Lifestyle migrants annually travel to a given destination and live there for a certain period of time. The extended sojourn leads to the issue of social integration, which plays a crucial role in relieving conflicts and constructing a harmonious society. However, existing studies have paid little attentions to the measurement of the social integration of lifestyle migrants. To address this research gap, this study explores the meaning and structure of lifestyle migrants’ integration, and develops a measurement model to better understand the dynamic process of integration. The reliability and validity of the assessment were tested with exploratory factor analysis and confirmatory factor analysis, and measurement invariance was conducted to further validate the scale. The results disclosed three dimensions of the social integration of lifestyle migrants: emotional attachment, cultural adaptation, and social participation. This measurement is an addition to existing literature and can serve as a foundation for future research. The scale also provides a practical instrument for monitoring the integration of lifestyle migrants, which has many implications for the destination management and planning.

Objective: To simplify Foley catheter-assisted thrombectomy to a six-step approach and determine the feasibility and results of this technique for renal cell carcinoma (RCC) with a Mayo level II to IV tumor thrombus (TT). Methods: The surgical records of patients with RCC with a Mayo level II to IV TT treated in our hospital were retrospectively reviewed. Fifteen patients who underwent radical nephrectomy and thrombectomy with a Foley catheter-assisted procedure were included. Epidemiological and clinicopathological features, operation-related variables, and outcomes were evaluated. Results: The TTs in all 15 patients were successfully retracted by the Foley catheter. The mean operation time was 420.1 ± 108.9 minutes. The mean intraoperative blood loss and perioperative red blood cell transfusion volumes were 1846.7 ± 1467.8 and 1288.7 ± 1060.6 mL, respectively. Five patients had perioperative complications. The median follow-up time was 9 (range, 0–34) months, and four patients died of the disease. Conclusions: Simplification of Foley catheter-assisted thrombectomy to a six-step approach results in the probability of avoiding thoracotomy or cardiopulmonary bypass to a certain degree and is associated with fewer complications, less blood loss, and less perioperative red blood cell transfusion. However, experienced surgeons and multidisciplinary cooperation are still needed.

Background: Surgical treatment for renal cell carcinoma (RCC) and inferior vena cava (IVC) tumor thrombus (TT) is difficult, and the postoperative complication rate is high. This study aimed to explore the safety and oncologic outcomes of neoadjuvant stereotactic ablative body radiotherapy (SABR) combined with surgical treatment for RCC and IVC-TT. Methods: Patients with RCC and IVC-TTs were enrolled in this study. All patients received neoadjuvant SABR focused on the IVC at a dose of 30 Gy in 5 fractions, followed by 2 ~ 4 weeks of rest. Then, radical nephrectomy and IVC tumor thrombectomy were performed for each patient. Adverse effects, perioperative outcomes, and long-term prognoses were recorded. Results: From June 2018 to January 2019, 8 patients were enrolled—4 with Mayo grade II TT and 4 with Mayo grade III TT. Four (50%) patients had complicated IVC wall invasion according to CT/MRI. All patients received neoadjuvant SABR as planned. Short-term local control was observed in all 8 patients. Only Grade 1–2 adverse events were reported. In total, 3 (37.5%) laparoscopic surgeries and 5 (62.5%) open surgeries were performed. The median operation time was 359 (IQR: 279–446) min, with a median intraoperative bleeding volume of 750 (IQR: 275–2175) ml. The median postoperative hospital stay was 7 (5–10) days. With a 26-month (range: 5–41) follow-up period, the estimated mean overall survival was 30.67 ± 5.38 months. Conclusions: This is the first preoperative radiotherapy study in Asia that focused on patients with TT. This study revealed the considerable safety of neoadjuvant SABR for RCC with IVC-TT. Trial registration: This study was registered in the Chinese Clinical Trials Registry on 2018-03-08 (ChiCTR1800015118). For more information, please see the direct link (https://www.chictr.org.cn/showproj.html?proj=25747).

