SUMMARY OBJECTIVE: Several prospective randomized trials have shown that hypofractionation has the same efficacy and safety as the conventional fractionation in the treatment of localized prostate cancer. There are many benefits of hypofractionation, including a more convenient schedule for the patients and better use of resources, which is especially important in low- and middle-income countries like Brasil. Based on these data, the Brazilian Society of Radiotherapy (Sociedade Brasileira de Radioterapia) organized this consensus to guide and support the use of hypofractionated radiotherapy for localized prostate cancer in Brasil. METHODS: The relevant literature regarding moderate hypofractionation (mHypo) and ultra-hypofractionation (uHypo) was reviewed and discussed by a group of experts from public and private centers of different parts of Brasil. Several key questions concerning clinical indications, outcomes and technological requirements for hypofractionation were discussed and voted. For each question, consensus was reached if there was an agreement of at least 75% of the panel members. RESULTS: The recommendations are described in this article. CONCLUSION: This initiative will assist Brazilian radiation oncologists and medical physicists to safely treat localized prostate cancer patients with hypofractionation.

ABSTRACT: Sorghum breeding programs are based predominantly on developing homozygous lines to produce single cross hybrids, frequently with relatively narrow genetic bases. The adoption of complementary strategies, such as genetic diversity study, enables a broader vision of the genetic structure of the breeding germplasm. The purpose of this study was to evaluate the genetic diversity of sorghum breeding lines using structure analysis, principal components (PC) and clustering analyses. A total of 160 sorghum lines were genotyped with 29,649 SNP markers generated by genotyping-by-sequencing (GBS). The PC and clustering analyses consistently divided the R (restorer) and B (maintainer) lines based on their pedigree, generating four groups. Thirty-two B and 21 R lines were used to generate 121 single-cross hybrids, whose performances were compared based on the diversity clustering of each parental line. The genetic divergence of B and R lines indicated a potential for increasing heterotic response in the development of hybrids. The genetic distance was correlated to heterosis, allowing for the use of markers to create heterotic groups in sorghum.

ABSTRACT The purpose of this study was to assess the effect of different herbicide treatments on moisture removal and calorific power of biomass sorghum for co-generation of electric energy through burning. The experiment was conducted in randomized complete block design with four replicates per treatment and a 6x4 factorial scheme (six herbicide treatments x four intervals between spraying and harvesting). The herbicide treatments were: two different doses of glyphosate (1.92 kg a.i. ha-1 and 3.84 Kg a.i. ha-1), paraquat (0.4 Kg a.i. ha-1), a commercial mixture of paraquat + diuron (0.6 + 0.3 Kg a.i. ha-1), glufosinate-ammonium (0.8 Kg a.i. ha-1) and control (unsprayed). The intervals between spraying and harvesting assessed were 7, 14, 21 and 28 days after desiccation (DAD). It was assessed: the number of leaves per plant, moisture content of leaves, panicles, culm and whole ground plants and Superior Calorific Power (SCP). The herbicides paraquat and paraquat + diuron promotes defoliation, after 14 DAD. Glyphosate, paraquat, paraquat + diuron and glufosinate-ammonium reduce leaf and panicle moisture, despite only glyphosate reduces moisture in the culm. The herbicides do not affect the SCP of biomass sorghum. Therefore, the herbicides, especially glyphosate, have high potential for pre-harvest desiccation in biomass sorghum.

ABSTRACT. Macauba fruits are oil-rich drupes with high moisture content at harvest. This feature can affect the chemical properties of the oil and increase the costs of biodiesel production. Therefore, it is necessary to adopt postharvest strategies to ensure oil quality. The aim of this work was to evaluate the effect of drying macauba fruit on the quality of the pulp oil. Husked and dehusked fruits were dried at 60°C and then stored. At 0, 15, 45, 100, and 180 days after storage, fruit samples were retrieved, and the oil from the pulp was evaluated for physicochemical parameters. The removal of the husk from the fruits considerably reduced the drying time compared to that of the husked fruits. Drying prevented deterioration of the fruit even after 180 days of storage, regardless of the presence of the husk. The drying process allowed for efficient storage of the macauba fruit while maintaining low levels of oil acidity. Furthermore, the oxidative stability of the pulp oil from the dehusked dried fruits lasted longer than that from the husked dried fruits. Therefore, drying is a viable alternative for the postharvest of macauba fruits to maintain the quality of the oil for biodiesel production.

