Evaluation of the efficacy and safety of conventional and interlaminar full-endoscopic decompressive laminectomy to treat lumbar spinal stenosis (ENDO-F trial): Protocol for a prospective, randomized, multicenter trial.

Lumbar spinal stenosis is a common spinal degenerative condition. Minimally invasive interlaminar full-endoscopic decompressive laminectomy provides greater patient satisfaction and faster recovery than open decompressive laminectomy. The aim of our randomized controlled trial will be to compare the safety and efficacy of interlaminar full-endoscopic laminectomy and open decompressive laminectomy. Our trial will include 120 participants (60 per group) who will undergo surgical treatment for lumbar spinal stenosis. The primary outcome will be the Oswestry Disability Index measured at 12 months postoperatively. Secondary patient-reported outcomes will include back and radicular leg pain measured via a visual analog scale; the Oswestry Disability Index; the Euro-QOL-5 Dimensions score measured at 2 weeks and at 3, 6, and 12 months postoperatively; and patient satisfaction. The functional measures will include time to return to daily activities postoperatively and walking distance/time. The surgical outcomes will include postoperative drainage, operation time, duration of hospital stay, postoperative creatine kinase (an indicator of muscle injury) level, and postoperative surgical scarring. Magnetic resonance and computed tomography images and simple radiographs will be obtained for all patients. The safety outcomes will include surgery-related complications and adverse effects. All evaluations will be performed by a single assessor at each participating hospital who will be blinded to group allocation. The evaluations will be conducted preoperatively and at 2 weeks and 3, 6, and 12 months postoperatively. The randomized, multicenter design of the trial, blinding, and justification of the sample size will reduce the risk of bias in our trial. The results of the trial will provide data regarding the use of interlaminar full-endoscopic laminectomy as an alternative to open decompressive laminectomy that results in similar surgical findings with less invasiveness. Trial registration: This trial is registered at cris.nih.go.kr. (KCT0006198; protocol version 1; 27 May 2021).

Transferability of Diffractive Structure in the Compression Molding of Chalcogenide Glass.

This study investigates the use of Ge28Sb12Se60 chalcogenide glass for the compression molding of an infrared optical lens with a diffractive structure. Firstly, a mold core was prepared through ultra-precision grinding of tungsten carbide, and a chalcogenide glass preform was crafted through a polishing process and designed with a radius that would prevent gas isolation during the molding process. The test lens was then molded at various temperature conditions using the prepared mold core and preform. The diffractive structures of both the mold core and the resulting molded lens were analyzed using a microscope and white light interferometer. The comparison of these diffractive structures revealed that the molding temperature had an effect on the transferability of the diffractive structure during the molding of the chalcogenide glass lens. Furthermore, it was determined that, when the molding temperature was properly adjusted, the diffractive structure of the core could be fully transferred to the surface of the chalcogenide lens. Optimized chalcogenide glass-based lenses have the potential to serve as cost-effective yet high-performance IR optics.

Comparing Complications of Biologic and Synthetic Mesh in Breast Reconstruction: A Systematic Review and Network Meta-Analysis.

Background In breast reconstruction, synthetic meshes are frequently used to replace acellular dermal matrix (ADM), since ADM is expensive and often leads to complications. However, there is limited evidence that compares the types of substitutes. This study aimed to compare complications between materials via a network meta-analysis. Methods We systematically reviewed studies reporting any type of complication from 2010 to 2021. The primary outcomes were the proportion of infection, seroma, major complications, or contracture. We classified the intervention into four categories: ADM, absorbable mesh, nonabsorbable mesh, and nothing used. We then performed a network meta-analysis between these categories and estimated the odds ratio with random-effect models. Results Of 603 searched studies through the PubMed, MEDLINE, and Embase databases, following their review by two independent reviewers, 61 studies were included for full-text reading, of which 17 studies were finally included. There was a low risk of bias in the included studies, but only an indirect comparison between absorbable and non-absorbable mesh was possible. Infection was more frequent in ADM but not in the two synthetic mesh groups, namely the absorbable or nonabsorbable types, compared with the nonmesh group. The proportion of seroma in the synthetic mesh group was lower (odds ratio was 0.2 for the absorbable and 0.1 for the nonabsorbable mesh group) than in the ADM group. Proportions of major complications and contractures did not significantly differ between groups. Conclusion Compared with ADM, synthetic meshes have low infection and seroma rates. However, more studies concerning aesthetic outcomes and direct comparisons are needed.