Measuring destination attractivity and finding the determinants of attractivity at the county scale can finely reveal migration flows and explain what kinds of counties have higher attractivity. Such understanding can help local governors make better policies to enhance county attractivity and attract more migrants for regional development. In this study, the county-scale relative intrinsic attractivity (RIA) of Guangdong Province is computed using the number of migrants and the corresponding distances between origins and destinations. The results show that the RIA has a higher positive correlation with the flows of migrants to destination and demonstrates an obvious phenomenon of distance decay. The RIA decreases faster when the distance between origins and destinations increases. Spatially, the RIA reveals a core-periphery belt pattern in Guangdong Province. The center of the Pearl River Delta is the highest core of RIA and the outside areas of the delta represent the low-RIA belt. The highest RIA is 6811 in Dongguan City and the lowest RIA is 1 in Yangshan County. The core area includes Dongguan, Shenzhen City and the southern regions of Guangzhou, Foshan and Zhongshan City where the RIA value is higher than 1000. The second belt is mainly composed of the periphery districts of the Pearl River Delta, which include Shunde, Nanhai, Luohu, Tianhe Huicheng, Panyu, Haizhu, Huiyang, Huadu, Yuexiu, Xiangzhou and the Yuexiu, Huangpu and Boluo, where the RIA values are higher than 100 and lower than 1000. The third belt includes the western wing, eastern wing and northern area. Most of these RIA values range from 1 to 2. In this belt, there are three areas with relatively higher RIA attractivity scattered in the ring: the downtowns of Zhanjiang City, Chaozhou and Shantou Cities and Shaoguan City. The areas farther away from the core have a lower RIA score. Determinants analysis indicates that the RIA is positively determined by destination economic development level, social service and living standard level and destination population quality. A region will be more attractive if it has higher per capital GDP, tertiary industry level, investment and number of industrial enterprises involved in economic development. A region with a high annual average wage of employees and high social service and living standards will be more attractive, while a region with low destination population quality, including aspects such as the adult illiteracy rate, will be less attractive.

The present study aimed to develop an accurate preoperative scoring system to predict the probability of using laparoscopic surgery in radical nephrectomy and thrombectomy. The clinical data of 123 patients with renal cell carcinoma with renal vein or inferior vena cava tumour thrombus admitted to the Department of Urology at Peking University Third Hospital between January 2015 and May 2018 were retrospectively analysed. Univariate and multivariate regression analyses were used to create the scoring system with an emphasis on the area improvement under the receiver operating characteristic curve. A total of 58 (47.2%) patients underwent complete laparoscopic surgery, 56 (45.5%) underwent complete open surgery and 9 (7.3%) underwent laparoscopic conversion to open surgery. The final multivariable model included the following three factors: Clinical node stage (P=0.030), Mayo classification (P<0.001) and tumour diameter (P=0.001). These three variables were then used to construct the score system named Peking University Third Hospital Laparoscopic Probability (PKUTHLP), which ranges from 0–5. The proportion of patients undergoing laparoscopic surgery for each level of the PKUTHLP score were as follows: 0 (n=20), 100%; 1 (n=34), 67.6%; 2 (n=21), 33.3%; 3 (n=21), 19.0%; 4 (n=23), 17.4%; and 5 (n=4), 0.0%. Overall, the PKUTHLP score accurately predicted the probability of using laparoscopic surgery in radical nephrectomy and thrombectomy; however, prospective validation of the PKUTHLP scoring system is required.

Tourist perceived value is an important antecedent to loyalty by enhancing satisfaction, revisiting intentions, and recommendations, thereby promoting sustainable development of forest parks. However, existing research has not sufficiently examined the configurations of perceived value in relation to increasing tourist loyalty specifically in the context of forest parks, representing a notable gap in the existing literature that requires further investigation. To address this gap, both covariance-based structural equation model (CB-SEM) and fuzzy-set qualitative comparative analysis (fsQCA) models were conducted to explore the joint effects of perceived value on tourist loyalty and identify pathways of perceived value dimensions to increase tourist loyalty, based on the Value-Satisfaction-Loyalty Chain model. A total of 404 valid questionnaires were collected from 436 visitors to the Yingde National Forest Park in southern China. Among the respondents, 54.2% were male, nearly 50% were over 36 years old, and 60% held a university degree. The results indicate that perceived value significantly influences tourist loyalty, with satisfaction playing a crucial mediating role between perceived value and loyalty. Notably, the indirect effect mediated by satisfaction was found to be greater than the direct effect of perceived value on loyalty. Five distinct pathways were identified for enhancing tourist loyalty, categorized into three models: the economic value-driven model, the functional value and epistemic value dual-core driven model, and the emotional and social value dual-core driven model. Additionally, four pathways were identified for enhancing tourist satisfaction, which subsequently improves tourist loyalty. These four pathways were grouped into two modes: the economic value-driven model and the functional value plus driven model. This study introduces an innovative perspective on the relationship between tourist perceived value and loyalty in forest parks, identifying key factors and configurations within the five dimensions of perceived value that enhance both tourist loyalty and satisfaction. Moreover, it extends the application of the Value-Satisfaction-Loyalty Chain theory to a forest park context. The findings provide valuable insights for forest park managers, guiding them in enhancing perceived value through targeted pathways to increase tourist revisit intentions and recommendations, ultimately supporting the park’s sustainable development. The influence of individual items on tourist satisfaction and loyalty, along with the identification of optimal item combinations to enhance loyalty, necessitates further investigation. Furthermore, a deeper exploration of the heterogeneity of factors and pathways for improving tourist loyalty is required.