A Study of African International Students in Japan: Analyzing the Process of Their Destination Choice

This paper aims to examine the current situation of acceptance international students from African countries and clarify issues of Japanese strategy. In particular, this focuses on the process of selecting Japan as a study abroad destination, and analyze the issues of acquisition strategies for international students in Japanese context. Since 2008, a national strategy called ‘300000 Foreign Students Plan’ and ‘Tokyo International Conference on African Development’ have called for the need to accept African international students. Government has increased the number of scholarship programs for African students, in addition, they established the new scholarship programs only for African students known as ABE Initiatives. For this strategy, large amount of national budget has been contributed. Under these national strategy, African students are regarded as human resources expected to connect Japan and Africa. The study utilizes the data collected from 16 African international students interviews and questionnaires from 90 foreign students. In the findings, some students come to Japan without the academic information. In addition, some students used social media as their primary means of information gathering in their destination choice. From this result, it can be considered that the image before studying abroad have become increasingly diversified from the actual situation. In the findings, the interest in working in Japan or Japanese-overseas companies was also confirmed. It means some students have career awareness that could be a bridge between Japan and Africa. However, in Japan, little career support is available among the students. Whether they are willing to build a positive relationship with their countries and Japan or not, they are just accepted and leave with little interest in Japanese society. These results imply a microcosm of the superficial relationship in higher education between Japan and Africa. Some African students decide to study Japan due to vague image. In Japanese society, there is not much interest about African students, who can be highly talented personnel both for Japan and for Africa. Even the strategy has been promoted by a huge amount of national budget. It is required to reconsider, in what purpose Japan accept international students from Africa, and what each stakeholder can do for the improvement of higher education in Japan and Africa.本研究は、平成30年度学生支援の推進に資する調査研究事業「アフリカの留学生を支援する制度・課題に関する国際比較研究」（研究代表者：川口純）の一環として、日本学生支援機構より支援を受け、実施したものである

心不全増悪で再入院した高齢患者の入院中と退院後の心不全増悪に関する認識の変化

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Recent Advances in Endosonography—Elastography: Literature Review

Ultrasonographic elastography is a modality used to visualize the elastic properties of tissues. Technological advances in ultrasound equipment have supported the evaluation of elastography (EG) in endosonography (EUS). Currently, the usefulness of not only EUS-strain elastography (EUS-SE) but also EUS-shear wave elastography (EUS-SWE) has been reported. We reviewed the literature on the usefulness of EUS-EG for various diseases such as chronic pancreatitis, pancreatic solid lesion, autoimmune pancreatitis, lymph node, and gastrointestinal and subepithelial lesions. The importance of this new diagnostic parameter, “tissue elasticity” in clinical practice might be applied not only to the diagnosis of liver fibrosis but also to the elucidation of the pathogeneses of various gastrointestinal diseases, including pancreatic diseases, and to the evaluation of therapeutic effects. The most important feature of EUS-EG is that it is a non-invasive modality. This is an advantage not found in EUS-guided fine needle aspiration (EUS-FNA), which has made remarkable progress in the field of diagnostics in recent years. Further development of artificial intelligence (AI) is expected to improve the diagnostic performance of EUS-EG. Future research on EUS-EG is anticipated

Factors Affecting Technical Difficulty in Balloon Enteroscopy-Assisted Endoscopic Retrograde Cholangiopancreatography in Patients with Surgically Altered Anatomy

Success rates of balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (BE-ERCP) for patients with a reconstructed intestinal tract after surgical procedures are unsatisfactory. We retrospectively investigated the factors associated with unsuccessful BE-ERCP. Ninety-one patients who had a reconstructed intestinal tract after gastrectomy or choledochojejunostomy were enrolled. Age, sex, operative method, malignancy, endoscope type, endoscopist’s skill, emergency procedure, and time required to reach the papilla/anastomosis were examined. The primary endpoints were the factors associated with unsuccessful BE-ERCP selective cannulation, while the secondary endpoints were the rate of reaching the papilla/anastomosis, causes of failure to reach the papilla/anastomosis, cannulation success rate, procedure success rate, and rate of adverse events. Younger age (odds ratio, 0.832; 95% CI, 0.706–0.982; p = 0.001) and Roux-en-Y partial gastrectomy (odds ratio, 54.9; 95% CI, 1.09–2763; p = 0.045) were associated with unsuccessful BE- ERCP. The rate of reaching the papilla/anastomosis was 92.3%, the success rate of biliary duct cannulation was 90.5%, procedure success rate was 78.0%, and the rate of adverse events was 5.6%. In conclusion, Roux-en-Y partial gastrectomy and younger age were associated with unsuccessful BE-ERCP. If BE-ERCP is extremely difficult to perform in such patients after Roux-en-Y partial gastrectomy, alternative procedures should be considered early