RESUMO A demanda e produção mundial de energia primária deverá crescer à taxa de 1,4 % ao ano, até 2035. No mesmo período, a produção de energias renováveis deverá crescer à taxa de 6,6 % ao ano, passando de 3 % para 9 % de energia primária mundial. Logo, a oferta de biocombustíveis assume papel estratégico para a segurança energética mundial. Neste contexto, o sorgo é uma alternativa promissora no setor bioenergético, devido às suas características agronômicas e adaptabilidade às condições edafoclimáticas limitantes. Objetivou-se avaliar o potencial produtivo de três grupos agronômicos de sorgo (biomassa, sacarino e forrageiro), bem como caracterizar quimicamente a biomassa desses materiais. Para isso, conduziu-se um experimento utilizando-se delineamento em blocos casualizados, no qual foram realizadas avaliações agronômicas, químicas (celulose, hemicelulose, lignina e cinzas) e teores de umidade. As cultivares de sorgo biomassa apresentaram alta produtividade (cerca de 30 t ha-1 de colmo seco), sendo, por isso, mais indicadas para a geração de biocombustíveis sólidos, isto é, queima direta. Já as cultivares de sorgo forrageiro apresentaram menor teor de lignina nos colmos, em relação às demais cultivares, sendo indicadas para a geração de biocombustíveis líquidos. Destaca-se, ainda, a possibilidade de produção de bioetanol de segunda geração a partir do bagaço de sorgo sacarino. Logo, o sorgo apresenta diferentes potenciais de uso que podem ser explorados pelo setor de bioenergia de acordo com o grupo agronômico e a parte física da planta.

ABSTRACT The global demand and production of primary energy is expected to grow at a rate of 1.4 % per year by 2035. In the same period, the production of renewable energy is expected to grow at a rate of 6.6 % per year, rising from 3 % to 9 % of world primary energy. Therefore, the biofuels supply assumes a strategic role for world energy security. In this context, sorghum is a promising alternative in the bioenergetic sector, due to its agronomic characteristics and adaptability to limiting edaphoclimatic conditions. This study aimed at evaluating the productive potential of three sorghum agronomic groups (biomass, saccharin and forage), as well as chemically characterizing the biomass of these materials. For that, a field experiment was carried out using a randomized block design, where agronomic and chemical characteristics (cellulose, hemicellulose, lignin and ash), as well as moisture contents, were evaluated. The biomass sorghum cultivars presented a high yield (about 30 t ha-1 of dry stalk), being, for this reason, more suitable for the generation of solid biofuels, i.e., direct burning. On the other hand, the forage sorghum cultivars presented a lower lignin content in the stalks, in relation to the other cultivars, being indicated for the generation of liquid biofuels. It is also worth mentioning the possibility of producing second-generation bioethanol from saccharin sorghum bagasse. Therefore, sorghum presents different use potentials that may be exploited by the bioenergy sector according to the agronomic group and plant physical part.

Abstract This study aimed to evaluate the relationship between fruit traits and their direct and indirect effects on the content of ascorbic acid and carotenoids in peaches and nectarines. The traits fruit mass (FM); equatorial diameter (ED); suture diameter (SD); polar diameter (PD); pulp firmness (FIR); soluble solids (SS); titratable acidity (TA); SS/TA ratio; contents of ascorbic acid (AA) and carotenoids (CT); and skin and pulp color were evaluated in 28 peach cultivars, and two nectarine cultivars. The phenotypic correlation coefficients were estimated (rf), and after multicollinearity diagnosis, unfolding was carried out in direct and indirect effects of the explanatory variables in the response variable by using path analysis. The strongest correlations were found between FM, SD, ED, and PD, and between carotenoid content and °h pulp. The traits considered in the path diagrams are not the main determinants of the ascorbic acid content. The yellow color of the pulp has the potential for indirect selection for carotenoid content.

