The SARS-CoV-2 pandemic has highlighted the critical deficiency of infectious disease (ID) specialists, a subspecialty that remains underrepresented among Japanese medical students. This nationwide cross-sectional survey was administered between April and August 2024 via an online questionnaire distributed to medical students throughout Japan. The survey assessed awareness of and interest in ID specialization, categorizing students by academic year: lower (first- and second-year students), middle (third- and fourth-year students), and upper grades (fifth- and sixth-year students). Of 502 respondents, data for 492 medical students were eligible, of whom 69.7% demonstrated awareness of ID specialists, with recognition rates increasing proportionally with academic progression.  Regarding career aspirations, 9.8% of respondents expressed interest in pursuing ID specialization, with the highest proportion observed among upper-grade students (19.4%). Male students (14.8%) expressed greater interest in ID specialization than female students (5.2%). The pandemic positively influenced 5.5% of students to consider ID specialization as a future career, whereas only 0.6% reported a negative impact. These findings underscore the necessity of enhanced educational initiatives to promote ID specialization among medical students, addressing current shortages and future infectious disease preparedness.

Purpose: Improving physical activity (PA) is important in patients with chronic obstructive pulmonary disease (COPD). Goal setting can be a possible intervention, but its effect cannot be maintained for six months. We evaluated the effects of providing an individualized target step count, reflecting the disease condition of each patient, on PA and other factors, such as myokines, after six months in patients with COPD. Patients and methods: We performed a randomized parallel group, open-label study (INTAR-Step study) between the target provision (intervention) group and the usual care (control) group and investigated differences in the proportion of subjects who achieved the target as a primary endpoint and differences in changes in PA parameters and myokines as secondary endpoints. This study was registered with UMIN-CTR (UMIN000046390, January 13, 2022). Results: A total of 73 patients were analyzed (intervention, n=38; control, n=35). The proportion of participants in the intervention group who achieved their target step count did not show a significant increase relative to the control group (p=0.157). However, the change in step count, and change in duration of activity at ≥3.0 metabolic equivalents were significantly increased in the intervention group. The Changes in the Growth differentiation factor-15 (GDF-15), fatty acid-binding protein-3, and Irisin levels also increased in the intervention group. Furthermore, GDF-15 levels were significantly higher in patients with increased step counts than in those with decreased step counts. Conclusion: Providing individualized step targets did not increase the proportion of subjects who achieved their targets, but it increased their step counts after six months. GDF-15 may be involved in the increase in the step count.

Additional file 6. The complete response data of the expert survey.

Additional file 6. The complete response data of the expert survey.

Additional file 3. All article list included in this study.

Additional file 3. All article list included in this study.

Supplementary Material 1

Supplementary Material 1

Additional file 1: S. Table1. Baseline characteristics of patients with RA who enrolled in the annual RA survey.

Additional file 1: S. Table1. Baseline characteristics of patients with RA who enrolled in the annual RA survey.