Comparative study of the efficacy and safety of minimally invasive interlaminar full-endoscopic discectomy versus conventional microscopic discectomy in single-level lumbar herniated intervertebral disc (ENDO-F Trial): a multicenter, prospective, randomized controlled trial protocol.

BACKGROUND: Advances in minimally invasive surgery have expanded the indications for interlaminar full-endoscopic discectomy. Although the clinical outcomes for this approach may be equivalent to those of conventional microscopic discectomy, the supporting evidence is still based on small, single-center, prospective, and retrospective studies. Therefore, a multicenter randomized controlled trial is warranted. METHODS: This will be a prospective, multicenter, randomized controlled trial comparing the efficacy and safety of interlaminar full-endoscopic discectomy to those of conventional microscopic discectomy. The trial will enroll 100 participants with a lumbar disc herniation, 50 in each group. The primary outcome will be the Oswestry Disability Index (ODI) score at 12 months post-surgery. Secondary outcomes will be back and leg pain (visual analog scale); the ODI; the EuroQol-5-dimension score; patient satisfaction; and walking distance/time and time to return to daily activities post-surgery. Surgical outcomes will include postoperative drainage, operative time, duration of hospital stay, postoperative creatine kinase level as an indicator of muscle injury, and postoperative scarring. Postoperative magnetic resonance imaging, computed tomography, and simple radiography will be performed to evaluate radiographic outcomes between the two surgical approaches. Surgery-related complications and adverse effects will be evaluated as safety outcomes. A single assessor at each participating hospital, blinded to group allocation, will assess the enrolled participants at baseline, at 2 weeks, and at 3, 6, and 12 months postoperatively. DISCUSSION: This trial is designed to determine whether interlaminar full-endoscopic discectomy is clinically comparable to microscopic discectomy to treat lumbar disc herniations. All efforts will be made to reduce bias, including adequate sample size, blinded analyses, and multicenter prospective registration. The outcomes will inform practice, providing the evidence needed for using interlaminar full-endoscopic over microscopic discectomy by confirming the potential of this technique to improve patient satisfaction and clinical outcomes. TRIAL REGISTRATION: Clinical Research Information Service; cris.nih.go.kr. (KCT0006277); protocol version (v1, June 8, 2021).

Continuous Titration of Inspired Oxygen Using Oxygen Reserve Index to Decrease Oxygen Exposure During One-Lung Ventilation: A Randomized Controlled Trial.

BACKGROUND: A high fraction of inspired oxygen (Fio2) is administered during one-lung ventilation (OLV). However, a high Fio2 is not physiologic and may lead to various complications. We hypothesized that continuous titration of Fio2 using the oxygen reserve index (ORI) reduces oxygen exposure compared to conventional management during OLV. METHODS: In this randomized, double-blinded trial, patients undergoing thoracic surgery were assigned to an ORI (n = 64) or a control group (n = 60). In the ORI group, ORI was continuously displayed using multiwavelength pulse co-oximetry (Masimo) between 0 and 1 (0, no reserve; 1, maximum reserve), and Fio2 was titrated for a target ORI of 0.21 at 5-minute intervals during OLV. In the control group, Fio2 was adjusted using arterial blood gas analysis measured at 15 minutes after OLV initiation. The primary end point was the time-weighted average Fio2 during OLV. RESULTS: Overall, time-weighted average Fio2 did not differ between the groups (control versus ORI: median [interquartile range], 0.87 [0.73-1.00] vs 0.82 [0.68-0.93]; P = .09). However, in a subgroup analysis, the ORI group reduced time-weighted average Fio2 after pulmonary vascular ligation compared to the control group (control versus ORI: median [interquartile range], 0.75 [0.70-1.00] vs 0.72 [0.59-0.89]; P = .0261). The incidence of intraoperative hypoxia (arterial oxygen saturation [Spo2] <94%; control versus ORI: 32% [19/60; 95% confidence interval (CI), 20-45] vs 19% [12/64; 95% CI, 10-31]; P = .09), and postoperative complications within the first 7 days did not differ between the groups. CONCLUSIONS: ORI-guided continuous Fio2 titration does not reduce overall oxygen exposure during OLV.

Paper-based colorimetric sensor for easy and simple detection of polygalacturonase activity aiming for diagnosis of Allium white rot disease.

