**Table 5.** DEA analysis.

**Table 5.** *Cont.*

**Figure 5.** DEA results.

Taking into account the generation of waste, recycling rate of all waste, recycling rate of e-waste, circular material uses rate, and the value added, Croatia, Netherlands, Luxembourg, Slovenia, Belgium, Denmark, Ireland are the leaders among EU countries. The lowest performers, Greece and Romania, reach slightly over 50% efficiency.

The concept of technological competitors was used to group the countries (listed in Table 5), which is illustrated in Figure 6 with an additional indication of the direction of dependences.

**Figure 6.** The competition of effective objects graph. The first graph (**a**) gathers competitors in the group of 100% efficient states. The next one presents the countries that may switch places with slight changes in data. The groups are as follows: (**b**) Estonia France, Cyprus Hungary, Austria, Italy Bulgaria, France Hungary, Lithuania; (**c**) Germany, Malta, Poland, Spain, Sweden, Czechia, Finland; (**d**) Portugal, Slovakia Latvia; € Romania, Greece. Designated groups connect countries with similar effectiveness. Group (**b**) includes countries with efficiency from 80.00% to 98.60%; group (**c**) from 70.08% to 88.70%; group (**d**) includes countries from 73.90% to 77.70%; group (**e**) consists of countries with a score slightly above 51%. The grouping allowed for the identification of similar countries that are in a sense dependent on each other in terms of the final assessment. After excluding 100% effective ones, changes in the characteristics of countries within the groups would affect the score of the remaining ones.

## **6. Discussion of Results**

Over the past few years, the concept of the circular economy gained increasing attention around the world as a way to counteract climate change and save resources. A CE could help overcome pressures on resources arising from the estimated growth of the global population. It is hoped that transition to a CE would result in new economic opportunities [155], new jobs (in terms of type and numbers), higher productivity [156], and the improved quality of life for all thanks to the environmental recovery, health benefits, and less pressure on land and Earth's resources.

The necessity to change the economic model and to decouple growth from resource consumption is of interest not only to politicians, but also to average European citizens. As research results indicate, most Europeans believe that environmental protection is very important to them personally [157].

Whereas the general interest in the CE is well reflected in the bulk of scientific publications, the specific issue of measuring the performance of countries in achieving a CE aims is not yet sufficiently grounded in the literature. This paper is a contribution to the discussion on CE metrics and measurement. It presents a methodology of an objectivised comparative assessment of the degree of implementation of CE principles in the EU member states. The proposed approach is based on the DEA method supported by factor analysis. Circular Economy Indicators published by the European Statistical Office (Eurostat) [158] served as the input data.

The conducted calculations and the analyses performed on their basis suggest that the position of a particular country in achieving the CE aims is strongly correlated with its GDP per capita. The fact that richer economies are more advanced in achieving CE aims may indirectly imply that the implementation of CE principles requires investments and expenditures that poorer countries are unable to bear. Apparently, transition towards the CE requires costly modern technology, perpetual knowledge generation, and advanced infrastructures [23].

Factor analysis shows that many CE indicators are strongly correlated with each other and may be aggregated into meta-indicators (factors) and represented by one indicator that displays the strongest correlation with a given meta-indicator. In this situation, it is reasonable to limit the number of CE indicators, which will simplify the CE statistics and the assessment of countries' standing in achieving CE goals.

Comparative performance assessment of the EU member states allows for splitting them into three groups of countries with a similar relative efficiency in the CE goals' implementation: (90%, 130%), (70–90%), (50–70%). This shows a certain stratification within the EU when it comes to CE goals' implementation.

Thanks to the competition graphs, it is possible to indicate optimal technologies (i.e., CE indicator values) of technological competitors of particular countries so that they achieve the results at least equal to the one of the reference country.

Limitations of this approach should also be pointed out. Firstly, the obtained country ranking depends directly on the chosen evaluation criteria. Therefore, it is important that the adopted indicators are well justified on scientific grounds and are reflective of the key aspects of CE. Secondly, with 27 countries under evaluation, the number of assessment criteria should not exceed the 6–9 range. Such limitation requires a significant decrease in the number of indicators chosen from the list of the UE Circular Economy Indicators. DEA analysis results are sensitive to the choice of input and output variables. Therefore, the CE indicators should be selected diligently, and various combinations of variables should be tested for stability of results [159]. Thirdly, results obtained with DEA may be sensitive to outliers; hence, the data should undergo preliminary screening with regards to their homogeneity. Fourthly, one should keep in mind that the results change in time; thus, the static assessment of particular countries at a given point in time should be complemented with the dynamic evaluation of the change of their performance in time.