RESUMO A macaúba [Acrocomia aculeata (Jacq.) Lood. ex Mart] vem sendo domesticada para subsidiar programas de produção de biodiesel no Brasil. Contudo, pouco se sabe sobre a produção de mudas desta espécie. Objetivou-se avaliar misturas de substratos, doses de calcário e de fósforo na correção do substrato e a frequência de adubação de cobertura em mudas de macaúba. Foram instalados três ensaios conduzidos em casa de vegetação, até o sexto mês de cultivo na fase de viveiro. Ensaio 1: avaliação de percentuais das frações orgânica e mineral totalizando sete misturas de substratos. Ensaio 2: avaliação de quatro doses de correção do solo com calcário versus quatro doses de fosfatagem. Ensaio 3: avaliação da frequência de fertilização com N, K e Mg em cobertura. Nos três ensaios foram observadas diferenças significativas para maioria das variáveis analisadas (altura de plantas, número de folhas, massa seca da parte aérea, massa seca da raiz, vigor e diâmetro do bulbo). Como resultados principais têm-se: Ensaio 1 - o melhor desenvolvimento das mudas é observado em substratos com pelo menos 25% de material orgânico. Ensaio 2 - doses variando de 0,50 a 1,25 kg de calcário associada à fosfatagem com 3,00 a 4,00 kg de superfosfato simples por m3 de substrato proporciona melhor desenvolvimento das mudas. Ensaio 3 - a adubação de cobertura proporciona melhor desenvolvimento das mudas independentemente da frequência.

ABSTRACT The macaw palm [Acrocomia aculeata (Jacq.) Lood. ex Mart] has been domesticated to subsidize biodiesel production programs in Brazil. However, little is known about the seedling production of this species. This study aimed to evaluate substrate mixtures, limestone and phosphorus rates for substrate amendment and topdressing frequency in macaw palm seedlings. Three trials were conducted in a greenhouse up to six months of nursery cultivation. Trial 1: determination of percent mineral and organic fractions of seven substrate mixtures. Trial 2: evaluation of four limerates for soil amendment versus four phosphorus rates. Trial 3: evaluation of N, K and Mg topdressing frequency. Significant differences were found in the three trials for most of the variables (plant height, leaf number, shoot dry mass, root dry mass, vigor and bulb diameter). The main results obtained were as follow: Trial1 - the best seedling growth was observed in substrates with at least 25% organic matter. Trial2 -lime rates ranging from 0.50 to 1.25 kg associated with 3 to 4 kg of single superphosphate per m3 of substrate provided the best seedling growth. Trial 3 - topdressing fertilization provided better development of seedlings regardless of frequency.

A different and rare type of atrophy with a predominant pattern in scapulo-peroneal distribution was described by Davidenkow in 1939. The syndrome was characterized by some researchers as a variant of Charcot-Marie-Tooth disease, however Davidenkow noticed that clinical and laboratorial manifestations did not corroborate exactly with this hypothesis. We describe a case of a female patient, 39 years-old, clinical picture similar to the syndrome described by Davidenkow, presenting scapulo-peroneal atrophy. Her first symptoms had appeared when she was 24, initially with proximal motor weakness in the upper limbs. This patient did not have family history of myopathy or neuropathy. Several tests were performed to exclude other syndromes that could be included in the differential diagnosis, by testing gene mutation, in addition to the physical examination and electromyography. The large spectrum of neuromuscular diseases makes difficult the diagnosis of Davidenkow’s syndrome which always should be considered in the differential diagnosis.

En 1939 Davidenkow describió un tipo de atrofia diferente y rara con un patrón predominante en distribución escápulo-peroneal. Algunos investigadores caracterizaron el síndrome como una variante de la enfermedad de Charcot-Marie-Tooth; sin embargo, Davidenkow percibió que las manifestaciones clínicas y de laboratorio no corroboraban exactamente esta hipótesis. Describimos el caso de una mujer de 39 años, con cuadro clínico semejante al síndrome descrito por Davidenkow, presentando atrofia escápulo-peroneal. Sus primeros síntomas comenzaron cuando tenía 24 años, inicialmente con debilidad motora proximal en los miembros superiores. No tenía historia familiar de miopatía o neuropatía y se excluyeron otros síndromes que se podrían incluir entre los diagnósticos diferenciales mediante la realización de pruebas de mutación genética, además del examen físico y electromiografía. El amplio espectro de enfermedades neuromusculares a veces dificulta su diagnóstico y debe ser siempre considerado en el diagnóstico diferencial.