Polygalacturonase (PG) activity in plants can serve as an important index for plant disease. However, the conventional method to detect PG activity is a complex process and requires a skilled technician and expensive analytical equipment. In this study, a paper-based colorimetric sensor was developed based on the principle of the ruthenium red (RR) dye method for easy and simple measurement of PG activity. The proposed paper-based sensor has a three-layer structure for detection of PG activity in samples. The sensor sensitivity was enhanced by optimizing the pH of the sodium acetate buffer used in polygalacturonic acid (PGA)-RR complex formation and the reaction temperature for PG and the PGA-RR complex. Further, for quantitative analysis of PG activity, Delta RGB analysis was conducted to detect color changes in the sensing window of the sensor. Results presented that the linear measurement range of the paper sensor was 0.02-0.1 unit with the limit of detection of 0.02 unit, which showed a similar detection range, but a lower detection limit, compared to the spectrophotometry. Furthermore, PG activity based on culture condition was measured using samples from Sclerotium cepivorum to verify the potential application of the developed paper-based sensor in the field. The measured activity showed no statistically significant difference from the values obtained from the spectrophotometry at 95% confidence level. Therefore, the paper-based colorimetric sensor can be used to predict plant diseases in Allium crops during the stage of pathogen invasion, potentially contributing to the improvement of crop production.

Highly sensitive enclosed multilayer paper-based microfluidic sensor for quantifying proline in plants.

Free proline, termed proline, is a biomarker used for diagnosing drought stress in plants. A previously developed proline-ninhydrin reaction-based paper sensor could quickly and easily detect proline, but it was limited by low sensitivity. In this study, we developed an enclosed multilayer paper-based microfluidic sensor with high sensitivity for the quantitative detection of proline in plants. The multilayer paper-based sensor was manufactured using simple wax printing and origami methods, and contained an internal mixing channel to allow good mixing of the proline with ninhydrin, increasing the proline-ninhydrin reactivity and providing accurate and sensitive proline detection. By preloading ninhydrin onto the sample loading area, uniform coloration of the sensing window was achieved, allowing quantitative analysis of various proline concentrations using a constant reaction time. Only the sensing window and sample loading area were exposed to limit sample evaporation and contamination from the external environment. The LOD of the fabricated sensor was 23 µM, which is approximately 29-fold lower than that of the previously proposed paper sensor (657 µM). Samples were extracted from A. thaliana plants subjected to drought stress for proline detection. The proline concentrations measured using the developed paper sensor and a spectrophotometric method were not statistically significant at a confidence level of 95%. Therefore, the developed sensor can be applied to measure proline concentrations precisely in the field with a low detection limit. The developed paper-based sensor can be used to detect the early stages of drought in plants and thus improve crop productivity.

Use of a multilayered acellular dermal substitute with simultaneous full-thickness skin graft for the one-stage coverage of nasal skin defects.

BACKGROUND: Nasal skin defect closures are challenging because the nose is a complex anatomic structure with several subunits, and the nasal tip and ala represent particularly difficult subunits to reconstruct. The traditional full-thickness skin graft (FTSG) is an easy and well-established method, but often results in undesirable outcomes in terms of the nasal contour caused by a lack of dermal tissue. AIMS: The purpose of the study is to report the outcomes of the simultaneous application of the acellular dermal substitute (Matriderm® ) with FTSG in the treatment of nasal skin defects. PATIENTS/METHODS: Five patients with various nasal skin defects were treated with multilayered Matriderm grafts followed by FTSGs harvested from the pre- or postauricular region. Graft survival, scar quality, and patient satisfaction were evaluated and compared with 10 patients treated with conventional FTSGs. RESULTS: One-stage Matriderm-aided FTSGs were well-taken in all cases. Scar quality in the Matriderm group (8.0 ± 1.9) was statistically superior to that in the FTSG only group (10.8 ± 1.7). The Matriderm-aided graft was also superior in patient satisfaction. CONCLUSIONS: The multilayered application of Matriderm in combination with FTSG is a reliable method for covering nasal skin defects, especially in the thick skin zone of the tip and ala.

The Outcome of Early Ablative Fractional Laser Treatment for Thyroidectomy Scars.

