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Mortality due to cardiovascular disease rises sharply in winter. Known as excess winter mortality, this phenomenon is partially explained by cold exposure-induced high blood pressure. Home blood pressure, especially in the morning, is closely associated with cardiovascular disease risk. We conducted the first large nationwide survey on home blood pressure and indoor temperature in 3775 participants (2095 households) who intended to conduct insulation retrofitting and were recruited by construction companies. Home blood pressure was measured twice in the morning and evening for 2 weeks. The relationship between home blood pressure and indoor temperature in winter was analyzed using a multilevel model with 3 levels: repeatedly measured day-level variables (eg, indoor ambient temperature and quality of sleep), nested within individual-level (eg, age and sex), and nested within household level. Cross-sectional analyses involving about 2900 participants (1840 households) showed that systolic blood pressure in the morning had significantly higher sensitivity to changes in indoor temperature (8.2 mm Hg increase/10°C decrease) than that in the evening (6.5 mm Hg increase/10°C decrease) in participants aged 57 years (mean age in this survey). We also found a nonlinear relationship between morning systolic blood pressure and indoor temperature, suggesting that the effect of indoor temperature on blood pressure varied depending on room temperature range. Interaction terms between age/women and indoor temperature were significant, indicating that systolic blood pressure in older residents and women was vulnerable to indoor temperature change. We expect that these results will be useful in determining optimum home temperature recommendations for men and women of each age group. Clinical Trial Registration— URL: http://www.umin.ac.jp/ctr/index.htm . Unique identifier: UMIN000030601.

Background: Bath-related sudden cardiac arrest frequently occurs in Japan, but the mortality data have not been sufficiently reported. Methods and Results:This prospective cross-sectional observational study was conducted in the Tokyo Metropolis, Saga Prefecture and Yamagata Prefecture between October 2012 and March 2013 (i.e., in winter). We investigated the data for all occurrences in these areas for which the emergency medical system needed to be activated because of an accident or acute illness related to bathing. Emergency personnel enrolled the event when activation of the emergency medical system was related to bathing. Of the 4,599 registered bath-related events, 1,527 (33%) were identified as bath-related cardiac arrest events. Crude mortality (no. deaths per 100,000) during the observational period was 10.0 in Tokyo, 11.6 in Yamagata and 8.5 in Saga. According to the mortality data for age and sex, the estimated number of bath-related deaths nationwide was 13,369 in winter, for the 6 months from October (95% CI: 10,862-16,887). Most cardiac arrest events occurred in tubs filled with water with the face submerged in the water. This suggests that drowning plays a crucial role in the etiology of such phenomena. Conclusions:The estimated nationwide number of deaths was 13,369 (95% CI: 10,862-16,887) in winter, for the 6 months from October. Crude mortality during the winter season was 10.0 in Tokyo, 11.6 in Yamagata and 8.5 in Saga.

This paper outlines the energy consumption and greenhouse gas emission trends in the residential and commercial sectors in Japan. The results showed that the increase in residential energy consumption in Japan is mainly caused by the widespread use of heating equipment, hot water supply apparatus, and other household electrical appliances. On the other hand, it was indicated that the increase in commercial energy use is mainly due to the increase of the floor area of buildings, particularly hotels, hospitals, and department stores. The paper also describes political measures to promote energy conservation, including the building energy conservation standard, Comprehensive Assessment System for Building Environmental Efficiency, top runner programs, financial incentives, and the dissemination of the Cool Biz concept. Finally, the projections of CO 2 emissions until 2050 are presented.Energy Efficiency

The United Nations' (UN) sustainable development goals (SDGs), the core of the 2030 Agenda for Sustainable Development and the UN Paris Agreement, were adopted in 2015. Involvement of not only national governments but also all other stakeholders including local governments is important to promote sustainable development and to achieve the goals. The question arises, therefore, of what methods should be used to best implement and assess sustainability issues at a local level. In this light, a new version of Comprehensive Assessment System for Built Environment Efficiency (CASBEE), CASBEE for Cities, is introduced for assessing the sustainability of cities and communities around the world based on SDG indicators and greenhouse gas (GHG) emissions. The tool allows users to understand the sustainability of cities and communities based on quality (Q) and environmental load (L) perspectives. The sustainability assessments show that cities in developed countries tend to have good grades for Q, but bad grades for L, while cities in developing countries tend to have the opposite trend. This will assist cities and communities in both developed and developing countries to understand urgent problems and to identify effective solutions for sustainable development.

Previous studies have revealed the relationships between specific residential environmental factors and residents' health status. However, no study has considered the comprehensive health risk due to the overall residential environment. Therefore, a large‐scale nationwide questionnaire survey was conducted using the CASBEE Health Checklist to examine the residential environment of detached houses and residents' health status. This analysis indicated that the overall residential environment is likely an important determinant of health and was associated with disease prevalence among residents.

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