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Aerodynamic breakup of vaporizing drops is commonly seen in many spray applications. While it is well known that vaporization can modulate interfacial instabilities, the impact of vaporization on drop aerobreakup is poorly understood. Detailed interface-resolved simulations were performed to systematically study the effect of vaporization, characterized by the Stefan number, on the drop breakup and acceleration for different Weber numbers and density ratios. It is observed that the resulting asymmetric vaporization rates and strengths of Stefan flow on the windward and leeward sides of the drop hinder bag development and prevent drop breakup. The critical Weber number thus generally increases with the Stefan number. The modulation of the boundary layer also contributes to a significant increase of drag coefficient. Numerical experiments were performed to affirm that the drop volume reduction plays a negligible role and the Stefan flow is the dominant reason for the breakup suppression and drag enhancement observed.
Goosegrass [Eleusine indica (L.) Gaertn.] is one of the most problematic weeds in plasticulture strawberry [Fragaria × ananassa (Weston) Duchesne ex Rozier (pro sp.) [chiloenis × virginiana]] production systems in Florida. A 2-yr trial was implemented to evaluate the effects of different E. indica densities on strawberry growth and yield. Eleusine indica densities evaluated were 0, 0.4, 0.8, 1.9, 2.7, and 3.8 plants m−2 equally distributed on the plastic-mulched bed top within the strawberry transplant holes. Eleusine indica density did not affect E. indica height or biomass. However, E. indica seed production was positively correlated with E. indica density in Season 1 and negatively correlated with E. indica density in Season 2. A negative linear regression was observed between E. indica density and strawberry yield in both seasons. For each increase in E. indica plants per square meter, strawberry yield was reduced by 316 and 2,356 kg ha−1 for Seasons 1 and 2, respectively. Our results highlight the importance of achieving adequate E. indica management to minimize yield losses.
The nature of the siloxane surface in smectites was investigated by measuring the adsorption of aromatic hydrocarbons from water by organo-clays. The organo-clays were prepared by replacing the hydrophilic, inorganic exchange cations of a series of smectites with the small, hydrophobic organic cation, trimethylphenylammonium (TMPA). Smectites with a range in charge densities were used that resulted in different TMPA contents in the organo-clays. Adsorption isotherms of benzene, alkylbenzenes, and naphthalene from water by the TMPA-smectites indicated that sorption was inversely related to TMPA content. The Langmuir form of the isotherms suggests that the aromatic compounds adsorb to the clay surface. Possible adsorptive sites in TMPA-smectites are limited to the TMPA cations and the siloxane oxygen surfaces. Because sorption increased as layer charge and TMPA content decreased, the organic compounds must adsorb to the siloxane surfaces.
Calculations based on an adsorbed compound monolayer, which was estimated by fitting adsorption data to the Langmuir equation, and the N2 specific surface area of each TMPA-clay, indicate that the surface area occupied by each adsorbed molecule increases as the planar area of the molecule increases. This strongly indicates that the planar surfaces of the compounds adsorb directly to the clay surface. Apparently, the TMPA cations function to keep the smectite interlayers open. Interactions between the phenyl groups of TMPA cations on opposing interlayer clay surfaces may act to increase the size of the adsorptive regions. These results show that the siloxane surfaces of smectites can effectively adsorb aromatic hydrocarbons from water if the hydrophilic, inorganic exchange cations are replaced with small, hydrophobic organic cations. The strong adsorption of hydrophobic organic molecules from water demonstrates the hydrophobicity of the siloxane surfaces in smectites.
Targeted spraying application technologies have the capacity to drastically reduce herbicide inputs, but to be successful, the performance of both machine vision–based weed detection and actuator efficiency needs to be optimized. This study assessed (1) the performance of spotted spurge recognition in ‘Latitude 36’ bermudagrass turf canopy using the You Only Look Once (YOLOv3) real-time multiobject detection algorithm and (2) the impact of various nozzle densities on model efficiency and projected herbicide reduction under simulated conditions. The YOLOv3 model was trained and validated with a data set of 1,191 images. The simulation design consisted of four grid matrix regimes (3 × 3, 6 × 6, 12 × 12, and 24 × 24), which would then correspond to 3, 6, 12, and 24 nonoverlapping nozzles, respectively, covering a 50-cm-wide band. Simulated efficiency testing was conducted using 50 images containing predictions (labels) generated with the trained YOLO model and by applying each of the grid matrixes to individual images. The model resulted in prediction accuracy of an F1 score of 0.62, precision of 0.65, and a recall value of 0.60. Increased nozzle density (from 3 to 12) improved actuator precision and predicted herbicide-use efficiency with a reduction in the false hits ratio from ∼30% to 5%. The area required to ensure herbicide deposition to all spotted spurge detected within images was reduced to 18%, resulting in ∼80% herbicide savings compared to broadcast application. Slightly greater precision was predicted with 24 nozzles but was not statistically different from the 12-nozzle scenario. Using this turf/weed model as a basis, optimal actuator efficacy and herbicide savings would occur by increasing nozzle density from 1 to 12 nozzles within the context of a single band.