BACKGROUND AND OBJECTIVES: Ablative fractional laser (AFL) systems are commonly used to treat various scars, and recent research has indicated that early treatment with AFL may have a preventive effect on scars. This study was designed to evaluate the efficacy of early treatment with a 10,600 nm carbon dioxide (CO2 ) AFL on thyroidectomy scars and compare it to late (conventional) treatment for the same and untreated controls. STUDY DESIGN/MATERIALS AND METHODS: We performed a prospective, evaluator-blinded, split-scar study on fresh thyroidectomy scars between July 2014 and July 2017. Scars were divided into two equal portions. Early AFL treatment had begun 1 month after surgery; five sessions on the right half of the scar was performed at 1-month intervals. Late AFL treatment followed for 1 month after the final early treatment session on the left half of the scar at the same interval. The scars were evaluated at 6 and 11 months postoperatively using scar analysis scales and patient questionnaires. RESULTS: Twenty-four out of 28 patients completed the study. The mean decrease in Vancouver Scar Scale (VSS) scores was significantly higher for the early treated right halves of the scars both at the 6th month (vs. untreated controls) and at the 11th month (vs. late treated controls). The VSS subset analysis showed that the early treated sides had significantly greater improvement in pliability and height than the control sides at each point of evaluation. CONCLUSIONS: Early postoperative AFL treatment is safe and effective in improving linear surgical scars, such as thyroidectomy scars, and may be a promising option for scar prevention. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.

Detection of proline using a novel paper-based analytical device for on-site diagnosis of drought stress in plants.

We developed and characterized a paper-based microfluidic sensor for the on-site diagnosis of drought stress in plants. Proline was used as a biomarker for analyzing drought stress, which was extracted by a colorimetric method using the proline-ninhydrin reaction. Paper was used as the main sensor material for the on-site detection of proline as it is easily transportable and cost-effective. The paper-based sensor was fabricated using wax-printing and origami methods, and the sensor was precoated with ninhydrin to allow for easy and convenient on-site use. Furthermore, a sample-to-ninhydrin ratio of 1:2 was found to confer optimal sensitivity to the drought diagnosis sensor. The concentration of proline in a sample was quantified by red-green-blue analysis to determine the change in green color intensity levels in response to distinct proline concentrations, which were detected by the sensor. The limit of detection of proline using the devised sensor was 657 µM, and the green color intensity level decreased with increasing proline concentration. In addition, the sensor was validated in an experimental drought stress model with Arabidopsis and subjected to drought stress for 21 days, and the amount of proline detected was 10 mM. The devised paper-based microfluidic sensor highlights the possibility of the on-site evaluation of drought stress in plants with potential to be utilized in various agricultural areas in the future.

Implementation of a pulse-type laser detection and ranging system based on heterodyne detection for long-range measurement with high repetition rate.

This paper presents the implementation of a pulse-type LAser Detection And Ranging (LADAR) system based on heterodyne detection for long-range measurement. A pulse-type LADAR based on an intensity direct-detection is certainly simple and mature, but it requires a high peak-power laser and a low-noise avalanche photodiode for long-range measurement, which restricts the scope of the application due to the weight, power consumption, and cost of the laser and the photodetector. In this work, heterodyne detection using a PIN photodiode is implemented to increase receiver sensitivity instead of using a low-noise avalanche photodiode. An optical phase-locked loop is adopted to generate an optical local oscillator signal for heterodyne detection. The proposed heterodyne detection scheme achieves a minimum detectable signal level of -52.6 dBm at a bandwidth of 1.2 GHz, and it is adopted in a pulse-type LADAR system for long-range measurement. The pulse-type LADAR system can measure a distance of 2.77 km at a repetition rate of 40 kHz, and it demonstrates great advantages for realizing real-time 3D imaging for long-range measurement with a high frame rate.

Optimization of the ninhydrin reaction and development of a multiwell plate-based high-throughput proline detection assay.

We developed a high-throughput technique for highly sensitive measurement of trace amounts of proline, an indicator of drought stress in plants, using an optimized proline-ninhydrin reaction. In order to do this, proline detection time was minimized by omitting phosphoric acid from the ninhydrin reagent. Chromophore extraction using toluene was also omitted, thus lowering the risks to environment and human health, and allowing the use of readily available polystyrene plates. Proline detection sensitivity was assessed based on the concentration of sulfosalicylic acid in the solution, which indicated that 1% sulfosalicylic acid yielded the best sensitivity and linearity. These findings were applied to a multiwell plate-based multiplex analysis using a dry oven for the simultaneous analysis of a large number of drought-stressed plant samples with trace amounts of proline. The results showed that proline could be effectively detected in plants grown in soil with water content under 5%, demonstrating its potential for diagnosing drought early. The proposed multiwell plate-based multiplex assay is expected to be useful in manifold agricultural applications.