The indicated limitations are a good guidance as far as possible future research directions are concerned. The authors intend to examine the sensitivity of various combinations

of CE indicators included in the country assessment, carry out simulations to evaluate the impact of outliers on the result stability, and look into the changes in CE performance of particular countries over a certain period of time.

Some policy implications may be derived from the study results. The objectivity and scalability of the DEA approach to the evaluation of CE implementation make it a suitable approach to comparing the effectiveness of CE policy packages [78] beyond the European Union. For example, benchmarking of OECD or G20 countries [160] with the use of the proposed approach is feasible. Such an internationally adoptable comparison tool will be necessary when the CE attains the status of a global policy [161,162]. Moreover, the CE agenda should not be used as an instrument of a disguised domination perpetrated by the richer countries with the aim of preserving their competitive advantage. The CE policy must not create winners and losers [163].


*Erosion Control Success Stories and Challenges in the Context of Sustainable Landscape… DOI: http://dx.doi.org/10.5772/intechopen.96267*

size, erosion, climate, and acidity), structural, and institutional contexts. The success stories resulted from planned land use, served in solving land related issues. High value indigenous tree species have been re-introduced in the area for the purposes of rehabilitating the ecosystem of Gishwati and developed lands have been effectively redistributed to beneficiaries. To sustain the established land husbandry works required a process of building capacity of people for increasing ownership and commitment of land beneficiaries. It comes into practice through HIMO approach through community sensitization, exploring social relations, monitoring of implemented works, and protecting grazing lands in restricted high risk zones. HIMO approach also created employment to more beneficiaries.


**7. Conflict of interest**

106 Progress in Hemodialysis – From Emergent Biotechnology to Clinical Practice

Preliminary studies in our laboratory have shown an interesting trend in the reduction of total MVs in a cross-over clinical study when patients shifted from high-flux HD to on-line

Fig. 7. Total MVs count in patients on maintenance HD. In a cross-over design, 8 patients were started on bicarbonate HD (black columns) and 8 patients on on-line HDF (grey columns). MVs were counted by cytofluorimetry. MVs were also characterized (data not shown) by the following specific markers: CD62P, CD41, CD42, CD31, for platelets; CD45, for leukocytes; CD31, CD146, CD144 for the endothelium: CD235 and CD242 (ICAM 4), for

More studies are needed to better assess the relevance of these observations and to better characterize the type and biological effects of the MVs. It is still to be fully elucidated whether MVs are a consequence or a cause of disease. Increasing evidence for their pathophysiologic role in other human diseases such as sepsis and tumors (Camussi et al., 2011) is rapidly accruing. Many points require further investigation. i. The stimuli and the molecular pathways that regulate the assembly within MVs of the biological active molecules that they shuttle. ii. The stimuli that trigger their release. iii. The surface receptors that may confer selective specificity. iv. The full diagnostic potential of MVs in different pathological conditions. v. The strategy to inhibit formation or to remove from circulation potentially harmful MVs. The recognition of MVs has opened a new era and new

perspectives of investigation also in biocompatibility of extracorporeal treatments.

The outlook of more biocompatible and physiological dialysis is today confronted with a older and sicker population in need of maintenance HD. The knowledge of biological mechanisms operating at the system level will be approached with the help of improved technologies hopefully able to reduce the deleterious effect of the repetitive contact with a foreign surface and to insure optimal performances for the elimination of small and middle molecule solutes. Advances in dialyzer membranes and geometries, as well as blood tubings

**5.2.3 MVs in treatment modalities**

HDF (**Figure 7**).

erythrocytes.

**6. Conclusions**

Ciro Tetta and Emanuele Gatti are full-time employees of Fresenius Medical Care.


**2. Observation**

We report the case of a 29-year-old woman with no history who presented with a right humeral mass of 50 mm x70mm evolving for 2 months and that has spontaneously ruptured. An axillo-humeral bypass using the basilic vein was made. The intraoperative findings were consistent with an aneurysm of the humeral artery. The axillary artery had an inflammatory aspect with a very thickened wall suggesting vasculitis, and the humeral artery downstream was narrowed.

Histological analysis of the resected lesions showed a non-specific panvascularitis. Investigations carried out postoperatively revealed recurrent bipolar aphtosis associated with a 2-year history of inflammatory arthralgia and a 2-month history of claudication of the left upper limb. Physical examination showed a mouth ulcer on the inside of the lower lip (**Figure 1**), scars of genital ulcers, pseudo folliculitis. Peripheral pulses were present, symmetrical but weak in the left upper limb. Pathergy test was positive.