The U.S. Department of Agriculture–Agricultural Research Service (USDA-ARS) has been a leader in weed science research covering topics ranging from the development and use of integrated weed management (IWM) tactics to basic mechanistic studies, including biotic resistance of desirable plant communities and herbicide resistance. ARS weed scientists have worked in agricultural and natural ecosystems, including agronomic and horticultural crops, pastures, forests, wild lands, aquatic habitats, wetlands, and riparian areas. Through strong partnerships with academia, state agencies, private industry, and numerous federal programs, ARS weed scientists have made contributions to discoveries in the newest fields of robotics and genetics, as well as the traditional and fundamental subjects of weed–crop competition and physiology and integration of weed control tactics and practices. Weed science at ARS is often overshadowed by other research topics; thus, few are aware of the long history of ARS weed science and its important contributions. This review is the result of a symposium held at the Weed Science Society of America’s 62nd Annual Meeting in 2022 that included 10 separate presentations in a virtual Weed Science Webinar Series. The overarching themes of management tactics (IWM, biological control, and automation), basic mechanisms (competition, invasive plant genetics, and herbicide resistance), and ecosystem impacts (invasive plant spread, climate change, conservation, and restoration) represent core ARS weed science research that is dynamic and efficacious and has been a significant component of the agency’s national and international efforts. This review highlights current studies and future directions that exemplify the science and collaborative relationships both within and outside ARS. Given the constraints of weeds and invasive plants on all aspects of food, feed, and fiber systems, there is an acknowledged need to face new challenges, including agriculture and natural resources sustainability, economic resilience and reliability, and societal health and well-being.
Postemergence herbicides used to control weeds in the space between raised, plastic-covered beds in plasticulture production systems are typically banded, and herbicides are applied to weeds and to where weeds do not occur. To reduce the incidence of off-targeted applications, the University of Florida developed a smart-spray technology for row middles in plasticulture systems. The technology detects weed according to categories and applies herbicides only where the weeds occur. Field experiments were conducted at the Gulf Coast Research and Education Center in Balm, FL, in fall 2021 and spring 2022. The objective was to evaluate the efficacy of postemergence applications of diquat and glyphosate in row middles in jalapeno pepper fields when banded or applied with smart-spray technology. The overall precision of the weed detection model was 0.92 and 0.89 for fall and spring, respectively. The actuation precision achieved was 0.86 and 1 for fall and spring, respectively. No significant differences were observed between banded and targeted applications either with glyphosate or diquat in terms of broadleaf, grass, and nutsedge weed density. No significant pepper damage was observed with either herbicide or application technique. The smart-spray technology reduced herbicide application volume by 26% and 42% in fall and spring, respectively, with no reduction in weed control or pepper yield compared to a banded application. Overall, the smart-spray technology reduced the herbicide volume applied with no reductions in weed control and no significant effects on crop yield.
To compare the prognostic value of mid-upper arm circumference (MUAC), weight-for-height Z-score (WHZ) and weight-for-age Z-score (WAZ) for predicting death over periods of 1, 3 and 6 months follow-up in children.
Design:
Pooled analysis of twelve prospective studies examining survival after anthropometric assessment. Sensitivity and false-positive ratios to predict death within 1, 3 and 6 months were compared for three individual anthropometric indices and their combinations.
Setting:
Community-based, prospective studies from twelve countries in Africa and Asia.
Participants:
Children aged 6–59 months living in the study areas.