RESUMO A exploração econômica da macaúba [Acrocomia aculeata (Jacq.) Lodd. ex Mart.] está passando por processo de transição do extrativismo para cultivos agronômicos, o que requer estudos com adubação para a cultura. Objetivaram-se avaliar a resposta de três acessos de macaúba a doses crescentes de nitrogênio e potássio, cultivados até o segundo ano no campo; e obter um referencial para os teores de nutrientes minerais na folha. O experimento foi montado em parcelas subdivididas, no delineamento em blocos casualizados, com cinco tratamentos principais nas parcelas (doses de N e K) e três tratamentos secundários nas subparcelas (acessos), com três repetições, cada parcela contendo três plantas. Ao final do segundo ano de cultivo, foram avaliados: altura de plantas, número de folhas, vigor e teores de nutrientes minerais nos tecidos foliares. Observou-se resposta diferenciada entre os acessos avaliados, indicando que existem genótipos mais eficientes no uso dos insumos minerais. Houve resposta diferenciada e positiva a doses crescentes de adubação com N e K em cobertura no desenvolvimento vegetativo de acessos de macaúba até o segundo ano de cultivo no campo, indicando que há variabilidade na espécie quanto à eficiência nutricional. A dose de fertilização com N e K correspondente a 360 g de N + 480 g de K2O por planta, aplicada em quatro parcelamentos durante os dois anos iniciais do cultivo, foi insuficiente para alcançar o desenvolvimento vegetativo máximo dos três acessos de macaúba avaliados. Não houve variação nos teores de macro e micronutrientes na matéria seca das folhas de macaúba dos três acessos avaliados.

ABSTRACT The economic exploitation of macaw palm [Acrocomia aculeate(Jacq.) Lodd. ex Mart.] is currently in transition, from extractivism to agricultural cultivation, thus requiring studies on the fertilization of the crop. This study evaluated the response of three genotypes of macaw palm to increasing rates of nitrogen and potassium, grown in the field until the 2nd year and to establish reference contents of mineral nutrients in the leaf. The experiment was a split-plot randomized block design with five main treatments (N and K rates) and three secondary treatments (genotypes), with three replications, each plot containing three plants. Plant height, leaf number, vigor, and nutrient contents in leaf tissues were evaluated at the end of 2nd year of cultivation. Differential responses were observed among genotypes, indicating that some genotypes are more efficient in the use of mineral inputs. There was a differentiated and positive response to increasing side-dressed N and K rates in the vegetative development of macaw genotypes until the 2nd year of field cultivation, indicating variability in the species in terms of nutrient use efficiency. The N and K fertilization rate corresponding to 360 g N + 480 g K2O per plant, in four split applications over the two years of cultivation, was insufficient to induce maximum vegetative development in the three macaw genotypes. There was no variation in macro- and micronutrient contents in leaf dry matter of the three macaw genotypes.

O objetivo deste estudo foi avaliar os efeitos da toxina botulínica tipo A (TXB-A) sobre a espasticidade de membro inferior em pacientes pós-AVE em reabilitação. Método: 21 pacientes hemiparéticos foram divididos em dois grupos que receberam doses de TXB-A de 300UI (Grupo 1) e 100UI (Grupo 2) e foram avaliados antes da injeção e 2, 4, 8 e 12 semanas após, quanto à escala de Ashworth modificada, tempo para andar 10 metros e escore motor da Medida de Independência Funcional (MIFm). Resultados: O grupo que utilizou dose mais alta teve melhora significativa da espasticidade. Ambos os grupos tiveram melhora do tempo para andar 10 metros e da MIFm sem diferença significativa entre eles. Conclusões: A melhora da velocidade de marcha e da independência funcional não foram correlacionadas com a dose de TXB-A na amostra analisada.

The objective of this study was to evaluate the effects of botulinum toxin type A (BTX-A) on spastic foot in stroke patients in a rehabilitation program. Method: Hemiparetic stroke patients (n=21) enrolled in a rehabilitation program were divided into two groups. The first group (n=11) received a total of 300UI BTX-A, and the second group (n=10) received 100 UI BTX-A. All patients were assessed at baseline and 2, 4, 8 and 12 weeks after injection for Modified Ashworth Score, time walking 10 meters, and the Functional Independence Measure (mFIM) motor score. Results: The higher-dose group exhibited a significant improvement in spasticity, and both groups showed an improvement in time walking 10 meters and mFIM, with no significant differences between them. Conclusions: Our findings suggest that gains in gait velocity and functional independence were not correlated to BTX-A dose.