Arterial Doppler objectified the patency of the left axillary, subclavian, humeral, radial and ulnar arteries which were thin with damped and demodulated spectra. A thoraco-abdominopelvic CT angiography was performed in search of other vascular lesions. It showed a saccular aneurysm of the left subclavian artery, bronchiolar micronodules, thoracic and sub-diaphragmatic lymphadenopathies, the largest of which contained central necrosis and some of which were calcified. The diagnosis of Behçet's disease with mucocutaneous and arterial involvement, associated with tuberculosis was made. Anti-tuberculous chemotherapy followed by corticosteroids and immunosuppressants (cyclophosphamide and Azathioprine), as well as colchicine, has led to an uneventful recovery without recurrence.

**103**

*Humeral Artery Aneurysm Revealing a Rare Association between Tuberculosis and Behçet's…*

Tuberculosis is an infectious disease that presents a public health problem in developing countries where it is endemic [3]. Tuberculosis continues to be a major cause of morbidity and mortality. In developed countries, there has been an upsurge in the last decade, especially among HIV carriers, immigrant population and the

Tunisia is an intermediate-endemic country with a recorded incidence of

Extra-pulmonary tuberculosis accounts for 15 to 30% of all locations [6].

signs are often seen like weight loss, anorexia and fever, but none of them is

Symptoms can be various depending on the location of the tuberculosis. General

The main cause of tuberculosis is *Mycobacterium tuberculosis*, a thin, slightly curved, aerobe bacillus. In comparison to other bacteria, M tuberculosis has a cell wall with a very high lipid content that resists staining by the usual Gram method. However, it accepts basic fuchsin dyes and is not easily discolorized even with acidalcohol; this resistance to decolorization by acid-alcohol is termed acid-fast [8]. M tuberculosis is transmitted via airborne droplet nuclei that are produced when persons with pulmonary or laryngeal tuberculosis cough, sneeze, speak, or sing [9]. Diagnosing active tuberculosis can be difficult. A chest X-ray and multiple sputum cultures for acid-fast bacilli are typically part of the initial evaluation [10]. Tuberculin testing is helpful, but it is not specific, and a negative test cannot

Cultures are slow but nevertheless remain the gold standard [11]: they allow the diagnosis to be confirmed and an antibiogram to be obtained. But they are rarely

The histopathological study is the key exam to prove the diagnosis of tuberculosis

Polymerase chain reaction should be used when having a positive direct examination, in order to distinguish the bacilli of the *Mycobacterium tuberculosis* from

The treatment consists of six months of antituberculosis chemotherapy: rifampicin and isoniazid, initially supplemented by two months of pyrazinamide and

Behçet's disease is a rare but severely debilitating vasculitis. The manifestations are typically mucocutaneous with orogenital ulcers and skin lesions [13]. However,

The symptoms are variable, which can explain the delay of the diagnosis in

Sex distribution is variable. The disease is usually severe in young adult men.

Behçet's disease occurs worldwide but clusters are found mainly along the 'silk road' with highest prevalence in Turkey, Japan and Iran, and lower prevalence in

It affects people of all ages with a predilection for those aged from 20 to 40 years.

Behçet's disease can affect potentially all organ systems because of its propensity

Oral and genital ulcers are the hallmarks of the disease, seen in up to 97% and

The confirmation of diagnosis is based on appropriate clinical symptoms after

by objectifying the tuberculoid granuloma with caseous necrosis. New diagnostic tools are available today such as Quantiféron.

Ganglion, pleural, urogenital and bone sites are the most common [7].

*DOI: http://dx.doi.org/10.5772/intechopen.95465*

35/100,000 inhabitants in 2019 [5].

**3. Discussion**

elderly [4].

specific.

exclude the diagnosis.

positive in paucibacillary tuberculosis.

other atypical mycobacteria.

many other locations can be seen.

to affect all arteries and veins.

60–90% of patients, respectively [15].

exclusion of differential diagnoses.

addition to the absence of specific blood test.

North American and northern European populations [14].

ethambutol [12].

**Figure 1.** *Mouth ulcer on the inside of the lower lip.*

*Humeral Artery Aneurysm Revealing a Rare Association between Tuberculosis and Behçet's… DOI: http://dx.doi.org/10.5772/intechopen.95465*


**1. Introduction**

Diet supplementation is an important aspect of aquaculture management, especially in intensive or semi-intensive fish culture, and is promising for increasing fish production [1]. Protein, on the other hand, is required for normal tissue function, fish body protein maintenance and replenishment, and growth. Due to the high cost of protein, it is more cost-effective to use all of the protein for tissue repair and growth rather than catabolizing it for energy [2].