Results:
For all anthropometric indices, the receiver operating characteristic curves were higher for shorter than for longer durations of follow-up. Sensitivity was higher for death with 1-month follow-up compared with 6 months by 49 % (95 % CI (30, 69)) for MUAC < 115 mm (P < 0·001), 48 % (95 % CI (9·4, 87)) for WHZ < -3 (P < 0·01) and 28 % (95 % CI (7·6, 42)) for WAZ < -3 (P < 0·005). This was accompanied by an increase in false positives of only 3 % or less. For all durations of follow-up, WAZ < -3 identified more children who died and were not identified by WHZ < -3 or by MUAC < 115 mm, 120 mm or 125 mm, but the use of WAZ < -3 led to an increased false-positive ratio up to 16·4 % (95 % CI (12·0, 20·9)) compared with 3·5 % (95 % CI (0·4, 6·5)) for MUAC < 115 mm alone.
Conclusions:
Frequent anthropometric measurements significantly improve the identification of malnourished children with a high risk of death without markedly increasing false positives. Combining two indices increases sensitivity but also increases false positives among children meeting case definitions.
Undesirable behaviours (UBs) are common in dogs and can jeopardise animal and human health, leading to dog abandonment and euthanasia. Dogs exhibiting UBs may have compromised welfare from underlying emotional motivations for the behaviour (eg anxiety) or from the methods used by owners to resolve the problem (eg aversive techniques). The objective of this study was to estimate proportional mortality due to UBs and risk factors for death due to UBs, including death from road traffic accidents, in dogs under three years of age attending primary-care veterinary practices in England from 2009-2014. Cases were identified by searching de-identified electronic patient records from primary-care veterinary practices participating in the VetCompass Programme. The findings highlight that dogs under three years of age are at a proportionately high risk of death due to UBs (33.7%) compared with other specific causes of death (eg gastrointestinal issues: 14.5%). Male dogs had 1.40x the odds of death from UB compared with females. The proportional mortality from UB for male dogs where information on the cause of death was available was 0.41. Neutered dogs had 1.94x the odds of death due to a UB compared with entire dogs. Aggression was the most prevalent UB overall. Veterinarians had recommended referral in 10.3% of cases where dogs died due to exhibiting a UB and had dispensed nutraceutical, pheromone or pharmacological treatment to 3.0% of the UB cases that died. This study shows that undesirable behaviours require better preventive measures and treatment, through further research and education of veterinarians, other professionals within the dog industry and owners.
Preemergence (PRE) herbicides are often banded over the entire top of raised beds for broadleaf and grass control in plasticulture vegetable production systems. However, broadleaf and grass weeds may emerge from the planting holes and tears in the plastic mulch. Banded application results in herbicides applied where no holes occur, and therefore, where they are not needed. Our objective is to identify herbicides that do not harm transplanted crops when directed at transplant holes after transplant (POST) with the aim to reduce off-target applications. Therefore, we evaluated tomato and pepper tolerance to PRE herbicides applied to transplant holes 2 wk after transplant and the subsequent effects on crop tolerance and weed density. Halosulfuron, S-metolachlor, metribuzin, and pendimethalin did not injure tomato transplants, reduce height, or reduce yield. Fomesafen caused some tomato injury (7%) but had no effect on other measured parameters in Trial I. All PRE herbicides injured peppers by ≥19%, although no effect on yield was observed. Overall, halosulfuron, S-metolachlor, metribuzin, and pendimethalin can be safely applied to tomato transplant holes 2 wk after transplant with no significant crop injury nor effects on final yield, but none of the evaluated herbicides are safe for use on pepper crops.
We summarize what we assess as the past year's most important findings within climate change research: limits to adaptation, vulnerability hotspots, new threats coming from the climate–health nexus, climate (im)mobility and security, sustainable practices for land use and finance, losses and damages, inclusive societal climate decisions and ways to overcome structural barriers to accelerate mitigation and limit global warming to below 2°C.
Technical summary
We synthesize 10 topics within climate research where there have been significant advances or emerging scientific consensus since January 2021. The selection of these insights was based on input from an international open call with broad disciplinary scope. Findings concern: (1) new aspects of soft and hard limits to adaptation; (2) the emergence of regional vulnerability hotspots from climate impacts and human vulnerability; (3) new threats on the climate–health horizon – some involving plants and animals; (4) climate (im)mobility and the need for anticipatory action; (5) security and climate; (6) sustainable land management as a prerequisite to land-based solutions; (7) sustainable finance practices in the private sector and the need for political guidance; (8) the urgent planetary imperative for addressing losses and damages; (9) inclusive societal choices for climate-resilient development and (10) how to overcome barriers to accelerate mitigation and limit global warming to below 2°C.
