadza, sekukuvadza masampuli... (mutori wechikamu wePA2; 3DP, hurukuro yeboka rekutarisa)."
Sekureva kwevadzidzi, huwandu hwezviyero zvakaputirwa nepurasitiki hwakaganhurirwa, uye kuwana zvimiro zvakadzika kwakaoma nekuda kwekuoma kwazvo. Kune modhi ye3DP, vanotarisira kuwedzera kunatsiridza hunhu hwemuviri nekugadzira modhi kuti ienderane nenzvimbo dzinofarirwa nedzidzo yakasarudzika. Vadzidzi vakabvumirana kuti modhi dzese dzakaputirwa nepurasitiki ne3DP dzinogona kushandiswa pamwe chete nedzimwe mhando dzezvishandiso zvekudzidzisa zvakaita setafura yeAnatomage kuti dziwedzere kudzidza.
"Mamwe maumbirwo emukati akadzika haaoneki zvakanaka (mutori wechikamu C14; plastination, comment-form)."
"Zvichida matafura ekuongorora zvitunha nedzimwe nzira dzingave dzinobatsira zvikuru (nhengo C14; plastination, ongororo yemahara yemagwaro)."
"Nekuona kuti mamodheru e3D akanyatsotsanangurwa, unogona kuva nemamodheru akasiyana anotarisa kunzvimbo dzakasiyana uye mativi akasiyana, akadai setsinga netsinga dzeropa (mutori wechikamu I26; 3DP, ongororo yemagwaro emahara)."
Vadzidzi vakakurudzirawo kuti mudzidzisi aratidze kuti angashandisa sei modhi iyi nemazvo, kana kuti mamwe mazano pamusoro pemifananidzo yemuenzaniso ine zvinyorwa kuti zvive nyore kudzidza nekunzwisisa muzvinyorwa zvehurukuro, kunyange zvazvo vakabvuma kuti chidzidzo ichi chakagadzirirwa kudzidza wega.
"...Ndinoonga nzira yekutsvagisa yakazvimiririra... pamwe nhungamiro yakawanda inogona kupihwa muchimiro chemasiraidhi akadhindwa kana mamwe manotsi... (mutori wechikamu C02; mhinduro dzemahara dzakajairika)."
"Nyanzvi dzezvemukati kana kuva nezvimwe zvishandiso zvekuona zvakaita semaanimation kana mavhidhiyo zvinogona kutibatsira kunzwisisa zviri nani chimiro chemamodeli e3D (nhengo C38; wongororo dzemagwaro emahara zvakazara)."
Vadzidzi vekurapa vegore rekutanga vakabvunzwa nezveruzivo rwavo rwekudzidza uye mhando yemasampuli akadhindwa e3D nepurasitiki. Sezvaitarisirwa, vadzidzi vakaona kuti masample akadhindwa e3D aive echokwadi uye akarurama kupfuura akadhindwa e3D. Mhedzisiro iyi yakasimbiswa neongororo yekutanga [7]. Sezvo zvinyorwa zvakagadzirwa kubva kuzvitunha zvakapihwa, ndezvechokwadi. Kunyangwe zvaive kopi ye1:1 yemuenzaniso wakadhindwa une hunhu hwakafanana hwechimiro [8], modhi yakadhindwa ye3D yakavakirwa papolymer yaionekwa seisina chokwadi uye isina chokwadi, kunyanya muvadzidzi vane ruzivo rwakadai semipendero ye oval fossa rwaisaonekwa mu3DP modhi yemoyo zvichienzaniswa ne plastinated modhi. Izvi zvinogona kunge zvichikonzerwa nemhando yemufananidzo weCT, iyo isingabvumidze kutsanangurwa kwakajeka kwemiganhu. Nokudaro, zvakaoma kupatsanura maumbirwo akadaro musoftware yekupatsanura, izvo zvinokanganisa maitiro ekudhinda e3D. Izvi zvinogona kukonzera kusava nechokwadi nezvekushandiswa kwezvishandiso zve3DP sezvo vachitya kuti ruzivo rwakakosha rucharasika kana zvishandiso zvakajairwa zvakaita semasampuli akadhindwa asina kushandiswa. Vadzidzi vanofarira kudzidziswa kwekuvhiya vangawana zvichidikanwa kushandisa mamodheru anoshanda [43]. Mhedzisiro yazvino yakafanana neongororo dzakapfuura dzakawana kuti mamodheru epurasitiki [44] uye 3DP sampuli hadzina kururama kwemamodheru chaiwo [45].
