Eco-industrial initiatives, which close industrial loops by turning wastes at one point in a value chain into inputs at another point, are attracting growing interest as a solution to the problem of sustainability of industrial systems. Although Germany and Japan have made important advances in building recycling incentives into their industrial systems and sought competitive advantage from doing so, China is arguably taking the issue even further (in principle) through its pursuit of a circular economy, now enshrined in law as an official national development goal. In this article, we review a number of the ecoindustrial initiatives taken in China and compare them using a common graphical representation with comparable initiatives taken in the West and elsewhere in East Asia. Our aim is to demonstrate some common themes across the case studies, such as the transformation from the former linear economy to a circular economy and the evolutionary processes in which dynamic linkages are gradually established over time. We discuss the drivers of these eco-industrial initiatives as well as the inhibitors, setting the initiatives in an evolutionary framework and introducing a notion of Pareto eco-efficiency to evaluate them. We make the argument that China might be capturing latecomer advantages through its systematic promotion of eco-industrial initiatives within a circular economy framework.

C hina's consumption of the world's resources is reaching crisis levels. To produce 46% of global aluminium, 50% of steel and 60% of the world's cement 1 in 2011, it consumed more raw materials than the 34 countries of the Organisation for Economic Cooperation and Development (OECD) combined: 25.2 billion tonnes. The nation's resource use is inefficient. China requires 2.5 kilograms of materials to generate US$1 of gross domestic product (GDP) compared with 0.54 kilograms in OECD countries (in 2005 dollars, adjusted for purchasing power parity). And it is wasteful. In 2014, China generated 3.2 billion tonnes of industrial solid waste, only 2 billion tonnes of which was recovered by recycling, composting, incineration or reuse. By comparison, firms and households in the 28 countries of the European Union generated 2.5 billion tonnes of waste in 2012, of which 1 billion was recycled or used for energy. In 2025, China is expected to produce almost one-quarter of the world's municipal solid waste 2. Unchecked, such levels of consumption and waste will strain the nation and the planet. In December 2015, a landslide at a waste dump in Shenzhen killed 73 people. China has also seen an increasing number of protests by local residents over wasteincineration projects in recent years. The YONGSKY/DREAMSTIME.COM

Treating patients with COVID-19 is expensive, thus it is essential to identify factors on admission associated with hospital length of stay (LOS) and provide a risk assessment for clinical treatment. To address this, we conduct a retrospective study, which involved patients with laboratory-confirmed COVID-19 infection in Hefei, China and being discharged between January 20 2020 and March 16 2020. Demographic information, clinical treatment, and laboratory data for the participants were extracted from medical records. A prolonged LOS was defined as equal to or greater than the median length of hospitable stay. The median LOS for the 75 patients was 17 days (IQR 13–22). We used univariable and multivariable logistic regressions to explore the risk factors associated with a prolonged hospital LOS. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated. The median age of the 75 patients was 47 years. Approximately 75% of the patients had mild or general disease. The univariate logistic regression model showed that female sex and having a fever on admission were significantly associated with longer duration of hospitalization. The multivariate logistic regression model enhances these associations. Odds of a prolonged LOS were associated with male sex (aOR 0.19, 95% CI 0.05–0.63, p = 0.01), having fever on admission (aOR 8.27, 95% CI 1.47–72.16, p = 0.028) and pre-existing chronic kidney or liver disease (aOR 13.73 95% CI 1.95–145.4, p = 0.015) as well as each 1-unit increase in creatinine level (aOR 0.94, 95% CI 0.9–0.98, p = 0.007). We also found that a prolonged LOS was associated with increased creatinine levels in patients with chronic kidney or liver disease (p < 0.001). In conclusion, female sex, fever, chronic kidney or liver disease before admission and increasing creatinine levels were associated with prolonged LOS in patients with COVID-19.

While debate on biofuels and bioenergy generally has sparked controversy over claimed greenhouse gas emissions benefi ts available with a switch to biomass, these claims have generally not taken into account indirect land use changes. Carbon emissions from land that is newly planted with biocrops, after land use changes such as deforestation, are certainly real -but efforts to measure them have been presented subject to severe qualifi cations. No such qualifi cations accompanied the paper by Searchinger et al. published in Science in February 2008, where the claim was made that a spike of ethanol consumption in the USA up to the year 2016 would divert corn grown in the USA and lead to new plantings of grain crops around the world to make up the shortfall, resulting in land use changes covering 10.8 million hectares and leading to the release of 3.8 billion tons of greenhouse gas emissions in terms of CO 2 equivalent. These emissions, the paper argued, would more than offset any savings in emissions by growing biofuels in the fi rst place; in fact they would create a 'carbon debt' that would take 160 years to repay. Such criticism would be devastating, if it were valid. The aim of this perspective is to probe the assumptions and models used in the Searchinger et al. paper, to evaluate their validity and plausibility, and contrast them with other approaches taken or available to be taken. It is argued that indirect land use change effects are too diffuse and subject to too many arbitrary assumptions to be useful for rule-making, and that the use of direct and controllable measures, such as building statements of origin of biofuels into the contracts that regulate the sale of such commodities, would secure better results.

China's moves to introduce a Circular Economy have attracted wide attention as a solution to severe problems of resource inefficiency and lack of resource productivity. This article highlights the distinctive strategy of focusing such efforts on existing industrial parks, turning them into eco-industrial parks. It provides three case studies and highlights the management issues involved as overcoming reverse salients and capturing network advantages. China is an especially instructive case because it starts well behind the Organisation for Economic Cooperation and Development (OECD) countries and thereby has much to gain by adopting comprehensive policies.