Social media summary
Science has evidence on barriers to mitigation and how to overcome them to avoid limits to adaptation across multiple fields.
The past 50 yr of advances in weed recognition technologies have poised site-specific weed control (SSWC) on the cusp of requisite performance for large-scale production systems. The technology offers improved management of diverse weed morphology over highly variable background environments. SSWC enables the use of nonselective weed control options, such as lasers and electrical weeding, as feasible in-crop selective alternatives to herbicides by targeting individual weeds. This review looks at the progress made over this half-century of research and its implications for future weed recognition and control efforts; summarizing advances in computer vision techniques and the most recent deep convolutional neural network (CNN) approaches to weed recognition. The first use of CNNs for plant identification in 2015 began an era of rapid improvement in algorithm performance on larger and more diverse datasets. These performance gains and subsequent research have shown that the variability of large-scale cropping systems is best managed by deep learning for in-crop weed recognition. The benefits of deep learning and improved accessibility to open-source software and hardware tools has been evident in the adoption of these tools by weed researchers and the increased popularity of CNN-based weed recognition research. The field of machine learning holds substantial promise for weed control, especially the implementation of truly integrated weed management strategies. Whereas previous approaches sought to reduce environmental variability or manage it with advanced algorithms, research in deep learning architectures suggests that large-scale, multi-modal approaches are the future for weed recognition.
Herbicide resistance has been studied extensively in agronomic crops across North America but is rarely examined in vegetables. It is widely assumed that the limited number of registered herbicides combined with the adoption of diverse weed management strategies in most vegetable crops effectively inhibits the development of resistance. It is difficult to determine whether resistance is truly less common in vegetable crops or whether the lack of reported cases is due to the lack of resources focused on detection. This review highlights incidences of resistance that are thought to have arisen within vegetable crops. It also includes situations in which herbicide-resistant weeds were likely selected for within agronomic crops but became a problem when vegetables were grown in sequence or in adjacent fields. Occurrence of herbicide resistance can have severe consequences for vegetable growers, and resistance management plans should be adopted to limit selection pressure. This review also highlights resistance management techniques that should slow the development and spread of herbicide resistance in vegetable crops.
Background: Infantile spasms (IS) is an epileptic encephalopathy, characterized by spasms, hypsarrhythmia, and developmental regression. This is a retrospective case series of children with IS who underwent epilepsy surgery at The Hospital for Sick Children (HSC) in Toronto, Canada. Methods: The records of 223 patients seen in the IS clinic were reviewed. Results: Nineteen patients met inclusion criteria. The etiology of IS was encephalomalacia in six patients (32%), malformations of cortical development in 11 patients (58%), atypical hypoglycaemic injury in one patient (5%), and partial hemimegalencephaly in one patient (5%). Nine patients (47%) underwent hemispherectomy and 10 patients (53%) underwent lobectomy/lesionectomy. Three patients (16%) underwent a second epilepsy surgery. Fifteen patients (79%) were considered ILAE Seizure Outcome Class 1 (completely seizure free; no auras). The percentage of patients who were ILAE Class 1 at most recent follow-up decreased with increasing duration of epilepsy prior to surgery. Developmental outcome was improved in 14/19 (74%) and stable in 5/19 (26%) patients. Conclusions: Our study found excellent seizure freedom rates and improved developmental outcomes following epilepsy surgery in patients with a history of IS with a structural lesion detected on MRI brain.