This cost is determined by a variety of factors, including the amount of protein in the product, the source and kind of ingredients sourced from plant or animal sources, and manufacturing techniques. Different feeding management solutions, such as on-demand feeding regimes, are in addition to generating low-cost diets and/or good husbandry and pond management [3] possibly aid in the growth of fish. One issue that fish farmers face is finding a balance between rapid fish growth and the most efficient use of available feed. Because managing their feed intake in accordance with their energy needs is expected to improve when fish are fed with a proper feeding frequency, growth and feed conversion ratio are expected to improve.

The concept of a feeding schedule was created to account for fluctuations in the protein requirements and digestibility of farmed fish. In terms of practicality, the

ideal condition would maximize the utilization of dietary protein for growth while reducing the usage of proteins for functional protein synthesis, gluconeogenesis, lipogenesis, and energy production [4].

Algae are photosynthetic creatures that provide the ultimate source of cellular carbon as well as chemical energy to other organisms. As a result, they were frequently referred to as primary producers. Microalgae (seaweed) and macroalgae (seaweed) are the two types of algae (unicellular). Microalgae require light, carbon dioxide, and nutrients to grow. Microalgae are grown for food, to produce valuable compounds, as biofilters to remove nutrients and other contaminants from wastewater, in the cosmetic and pharmaceutical industries, and for aquaculture. Also, due to their high oil content and quick biomass production, microalgae could be a viable source of biofuel [5].

Because the fish expends energy to collect prey but gains no energy from ingesting it, some plankton pass through the gut of planktivorous fishes undigested. In this circumstance, the fish may detect and reject such undesirable creatures. In the early stages of a fish's life, natural food is essential [6].

Cyanobacteria have been used in photosynthesis and its genetic control, photoregulation of genetic expression, cell differentiation and N2fixation, nitrogen, carbon, and hydrogen metabolism, resistance to environmental stress, and molecular evolution due to their benefits for humans, animals, and the environment (photosynthesis) [7]. When carp are removed, algal output decreases due to nutrient depletion, macrophytes grow due to reduced turbidity, and zooplankton increases due to increased macrophyte cover.

*Spirulina* is a cyanobacterium that has been commercially produced for over 10 years because of its high nutritional content, which includes protein, amino acids, vitamins, minerals, vital fatty acids, and carotene [8]. *Spirulina* can be used as a nutritional supplement for people, as well as a feed supplement for animals with economic benefits. For example, when fed to trout, sea bass, fancy carp, red tilapia, shrimp, and mollusk, it can be a good food supplement*.* The alga has been discovered to be a good source of protein as well as a way to improve the color, flavor, and quality of meat [9].

*Spirulina* has been shown to have therapeutic effects in animals, including fish, as a growth promoter, probiotic, and immune system booster [10]. *Spirulina* is used to help livestock, poultry, prawns, carp, canaries, and exotic birds develop faster [11]. Preclinical research indicates *Spirulina* possesses antimutagenic, hypocholesterolemic, immunological, and antiviral effects.

*Spirulina*'s chlorophyll functions as a purifying and cleansing agent against harmful chemicals. It is also utilized as a probiotic agent and as a food supplement to increase color in ornamental fish. *Spirulina* contains protein (60–70%), necessary amino acids and fatty acids, phycocyanin (14%), chlorophyll (1%) and carotenoid colors (0.37%), vitamin B-12, and minerals that play key functions in animals in a variety of ways [10, 12].

*Spirulina* is a source of linolenic acid (GLA), an important fatty acid with therapeutic effects. Iron, calcium, chromium, copper, magnesium, manganese, phosphorus, potassium, sodium, and zinc are among the minerals found in *Spirulina*. By breaking down indigestible feed components, *Spirulina* promotes the intestinal flora of fish, according to Bargey's Manual of Determinative Bacteriology, *Spirulina* is an oxygenic photosynthetic bacterium that belongs to the Cyanobacteria and Prochlorales families. In this classification, the sequence of the rRNA subunit 16S is considered. In 1989, these microorganisms were classified into two genera, according to the suggestion by Gomont in 1892 [12].

*Spirulina* is becoming a popular health food all over the world. It is a filamentous Cyanobacterium that belongs to the Cyanophyte class of algae. Furthermore, *Spirulina* is a natural resource that is high in protein, amino acids, vitamins, minerals, essential fatty acids, B-complex, and -carotene [13].

*Spirulina* has been shown to be capable of breaking down indigestible feed components and improving the intestinal flora in fish in previous studies [12]. In fish, the creation and release of enzymes that transfer lipids for growth rather than storage. Furthermore, the -carotene in *Spirulina* helps to keep the mucous membrane in place, preventing hazardous materials from entering the body. *Spirulina*'s chlorophyll functions as a purifying and cleansing agent against harmful chemicals [14].