A Randomized Phase II Study of Leucovorin/5-Fluorouracil with or without Oxaliplatin (LV5FU2 vs. FOLFOX) for Curatively-Resected, Node-Positive Esophageal Squamous Cell Carcinoma.

PURPOSE: The optimal perioperative treatment for resectable esophageal squamous cell carcinoma (ESCC) remains controversial. We evaluated the efficacy and safety of leucovorin and 5-fluorouracil (LV5FU2) and LV5FU2 plus oxaliplatin (FOLFOX) combination chemotherapies administered adjuvantly for curatively-resected, node-positive ESCC. MATERIALS AND METHODS: Patients with pathologically node-positive esophageal cancer after curative R0 resection were enrolled and randomly assigned to receive LV5FU2 or FOLFOX biweekly for up to eight cycles. The primary endpoint was disease-free survival (DFS). RESULTS: Between 2011 and 2015, 62 patients were randomized into the two treatment groups (32 in the LV5FU2 arm and 30 in the FOLFOX arm). The median age was 60 years and both groups had similar pathologic characteristics in tumor, nodal status, and location. Treatment completion rates were similarly high in both groups. The DFS rate at 12 months was 67% in the LV5FU2 group and 63% in the FOLFOX group with a hazard ratio of 1.3 (95% confidence interval [CI], 0.66 to 2.62). After a median follow-up period of 27 months, the median DFS was 29.6 months (95% CI, 4.9 to 54.2) in the LV5FU2 arm and 16.8 months (95% CI, 7.5 to 26.1) in the FOLFOX arm (p=0.428), respectively, while the median overall survival was not reached in either arm. Grade 3 or 4 neutropenia was more frequent in patients in the FOLFOX arm than the LV5FU2 arm (20.0% vs. 3.1%). CONCLUSION: The addition of oxaliplatin (FOLFOX) did not lead to better efficacy compared to LV5FU2 chemotherapy in an adjuvant setting in node-positive ESCC patients.

Polymeric cantilever integrated with PDMS/graphene composite strain sensor.

This paper describes the mechanical and electrical characteristics of a polydimethylsiloxane (PDMS) cantilever integrated with a high-sensitivity strain sensor. The strain sensor is fabricated using PDMS and graphene flakes that are uniformly distributed in the PDMS. In order to prepare PDMS/graphene composite with uniform resistance, a tetrahydrofuran solution is used to decrease the viscosity of a PDMS base polymer solution. A horn-type sonicator is then used to mix the base polymer with graphene flakes. Low viscosity of the base polymer solution improves the reliability and reproducibility of the PDMS/graphene composite for strain sensor applications. After dicing the composite into the desired sensor shape, a tensile test is performed. The experimental results show that the composite with a concentration of 30 wt.% exhibits a linear response up to a strain rate of 9%. The graphene concentration of the prepared materials affects the gauge factor, which at 20% graphene concentration reaches about 50, and with increasing graphene concentration to 30% decreases to 9. Furthermore, photolithography, PDMS casting, and a stencil process are used to fabricate a PDMS cantilever with an integrated strain sensor. The change in resistance of the integrated PDMS/graphene sensor is characterized with respect to the displacement of the cantilever of within 500 µm. The experimental results confirmed that the prepared PDMS/graphene based sensor has the potential for high-sensitive biosensor applications.

Surface-patterned SU-8 cantilever arrays for preliminary screening of cardiac toxicity.

Arrays of a µgrooved SU-8 cantilever were utilized to analyze changes in the contraction force and beating frequency of cardiomyocytes in vitro. The longitudinally patterned µgrooves facilitates alignment of cardiomyocytes on top of the SU-8 cantilever, which increases the contraction force of cardiomyocytes by a factor of about 2.5. The bending displacement of the SU-8 cantilever was precisely measured in nanoscale using a laser-based measurement system combined with a motorized xyz stage. The cantilever displacement due to contraction of the cardiomyocytes showed the maximum on day 8 after their cultivation. Following preliminary experiments, Isoproterenol, Verapamil, and Astemizole were used to investigate the effect of drug toxicity on the physiology of cardiomyocytes. The experimental results indicated that 1 µM of Isoproterenol treatment increased contraction force and beating frequencies of cardiomyocytes by 30% and 200%, respectively, whereas 500 nM of Verapamil treatment decreased contraction force and beating frequencies of cardiomyocytes by 56% and 42%, respectively. A concentration of less than 5 nM of the hERG channel suppression drug Astemizole did not change the contraction forces in the displacement but slightly decreased the beating frequencies. However, irregular or abnormal heartbeats were observed at Astemizole concentrations of 5 nM and higher. We experimentally conformed that the proposed SU-8 cantilever arrays combined with the laser-based measurement systems has the great potential for a high-throughput drug toxicity screening system in future.