A survey of weed flora and basic weed management practices was conducted in commercial strawberry [Fragaria × ananassa (Weston) Duchesne ex Rozier ssp. ananassa] fields in central Florida during the 2019 to 2020 field season. Forty-one fields on 14 farms were surveyed, which represents a total of 907 ha or 23% of the acreage planted to strawberries in Florida. All conventional fields were fumigated, and combinations of chloropicrin and 1,3-dichloropropene were used on 72% of the fumigated acreage. Preemergence or postemergence herbicides were used in row middles on 100% of the conventional acreage, but preemergence herbicides applied under the plastic mulch were only used on 12% of the acreage. A total of 47 weed species were identified during the survey. The five weed species with the highest frequency were goosegrass [Eleusine indica (L.) Gaertn.], cutleaf evening primrose (Oenothera laciniata Hill), Carolina geranium (Geranium carolinianum L.), common ragweed (Ambrosia artemisiifolia L.), and eclipta [Eclipta prostrata (L.) L.] which occurred in 83%, 63%, 58%, 58%, and 46% of all fields surveyed, respectively. The five species with the highest overall relative abundance were E. indica, O. lanciniata, G. carolinium, A. artemisiifolia, and Brazil pusley (Richardia brasiliensis Gomes). The frequency and distribution of E. indica is of particular concern, because populations in strawberry fields are thought to be resistant to paraquat, which is the primary herbicide used for crop termination. Weed density tended to be low overall, which suggests the integrated weed management (IWM) programs adopted by most growers are effective. Mean weed density tended to be similar on conventional and organic fields and unaffected by fumigant applied the year of the survey or the number of years strawberries had been grown consecutively in a field. Weed management research moving forward should focus on the development of IWM programs for E. indica, O. lanciniata, G. carolinium, and A. artemisiifolia.
Healthcare facilities are a well-known high-risk environment for transmission of M. tuberculosis, the etiologic agent of tuberculosis (TB) disease. However, the link between M. tuberculosis transmission in healthcare facilities and its role in the general TB epidemic is unknown. We estimated the proportion of overall TB transmission in the general population attributable to healthcare facilities.
Methods:
We combined data from a prospective, population-based molecular epidemiologic study with a universal electronic medical record (EMR) covering all healthcare facilities in Botswana to identify biologically plausible transmission events occurring at the healthcare facility. Patients with M. tuberculosis isolates of the same genotype visiting the same facility concurrently were considered an overlapping event. We then used TB diagnosis and treatment data to categorize overlapping events into biologically plausible definitions. We calculated the proportion of overall TB cases in the cohort that could be attributable to healthcare facilities.
Results:
In total, 1,881 participants had TB genotypic and EMR data suitable for analysis, resulting in 46,853 clinical encounters at 338 healthcare facilities. We identified 326 unique overlapping events involving 370 individual patients; 91 (5%) had biologic plausibility for transmission occurring at a healthcare facility. A sensitivity analysis estimated that 3%–8% of transmission may be attributable to healthcare facilities.
Conclusions:
Although effective interventions are critical in reducing individual risk for healthcare workers and patients at healthcare facilities, our findings suggest that development of targeted interventions aimed at community transmission may have a larger impact in reducing TB.
To improve maternal health outcomes, increased diversity is needed among pregnant people in research studies and community surveillance. To expand the pool, we sought to develop a network encompassing academic and community obstetrics clinics. Typical challenges in developing a network include site identification, contracting, onboarding sites, staff engagement, participant recruitment, funding, and institutional review board approvals. While not insurmountable, these challenges became magnified as we built a research network during a global pandemic. Our objective is to describe the framework utilized to resolve pandemic-related issues.
Methods:
We developed a framework for site-specific adaptation of the generalized study protocol. Twice monthly video meetings were held between the lead academic sites to identify local challenges and to generate ideas for solutions. We identified site and participant recruitment challenges and then implemented solutions tailored to the local workflow. These solutions included the use of an electronic consent and videoconferences with local clinic leadership and staff. The processes for network development and maintenance changed to address issues related to the COVID-19 pandemic. However, aspects of the sample processing/storage and data collection elements were held constant between sites.
Results:
Adapting our consenting approach enabled maintaining study enrollment during the pandemic. The pandemic amplified issues related to contracting, onboarding, and IRB approval. Maintaining continuity in sample management and clinical data collection allowed for pooling of information between sites.
Conclusions:
Adaptability is key to maintaining network sites. Rapidly changing guidelines for beginning and continuing research during the pandemic required frequent intra- and inter-institutional communication to navigate.
Background: Mean arterial pressure augmentation is one current established practice for management of patients with SCI. We present the first data investigating the effectiveness of Intrathecal Pressure (ITP) reduction through CSF drainage (CSFD) in managing patients with acute traumatic SCI at a large academic center. Methods: Data from 6 patients with acute traumatic SCI were included. A lumbar intrathecal catheter was used to monitor ITP and volume of CSFD. CSFD was performed and recorded hourly. ITP recordings were collected hourly and the change in ITP was calculated (hour after minus before CSFD). 369 data points were collected and change in ITP was plotted against volume of CSFD. Results: Data across all patients showed variability in the ITP over time without a significant trend (slope=0.016). We found no significant change in ITP with varying amounts of CSFD (slope=0.007, r2=0.00, p=0.88). Changes in ITP were not significantly different across groups of CSFD but the variation in the data decreased with increasing levels of CSFD. Conclusions: We present the first known data on changes in ITP with varying degrees of CSFD in patients with acute traumatic SCI. These results may provide insight into the complexity of ITP changes in patients post-injury and help inform future SCI management.