Phosphorus and nitrogen from agricultural and industrial effluents, as well as home wastewater, can produce major eutrophication in any aquatic body. These nutrients, on the other hand, can be used to boost plant growth, such as phytoplankton, which can be used as natural fish food or in pharmaceuticals. Due to its great nutritional content, *Spirulina* is one of the most promising microalgae for culture [15].


Section 3 Fruit Production

Prunus

[33] Tzonev R, Yamaguchi M.

1999;**488**:239-242

2004;**10**(4):21-26

(Prague). 2007;**34**:47-53

scienta. 02.028

scienta

Investigations on some far-east *Prunus* species: Phenology. Acta Horticulturae. British Columbia. Canadian Journal of

[42] Roversi A, Ughini V. Influence of weather conditions of the flowering period on sweet cherry fruit set. Acta Horticulturae. 1996;**410**:427-433

Plant Science. 1999;**79**:129-137

[34] Nyeki JM, Popovics SL. Strategy of the sour cherry verticum in the northern great plain region Hungary (analytic study). International Journal of Horticultural Science. 2002;**11**:7-31

[35] Bekefi Z. Self-fertility studies of some sweet cherry (*Prunus avium* L.) cultivars and selections. International Journal of Horticultural Science.

[36] Tosun F, Koyuncu F. Investigations of suitable pollinator for 0900 Ziraat sweet cherry cv.: Pollen performance tests, germination tests, germination procedures, in vitro and in vivo pollinations. Horticultural Science

[37] Beyhan N, Karakaş B. Investigation of the fertilisation biology of some sweet cherry cultivars grown in the central northern Anatolian region of Turkey. Scientia Horticulturae. 2009;**121**(3):320-326. DOI: 10.1016/j.

[38] Moghadam EG, Hosseini P,

Acad. of Sciences; 1992

Mokhtarian A. Blooming phenology and self-incompatibility of some commercial cherry (*Prunus avium* L.) cultivars. Iranian journal of Horticultural Science. 2009;**123**(1):29-33. DOI: 10.1016/j.

[39] Davarynejad GH. Flowering Biology Fertility and Combination of Apple Cultivars [Ph.D dissertation]. Hung.

[40] Sanzol J, Herrero M. The 'effective pollination period' in druit trees. Scientia Horticulturae. 2001;**90**:1-17

[41] Caprio JM, Quamme HA. Weather conditions associated with apple production in the Okanagan Valley of

**78**

**81**

**Chapter 5**

**Abstract**

**1. Peach**

**1.1 Origin and distribution**

**1.2 Importance and uses**

Production Technology of Peach,

In this chapter production technology of peach, plum and apricot in India is elaborated in detail in relation to introduction, origin and distribution of crop, importance and uses, morphological features of tress, other related species involved, climate and soil requirement, varieties, propagation and raising of rootstocks, planting and planting densities, cropping systems, manure and fertilisers application, cultural practices, weed management, orchard floor management, after care training and pruning, pollination and pollinizers, flowering and crop regulation, use of growth regulators, fruiting in the crop, fruit thinning and drop, maturity and harvesting, post-harvest management, handling and storage, insects, pests and diseases, special production problems like low productivity, unfruitfulness and self-incompatibility, premature leaf fall, replant problem, alternate

Peach has a good position among stone fruits and is rated as the third most important temperate fruit in India. With the introduction of chilling varieties, the

Early writers were of the opinion that peach is a native of Persia. The cultivated form of peach has come from China. The scientist from Spain introduced the Peach in America, and 50 years after Cortez, it was introduced in Mexico. Peach is grown as a commercial and home fruit in most of the temperate countries of the globe. The major peach-producing countries are Italy, the USA, Spain, China, France, Greece, Russia, Mexico, Japan and Argentina. In India, it is mainly cultivated in J&K,

Peach is a delicious, juicy and highly palatable fruit. It is a rich source of vitamin A, iron and protein. The fruit is generally consumed fresh, but delicious products like squashed and dried products, frozen preserves, jam, nectar, juice, beverage, marmalade, etc. can be made from it. Peaches are also a good source of low-calorie diet.

Plum and Apricot in India

bearing and remedies and physiological disorders of the crop.

**Keywords:** peach, plum, apricot, production technology, India

crop is becoming popular in the subtropical plains of North India.

Scientific name: *Prunus persica* Family: Rosaceae.

Himachal Pradesh, Uttaranchal, Punjab and Delhi.

*Bhende Siddhesh Shamrao*