Kuti vadzidzi vagone kusvika kuvadzidzi uye nekudaro vagutsikane, mutengo uye kuwanikwa kwezvishandiso zvinofanirawo kufungwa nezvazvo. Mhedzisiro yacho inotsigira kushandiswa kwemamodheru e3DP pakuwana ruzivo rweanatomiki nekuda kwekugadzirwa kwawo kunodhura zvishoma [6, 21]. Izvi zvinoenderana neongororo yapfuura yakaratidza kushanda kwakafanana kwemamodheru epurasitiki nemamodheru e3DP [21]. Vadzidzi vainzwa kuti mamodheru e3DP ainyanya kubatsira pakudzidza pfungwa dzekutanga dzeanatomiki, nhengo, uye hunhu, nepo mamodheru epurasitiki ainyanya kukodzera kudzidza anatomiki yakaoma. Pamusoro pezvo, vadzidzi vakakurudzira kushandiswa kwemamodheru e3DP pamwe chete nemamodheru ezvitunha aripo uye tekinoroji yemazuva ano yekuvandudza kunzwisisa kwevadzidzi nezveanatomiki. Nzira dzakawanda dzekumiririra chinhu chimwe chete, senge kumepa anatomiki yemoyo uchishandisa zvitunha, kudhinda kwe3D, kuskena kwevarwere, uye mamodheru e3D chaiwo. Iyi nzira ye multi-modal inobvumira vadzidzi kuratidza anatomiki nenzira dzakasiyana, kutaurirana zvavakadzidza nenzira dzakasiyana, uye kubatanidza vadzidzi nenzira dzakasiyana [44]. Tsvagiridzo yakaratidza kuti zvinhu zvekudzidza zvechokwadi zvakaita sematurusi ezvitunha zvinogona kunetsa kune vamwe vadzidzi maererano nemutoro wekuziva une chekuita neanatomiki yekudzidza [46]. Kunzwisisa kukanganiswa kwemutoro wepfungwa pakudzidza kwevadzidzi uye kushandisa matekinoroji kuderedza mutoro wepfungwa kuti vagadzire nzvimbo yekudzidza iri nani kwakakosha [47, 48]. Vasati vatanga vadzidzi kudzidza nezvezvinhu zvechitunha, mamodheru e3DP anogona kuva nzira inobatsira yekuratidza zvinhu zvakakosha uye zvakakosha zvemuviri wemunhu kuitira kuderedza mutoro wepfungwa uye kusimudzira kudzidza. Pamusoro pezvo, vadzidzi vanogona kutora mamodheru e3DP kuenda kumba kuti anongororwe pamwe chete nemabhuku ekudzidza nezvinhu zvekudzidzisa uye kuwedzera kudzidza kwemuviri wemunhu kunze kwerabhoritari [45]. Zvisinei, tsika yekubvisa zvikamu zve3DP haisati yaitwa muchikoro chemunyori.