GalNAc-T14 promotes metastasis through Wnt dependent HOXB9 expression in lung adenocarcinoma.

While metastasis, the main cause of lung cancer-related death, has been extensively studied, the underlying molecular mechanism remains unclear. A previous clinicogenomic study revealed that expression of N-acetylgalactosaminyltransferase (GalNAc-T14), is highly inversely correlated with recurrence-free survival in those with non-small cell lung cancer (NSCLC). However, the underlying molecular mechanism(s) has not been determined. Here, we showed that GalNAc-T14 expression was positively associated with the invasive phenotype. Microarray and biochemical analyses revealed that HOXB9, the expression of which was increased in a GalNAc-T14-dependent manner, played an important role in metastasis. GalNAc-T14 increased the sensitivity of the WNT response and increased the stability of the ß-catenin protein, leading to induced expression of HOXB9 and acquisition of an invasive phenotype. Pharmacological inhibition of ß-catenin in GalNAc-T14-expressing cancer cells suppressed HOXB9 expression and invasion. A meta-analysis of clinical genomics data revealed that expression of GalNAc-T14 or HOXB9 was strongly correlated with reduced recurrence-free survival and increased hazard risk, suggesting that targeting ß-catenin within the GalNAc-T14/WNT/HOXB9 axis may be a novel therapeutic approach to inhibit metastasis in NSCLC.

A self-adjustable four-point probing system using polymeric three dimensional coils and non-toxic liquid metal.

This paper describes a self-adjustable four-point probe (S4PP) system with a square configuration. The S4PP system consists of 3D polymer coil springs for the independent operation of each tungsten (W) probe, microfluidic channels filled with a nontoxic liquid metal, and a LabView-based control system. The 3D coil springs made by PMMA are fabricated with a 3D printer and are positioned in a small container filled with the non-toxic liquid metal. This unique configuration allows independent self-adjustment of the probe heights for precise measurements of the electrical properties of both flexible and large-step-height microsamples. The feasibility of the fabricated S4PP system is evaluated by measuring the specific resistance of Cr and Au thin films deposited on silicon wafers. The system is then employed to evaluate the electrical properties of a Au thin film deposited onto a flexible and easily breakable silicon diaphragm (spring constant: ∼3.6 × 10(-5) N/m). The resistance of the Cr thin films (thickness: 450 nm) with step heights of 60 and 90 µm is also successfully characterized. These experimental results indicate that the proposed S4PP system can be applied to common metals and semiconductors as well as flexible and large-step-height samples.

Self-assembly of fluorescent and magnetic Fe3O4@coordination polymer nanochains.

Fluorescent and magnetic Fe3O4@coordination polymer (Fe3O4@CP) nanochains are synthesized via a simple one-pot solvothermal reaction of magnetite (Fe3O4) and coordination polymer precursors in the presence of an external magnetic field. The shell thickness within Fe3O4@CPs was easily regulated by varying the amounts of coordination polymer precursors used during the reaction.

Selective nano-patterning of graphene using a heated atomic force microscope tip.

In this study, we introduce a selective thermochemical nano-patterning method of graphene on insulating substrates. A tiny heater formed at the end of an atomic force microscope (AFM) cantilever is optimized by a finite element method. The cantilever device is fabricated using conventional micromachining processes. After preliminary tests of the cantilever device, nano-patterning experiments are conducted with various conducting and insulating samples. The results indicate that faster scanning speed and higher contact force are desirable to reduce the sizes of nano-patterns. With the experimental condition of 1 µm/s and 24 mW, the heated AFM tip generates a graphene oxide layer of 3.6 nm height and 363 nm width, on a 300 nm thick SiO2 layer, with a tip contact force of 100 nN.