Apesar do reconhecimento do escritório de gerenciamento de projetos (EGP) como uma unidade de promoção da maturidade e para o alcance da eficácia em gerenciamento de projetos, sua implantação nas organizações muitas vezes não é bem sucedida. Este artigo objetiva analisar as melhores práticas em implantações de EGP que contribuem, de uma forma geral, para a otimização dos processos do negócio e dos resultados da organização. Através de uma revisão da literatura, propomos um conjunto de melhores práticas e os critérios para avaliação da eficácia na implantação de EGP. Com isto, realizou-se uma pesquisa de campo utilizando-se um questionário de pesquisa, onde foram levantadas as aplicações dessas melhores práticas e o sucesso dos EGPs para um determinado grupo de organizações. De posse desses dados, foram identificadas as melhores práticas mais aplicadas em implantação de EGP. Em seguida, foi realizada uma análise estatística que evidenciou 14 melhores práticas que comprovaram aumentar o sucesso na implantação do EGP.

Despite the recognition of the Project Management Office (PMO) as a unit to promote maturity in project management and increase the success of projects, its implementation in organizations is often not successful. This research analyzes the best practices of successful PMO implementations, thereby increasing their likelihood of success. Through a literature review, best practices and criteria for measuring success were identified. Through a field survey with questionnaire use, these best practices and PMO success were raised to a group of organizations. Best practices most applied in PMO deployment were identified through these data. Statistical analysis revealed that 14 best practices increase the PMO implantation success.

Em regiões de clima subtropical, os modelos e métodos propostos para avaliação da necessidade de frio das fruteiras de clima temperado não apresentam, muitas vezes, resultados satisfatórios. Isto demonstra a necessidade do desenvolvimento de alternativas para se estimar a necessidade de frio dessas plantas. Este trabalho teve como objetivo analisar as correlações entre os dados fenólogicos e a necessidade de frio das sementes de 18 cultivares de pessegueiro e um cultivar de nectarineira. Para realização dos estudos de correlação, foram realizados dois experimentos, separadamente, sendo o primeiro por acompanhamento das características fenológicas em campo e, o segundo, com o estudo da necessidade de frio acumulado, para germinação de 50 e de 100% das sementes, de cada cultivar. Houve correlação significativa entre o número de dias necessários para o início do florescimento (r = 0,70**, 0,55*) e plena floração (r = 0,72**, 0,73**) e o número de unidades de frio acumulado, para germinação de 50 e de 100% das sementes estratificadas. O número de dias para o início da brotação e fim da dormência apresentou correlação significativa com o número de unidades de frio acumulado, para 50 e 100% de germinação (r = 0,48*, 0,50*, respectivamente). Entretanto, o mesmo efeito significativo nestes dados fenológicos não foi observado para o número de unidades de frio acumulado, para 50% de germinação, como, também, entre o número de unidades de frio acumulado para estratificação das sementes e a época de colheita dos frutos.

In subtropical climate areas, the models and methods proposed to evaluate the chilling requirement of temperate fruit crops often do not provide satisfactory results, thus calling for the development of alternative techniques. The aim of this study was to evaluate the correlations between some phonological traits and chilling requirement for seed germination of 18 peach cultivars and one nectarine cultivar. Two experiments were installed separately for the correlation studies. In experiment 1, the phenological traits were observed in the field, while in experiment 2, the chilling requirement for 50 and 100% seed germination of each cultivar was assessed. The number of days for beginning of bloom (r = 0.70**, 0.61**) and full bloom (r = 0.72**, 0.76**) were both significantly correlated with the number of chilling units for 50% and 100% germination of seeds. The number of days for beginning of budding and dormancy break were both significantly correlated with the number of chilling units for 50% and 100% germination (r = 0.48*, 0.50*, respectively). However, the same significant effect for these phenological traits was not found between chilling units and 50% germination of seeds, as well as between chilling units and harvest dates.