Background: Length of stay (LOS) is a surrogate for care complexity and a determinant of occupancy and service provision. Our primary goal was to assess changes in and determinants of LOS at a quaternary spinal care center. Secondary goals included identifying opportunities for improvement and determinants of future service planning. Methods: This is a prospective study of patients admitted from 2006 to 2019. Data included demographics, diagnostic category (degenerative, oncology, deformity, trauma, other), LOS (mean, median, interquartile range, standard deviation) and in-hospital adverse events (AEs). Results: 13,493 admissions were included. Mean age has increased from 48.4 (2006) to 58.1 years (2019) (p=<0.001). Mean age increased overtime for patients treated for deformity (p=<0.001), degenerative pathology (p=<0.001) and trauma (p=<0.001), but not oncology (p=0.702). Overall LOS has not changed over time (p=0.451). LOS increased in patients with degenerative pathology (p=0.019) but not deformity (p=0.411), oncology (p=0.051) or trauma (p=0.582). Emergency admissions increased overtime for degenerative pathologies (p=<0.001). AEs and SSIs have decreased temporally (p=<0.001). Conclusions: This is the first North American study to analyze temporal trends in LOS for spine surgery in an academic center. Understanding temporal trends in LOS and patient epidemiology can provide opportunities for intervention, targeted at the geriatric populations, to reduce LOS.
Background: Prolonged length of stay (LOS) is associated with increased resource utilization and worse outcomes. The goal of this study is identifying patient, surgical and systemic factors associated with prolonged LOS overall and per diagnostic category for adults admitted to a quaternary spinal care center. Methods: We performed a retrospective analysis on 13,493 admissions from 2006 to 2019. Factors analyzed included patient age, sex, emergency vs elective admission, diagnostic category (degenerative, deformity, oncology, trauma), presence of neurological deficits in trauma patients, ASIA score, operative management and duration, blood loss, and adverse events (AEs). Univariate and multivariate analyses determined factors associated with prolonged LOS. Results: Overall mean LOS (±SD) was 15.80 (±34.03) days. Through multivariate analyses, predictors of prolonged LOS were advanced age (p<0.001), emergency admission (p<0.001), advanced ASIA score (p<0.001), operative management (p=0.043), and presence of AEs (p<0.001), including SSI (p=0.001), other infections (systemic and UTI) (p<0.001), delirium (p=0.006), and pneumonia (p<0.001). The effects of age, emergency admission, and AEs on LOS differed by diagnostic category. Conclusions: Understanding patient and disease factors that affect LOS provides opportunities for QI intervention and allows for an informed preoperative discussion with patients. Future interventions can be targeted to maximize patient outcomes, optimize care quality, and decrease costs.
Background: Infantile spasms (IS) is an epileptic encephalopathy, characterized by epileptic spasms, hypsarrhythmia, and developmental regression. This is a retrospective case series detailing the experience in children with IS who have undergone epilepsy surgery at The Hospital for Sick Children (HSC). Methods: Records of 223 patients from HSC were reviewed. Patients were included if they had a current or previous history of IS with a lesion detected on MRI/PET scan who underwent epilepsy surgery. Results: Nineteen patients were included. The etiology of IS was encephalomalacia in six patients (32%), malformations of cortical development in 11 patients (58%), atypical hypoglycaemic injury in one patient (0.5%), and partial hemimegalencephaly in one patient (0.5%). The median age at the onset of IS was five months. The median age at surgery was 18 months. Nine patients (47%) underwent hemispherectomy and 10 patients (53%) underwent lobectomy/lesionectomy. Fifteen patients (79%) were considered ILAE Seizure Outcome Class 1. Developmental outcome was improved in 14/19 (74%) and stable in 5/19 (26%) patients. Conclusions: Even with a generalized EEG pattern such as hypsarrhythmia, patients should be considered for focal resective surgery. Early surgical intervention shortens the duration of active epilepsy thus limiting the potentially irreversible effects of on-going seizures.