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In this work, TiO2‐SiO2‐x%Al2O3 (x = 0–50) nanocomposite thin films (NCTFs) with high purity, relatively homogeneity, high transmittance, excellent hardness, and crack‐free were synthesized successfully by a spin‐coating technique. It was demonstrated that the transmittance and the hardness of TiO2‐SiO2‐x%Al2O3 NCTFs are strongly affected by the Al2O3 content. The highest transmittance of 90.9% in the visible region (400 to 800 nm) and the excellent hardness and scratch resistance with a maximum hardness value of 7 Mohs and 11.8 GPa of nanoindentation and a critical scratch load of 47.6 mN for the TiO2‐SiO2‐30%Al2O3 NCTF annealed at 500°C in the air for 3 h was achieved. A hardness enhancement mechanism was proposed and discussed in detail. The obtained results show that the fabricated TiO2‐SiO2‐Al2O3 NCTFs have a great potential for anti‐scratch resistance surface applications. [ABSTRACT FROM AUTHOR]

Background An endotracheal tube cuff pressure between 20 and 30 cmH2O is recommended to prevent ventilator-associated respiratory infection (VARI). We aimed to evaluate whether continuous cuff pressure control (CPC) was associated with reduced VARI incidence compared with intermittent CPC. Methods We conducted a multicenter open-label randomized controlled trial in intensive care unit (ICU) patients within 24 hours of intubation in Vietnam. Patients were randomly assigned 1:1 to receive either continuous CPC using an automated electronic device or intermittent CPC using a manually hand-held manometer. The primary endpoint was the occurrence of VARI, evaluated by an independent reviewer blinded to the CPC allocation. Results We randomized 600 patients; 597 received the intervention or control and were included in the intention to treat analysis. Compared with intermittent CPC, continuous CPC did not reduce the proportion of patients with at least one episode of VARI (74/296 [25%] vs 69/301 [23%]; odds ratio [OR] 1.13; 95% confidence interval [CI].77–1.67]. There were no significant differences between continuous and intermittent CPC concerning the proportion of microbiologically confirmed VARI (OR 1.40; 95% CI.94–2.10), the proportion of intubated days without antimicrobials (relative proportion [RP] 0.99; 95% CI.87–1.12), rate of ICU discharge (cause-specific hazard ratio [HR] 0.95; 95% CI.78–1.16), cost of ICU stay (difference in transformed mean [DTM] 0.02; 95% CI −.05 to.08], cost of ICU antimicrobials (DTM 0.02; 95% CI −.25 to.28), cost of hospital stay (DTM 0.02; 95% CI −.04 to.08), and ICU mortality risk (OR 0.96; 95% CI.67–1.38). Conclusions Maintaining CPC through an automated electronic device did not reduce VARI incidence. Clinical Trial Registration NCT02966392. [ABSTRACT FROM AUTHOR]