Devido à necessidade de estudos atuais sobre as Áreas de Preservação Permanentes (APPs) para o município de Alegre-ES, propõem-se, neste estudo, demonstrar como a utilização de Geotecnologias pode ajudar de forma eficaz o mapeamento dessas áreas, auxiliando no entendimento das áreas a serem preservadas no município. O estudo foi realizado em todo o município de Alegre,ES, com o objetivo de elaborar mapas analógicos e digitais do município, com o auxílio de Geotecnologias; delimitar as Áreas de Preservação Permanente na ótica da Legislação Ambiental e ressaltar a importância de identificar as áreas de forma automática para que se possam implantar projetos ambientais que visem a promover ações em busca de um relacionamento sustentável entre homem e ambiente de forma mais eficiente. O município de Alegre possui uma área de 336,39 km² de APPs totais (43,50% da área total do município). A metodologia adotada para delimitação automática das APPs foi eficiente, revelando que as mesmas , ao redor de nascentes (buffer de 50 m), nas encostas com declividade superior a 45 graus, topo de morro (terço superior de morros) e margens dos cursos d'água (buffer de 30 m) representaram respectivamente 9,86 km² (1,27%), 8,99 km² (1,16%), 237,35 km² (30,69%) e 95,11 km² (12,30%) da área total do município.

Due to the need of current studies on the Permanent Preservation Areas (APPs) for the county of Alegre - ES, it is proposed in this study to demonstrate how the use of Geotechnologies can help in an effective way to map those areas, helping to understand the areas to be preserved in the county. The study was accomplished in the whole county of Alegre - ES which objectives were: a) to elaborate analogical and digital maps of the county, with the aid of Geotechnologies; b) to delimit the Areas of Permanent Preservation in the optics of the Environmental Legislation and c) to emphasize the importance of identifying the areas in an automatic way so that it can implant environmental projects that seek to promote actions in search of a maintainable relationship between man and environment in a more efficient way. The county of Alegre has an area of 336,39 km² of APPs (43,50% of the total area of the county). The methodology for automatic delimitation of APPs was efficient, indicating that the same, around of spring (buffer of 50 m), in the hillsides with steepness superior to 45 degrees, hill top (superior third of hills) and margins of the courses of water (buffer of 30 m) they acted respectively 9,86 km² (1,27%), 8,99 km² (1,16%), 237,35 km² (30,69%) and 95,11 km² (12,30%) of the total area of the county.

OBJETIVO:Correlacionar a densitometria do cristalino(PNS - patient nuclear score)por meio da imagem de Scheimplufgcom o tempo de facoemulsificação e o gasto de energia. MÉTODOS: Estudo observacional prospectivo, envolvendo 22 olhos de 22 pacientes que se submeteram à cirurgia de catarata por facoemulsificação com implante de lente intraocular. A densitometria do cristalino (PNS) foi medida através da tomografia de segmento anterior e córnea (Pentacam) no pré-operatório com a imagem de Scheimplufg. O tempo de facoemulsificação e o gasto de energia foram verificados e anotados ao término de cada cirurgia. O teste de correlação de Pearson foi utilizado para análise estatística através do programa Bioestat 5.0. Foi considerado como estatisticamente significante p < 0,05%. RESULTADOS: As correlações entre PNS x Tempo de Facoemulsificação (s) e PNS x Gasto de Energia obtiveram respectivamente um p < 0,0050 e RP (Coeficiente de Pearson) de 0,5757 e p < 0,0029 e RP (Coeficiente de Pearson) de 0,6034. CONCLUSÃO: Observamos uma forte associação entre o método objetivo de classificação da catarata através da imagem de Scheimplufg (PNS), tempo e gasto de energia. Assim há possibilidade de realizarmos um planejamento cirúrgico pré-operatório baseado em métodos objetivos da classificação da catarata, reduzindo a fluídica, energia e tempo na cirurgia de facoemulsificação.

PURPOSE: To evaluate and to correlate the PNS (patient nuclear score) and time and energy (power US) in patients priorto and following phacoemulsification with intraocular lens implantation. METHODS: This is a prospective study. Twenty two consecutive patients (22 eyes) that underwent phacoemulsification surgery and intraocular lens implantation were enrolled. Full ophthalmologic clinical assessment including Pentacam (Oculus, Pentacam) measurements were performed in all cases prior to surgery (Pre). Excluison criteria were corneal disease or scars. RESULTS: There are statistically significant difference between PNS and Time with p < 0,0050 and PNS x Energy with p < 0,0029. CONCLUSION: Preoperatively adjusting phaco parameters based on cataract grade helped improve overall efficiency by reducing the amount of energy and fluid used in the eye and reducing overall phaco time.