**6. Conclusions and development**

**Figure 10.** Diagrammatic sketch for the formation of blue TiO2

chemical performances [33] (**Figure 10**).

236 Titanium Dioxide - Material for a Sustainable Environment

*5.6.2. Ice-water quenching*

Ti3+ self-doped TiO2

consisted of various TiO2

for charge separation and H2

(2016), Royal Society of Chemistry [9].

analysis and characterization results showed that the synergetic action of the special TiO2 (B) phase, Ti3+ self-doping, and the 1D rod-shaped single-crystalline nanostructure resulted in a narrowed bandgap of 2.61 eV, which enhanced the photocatalytic and photoelectro-

generation in blue P25 (green part: ordered TiO2

**Figure 9.** (a) Comparison of the hydrogen generation and cycling performance of 0.5 wt% platinized P25, nonplatinized P25 and nonplatinized blue P25 after 1 day of continuous reaction using methanol as a sacrificial agent. A simulated full solar spectrum was used as the excitation source, which produced approximately 100 mW cm−2 in the samples, which

Liu et al. applied ice-water quenching as a facile strategy for the synthesis of blue color of

[23]. In the typical process, commercial P25 materials were quenched in

nanocrystals in a 100 mL quartz reactor filled with 70 mL of solution. (b) Proposed mechanism

, gray part: disordered TiO2

). Copyright

Chemical Society [33].

(B) single-crystalline nanorod. Copyright (2016) American

In this chapter, blue TiO2 that has a low energy bandgap is introduced as an advanced semiconducting material for possible applications in the visible-light-driven photocatalysis. A variety of preparation methods for blue TiO2 photocatalysts with Ti3+ states of a high oxygen defect density have been successfully introduced. For the synthesis of the blue TiO2 in the applications of photocatalysis, hydrogenation method using TiO2 with hydrogen at 500°C or with hydride reducing agent at 450°C, hydrothermal method using Ti precursors or Zn powder reducing agent under HF solvent, electrochemical reduction method using anodizing TiO2 at 60 and 80 V and then annealing at 450°C, and metal reduction method using Al at 500°C, Na and NaCl solid milling, or Li-EDA solution at room temperature and atmospheric pressure. For the preparation of blue TiO2 , the most recently developed metal solution room temperature method can give phase-selective reduction between the anatase and rutile TiO2 phases. For the first time, the phase selective "disordered rutile and crystalline anatase" P25 TiO2 nanoparticles are reported, which turns out that it is a very effective photocatalyst for hydrogen evolution reaction and removal of algae under solar irradiation. However, how to quantitatively control surface defects and the properties of the interface between the order and disorder surface layer still remain as important challenges to understand the true physicochemical properties of blue TiO2 .

As mentioned in the introduction, in the near future, we would like to further address beneficial applications in clean energy conversion and storage media and protecting the environment, including the hydrogen evolution reaction, carbon dioxide reduction, and degradation of pollutants by using noble blue TiO2 under visible light.

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nanocrystals using TiF4


**4. Resident education during COVID**

The 2020 COVID-19 pandemic has had an impact on all aspects of general surgery training. Residency conferences and didactics moved to online platforms, rotations were canceled to reduce viral exposure, and non-urgent elective cases were delayed or rescheduled [7, 8, 27]. A concern for skills decay with the decrease in opportunities for procedural training emerged as a result.

There has been a significant reduction in surgical case volumes among all surgical specialties throughout the COVID 19 pandemic. For example, Aziz et al. found a significant reduction in operative case volume among 1,102 general surgery trainees in the United States [8]. Reduction in case volume has caused concern among both residents and directors as minimum case requirements are increasingly difficult to obtain. Rosen et al. demonstrated these results among the urological community as 60% of urology program directors were concerned that residents would not reach required operative volumes secondary to the COVID pandemic [28]. Similarly, there has been a shift to nonoperative management among previously emergent presentations like appendicitis [27]. The pandemic has shed light on an evident shift in surgical management that has been occurring over the past 50 years. Even before the emergence of COVID-19, the introduction of new data and technologies for certain disease processes, that were managed with complex surgical procedures in the past, has led to treatment with less invasive methods. For example, in surgical oncology the advent of the sentinel lymph node biopsy has drastically decreased the amount of completion lymph node dissections for melanoma and breast cancer [29, 30]. The advent of endovascular surgical techniques in vascular and cardiothoracic surgery has decreased trainee's exposure to a variety of open surgical cases. Smith et al. demonstrated a significant decrease in the amount of open abdominal aortic aneurysm repairs. Over a five-year study period from 2010 to 2014 trainees demonstrated a 38% decrease in open repairs, with one half of trainees in 2014 having exposure to less than five open repairs [31].

The obvious concern among surgical residents is inadequate operative skills secondary to decreased case volumes. Simulation training is now as important as ever to develop surgical skills among trainees. Doulias et al. argues that to prevent deterioration of operative skills, programs need to expand simulation training [32]. To improve surgical skills, online video conferencing platforms are now used to provide real time feedback from experts to surgical trainees undergoing laparoscopic and robotic training.

Despite many negative impacts from COVID on training Hope et al. argues for some positive implications. The authors argue that the adaptation of online learning has allowed greater access to educational material. Electronic-learning has now become a staple within surgical education [27]. Focus has shifted from in person lectures to a variety on online tools like podcasts, social media, YouTube videos, virtual peer reviewed libraries, and video conferencing platforms. Video conference platforms like Microsoft Teams and Zoom have provided an outlet for remote didactics, conferences, and virtual rounding [32]. Future studies will investigate the effectiveness of these new learning modalities on surgical education, but they will likely continue to have an impact in the post COVID era.

#### **5. Conclusion**

Surgical education over the last 50 years has proven to be a constantly evolving process. No longer is the Hasteadian "see one, do one, teach one" the sole maxim in training. With a growing emphasis on both patient safety and resident well-being,

### *Surgical Education in the 21st Century DOI: http://dx.doi.org/10.5772/intechopen.99406*

there has been a development of novel training paradigms. Greater emphasis has been placed on surgical simulation as a means for increasing operative skills. Training today also places an emphasis on didactics, conferences, and research as protected time is set aside for during the 80-hour work week for residents to develop their skills outside of the operating room. The lasting effects of the COVID-19 pandemic on surgical education are unknown, but the use of simulation and online training will likely continue to increase throughout the remainder of the 21st century to ensure stable and consistent training.