Muchidzidzo ichi, sampuli dzakagadzirwa nepurasitiki dzairemekedzwa kupfuura 3DP replicas. Mhedziso iyi inoenderana neongororo yapfuura inoratidza kuti sampuli dzechitunha se "murwere wekutanga" dzinoda ruremekedzo netsitsi, nepo mamodheru ekugadzira asingadaro [49]. Nyama dzemunhu dzakagadzirwa nepurasitiki dzinoenderana uye dziri dzechokwadi. Kushandiswa kwezvinhu zvechitunha kunobvumira vadzidzi kukudziridza pfungwa dzehunhu uye dzetsika [50]. Pamusoro pezvo, maonero evadzidzi emaitiro epurasitiki anogona kukanganiswa neruzivo rwavo rwuri kukura rwezvirongwa zvekupa chitunha uye/kana maitiro epurasitiki. Plastination imhando yezvitunha zvinopihwa zvinotevedzera tsitsi, kuyemurwa uye kuonga kunoita vadzidzi kune vanopa [10, 51]. Hunhu uhu hunosiyanisa vanamukoti vane hunhu uye, kana hukakudziridzwa, hunogona kuvabatsira kufambira mberi nehunyanzvi nekuonga uye kunzwira tsitsi varwere [25, 37]. Izvi zvakafanana nevadzidzisi vakanyarara vachishandisa kupatsanurwa kwevanhu vakanyorova [37,52,53]. Sezvo sampuli dzepurasitiki dzakapihwa kubva kuzvitunha, dzakaonekwa sevadzidzisi vakanyarara, izvo zvakawana ruremekedzo rwechishandiso chitsva ichi chekudzidzisa. Kunyangwe vachiziva kuti mamodheru e3DP anogadzirwa nemichina, vachiri kufarira kuishandisa. Boka rega rega rinonzwa richitarisirwa uye modheru yacho inobatwa nekungwarira kuchengetedza kunaka kwayo. Vadzidzi vanogona kunge vachitoziva kuti mamodheru e3DP anogadzirwa kubva padata revarwere rezvidzidzo. Pachikoro chemunyori, vadzidzi vasati vatanga kudzidza zvemamodheru, kosi yekutanga yeanatomy inopiwa pamusoro penhoroondo yemamodheru, mushure mezvo vadzidzi vanopika mhiko. Chinangwa chikuru chemhiko ndechekudzidzisa vadzidzi kunzwisisa tsika dzevanhu, kuremekedza mamodheru, uye hunyanzvi. Kusanganiswa kwezvishandiso zveanatomy nekuzvipira kunogona kubatsira kusimbisa pfungwa yekutarisira, kuremekedza, uye pamwe kuyeuchidza vadzidzi nezvemabasa avo eramangwana kune varwere [54].
Nezvekuvandudzwa kwezvishandiso zvekudzidza mune ramangwana, vadzidzi vanobva kumapoka eplastination ne3DP vakaisa kutya kuparadzwa kwechivako mukutora kwavo chikamu nekudzidza. Zvisinei, kunetseka nezvekukanganiswa kwechimiro chezvienzaniso zveplated kwakasimbiswa panguva yekukurukurirana kwemapoka akatarisana. Kucherechedzwa uku kwakasimbiswa nezvidzidzo zvekare pamasampuli epurasitiki [9, 10]. Kugadziriswa kwechimiro, kunyanya mamodheru emutsipa, kunodiwa kuti uongorore zvivakwa zvakadzama uye unzwisise hukama hwenzvimbo dzine mativi matatu. Kushandiswa kweruzivo rwekubata (tactile) neruzivo rwekuona kunobatsira vadzidzi kugadzira mufananidzo wakadzama uye wakakwana wepfungwa wezvikamu zvemuviri zvine mativi matatu [55]. Zvidzidzo zvakaratidza kuti kugadziriswa kwezvinhu zvepanyama zvinogona kuderedza mutoro wekuziva uye kutungamira mukunzwisisa nekuchengetedza ruzivo zviri nani [55]. Zvakataurwa kuti kuwedzera mamodheru e3DP nemuenzaniso wepurasitiki kunogona kuvandudza kudyidzana kwevadzidzi nemuenzaniso pasina kutya kukuvadza zvivakwa.
Nguva yekutumira: Chikunguru-21-2023