Systematic Model Research Articles

Indian Ocean Intermediate Water Masses and Their Simulations by CMIP6 Models

Abstract Water masses are carriers of anthropogenic fingerprints in the ocean interior, with their property changes manifesting oceanic thermodynamic responses to climate change. Yet, delimiting ocean water masses remains challenging in either observational atlas or climate models. This study analyzes the distribution of Indian Ocean seawater in the density–spicity space and uses volumetric maxima and minima between σ = 27.1 and 27.4 kg m−3 to track the cores and boundaries of intermediate water masses, respectively. In addition to the well-known Antarctic Intermediate Water (AAIW) and Red Sea–Persian Gulf Intermediate Water (RS-PGIW), two other water masses are identified by the new approach. One is the Indian-AAIW (I-AAIW), as a mixture of the AAIW and the Indonesian Throughflow water, existing in the South Equatorial Current and the Agulhas Current system. The other [equatorial Indian Intermediate Water (EIIW)] exits in the equatorial Indian Ocean and Bay of Bengal, sourced from the RS-PGIW and overlying fresh waters. These waters are corroborated by nutrient and dissolved oxygen data. Around half (26 out of 51) of phase 6 of the Coupled Model Intercomparison Project (CMIP6) models can reasonably simulate these intermediate water masses. Compared with the observed water masses, the intermediate water masses in models are of a smaller thickness and the RS-PGIW is colder and fresher. The former arises from a warm bias in the thermocline, whereas the latter is likely linked to insufficient ventilation in the Red Sea and Persian Gulf in models owing to coarse grid resolution and a surface cold bias. Significance Statement Oceanic water masses are important for understanding climate change. Yet, the definition of water masses is controversial. Here, we use volumetric minima in the density–spicity space to track the boundaries of intermediate (27.1–27.4 kg m−3) water masses in the Indian Ocean. We identify four water masses: AAIW, I-AAIW, EIIW, and RS-PGIW. We delineate the geographical location of each water mass, including two newly identified water masses (I-AAIW and EIIW). We also examined the performance of 51 CMIP6 models in simulating these water masses and found that 26 models can reasonably simulate the distribution of these water masses. There are two systematic model biases emerging from these models. The intermediate water masses in models are of a thinner thickness arising from a warm bias in the thermocline, and the RS-PGIW is colder and fresher owing to insufficient ventilation in the Red Sea and Persian Gulf. These results provide a useful benchmark for understanding water masses in a changing climate and constraining climate models.

Dynamic characteristics and transmission efficiency of energy-harvesting shock absorber with low speed and heavy duty capacity

Traditional hydraulic shock absorbers commonly encounter challenges such as cavitation, oil leakage, and the management of energy dissipation. The proposed regenerative shock absorber, which utilizes a ball screw mechanism, offers advantages such as high efficiency and heavy load capacity. This paper focuses on the design, modeling, and testing of a mechatronic shock absorber. Virtual prototype simulation techniques are employed to investigate the dynamic behaviors of the shock absorber. The paper presents a systematic efficiency model of a shock absorber, which is based on the ball screw and gearbox mechanisms. The study comprehensively analyzes the effects of rotation speed, axial load, and structure parameters on transmission efficiency. The results demonstrate that a peak power of 38 W can be achieved with a damping force of only 340 N, and the recovery efficiency can reach up to 28%. The experimental test results validate the effectiveness and reliability of the proposed dynamic and efficiency models. The originality of this study lies in the development of a novel energy-harvesting shock absorber with a ball screw mechanism in series with a gearbox, which shows excellent energy recovery potential and transmission efficiency under low speed and high duty conditions.

Subductability of continental lithosphere

Multiple lines of evidence from geological and geophysical observations indicate the deep subduction of continental lithosphere; however, the potential and driving forces of (self-sustained) continental subduction remain unclear. Here, systematic thermal-petrological models were conducted to quantitatively evaluate the subductability of continental lithosphere by analyzing its density structure and slab-pull evolution during subduction. The results indicate that the metamorphic densification of deeply subducted continental lithosphere (upper, middle, lower crust and lithospheric mantle) could provide considerable driving force for continental deep subduction. The numerical models further indicate that, if a Phanerozoic or Proterozoic continental lithosphere is dragged to a large depth of >300 km, then the continental slab pull overcomes the overall resistance force. Consequently, the continental subduction occurs self-consistently without any drag from the preceding oceanic slab. For Archean continental lithosphere, it is more difficult for self-sustained subduction to occur, due to the highly depleted mantle composition. In addition, we also systematically quantified the effects of multiple factors, including the scraping of continental crust, subduction velocity, subduction angle, and variable bulk-rock compositions of continental crust. Finally, a representative case study of the Himalayan orogen revealed that the slab pull of presently subducting Indian continental lithosphere ranges from 13 TN/m to 29 TN/m, providing a major contribution for the ongoing India-Asia collision.

Effect of Coupling Impedance on Stability Assessment of Grid-Forming Converters Under Various Grid Conditions

The phenomenon of frequency coupling is widely observed in grid-forming (GFM) converters due to the presence of asymmetrical controls and nonlinear blocks. However, the factors influencing frequency coupling have not been thoroughly explored. This paper introduces a systematic small-signal impedance model of GFM converters that intuitively reflects the factors affecting frequency coupling and provides a detailed analysis of how coupling impedance affects stability. It is demonstrated that the influencing factors of coupling impedance are an active power loop and reactive power loop. Specifically, the active power loop influences coupling impedance characteristics near the fundamental frequency, while the reactive power loop impacts the entire frequency range. This paper first reveals that the reactive power loop has a more pronounced effect on frequency coupling than the active power loop. Additionally, the variation in the steady-state operating points also affects the degree of frequency coupling of the GFM converters, primarily affecting the coupling impedance characteristics beyond the fundamental frequency, and the low operating points tend to affect system stability adversely. Finally, simulation results validate the accuracy of the mathematical model and theoretical analysis.

Fidaxomicin resistance in Clostridioides difficile: a systematic review and predictive modeling with RNA polymerase binding sites.

Fidaxomicin (FDX), an RNA polymerase (RNAP) inhibitor antibiotic, is a guideline-recommended therapy for Clostridioides difficile infection. Mutations associated with reduced FDX minimum inhibitory concentrations (MICs) have been identified. However, the molecular characterization of these mutations on FDX binding and the development of FDX resistance have not been studied. The purpose of this systematic review was to identify FDX resistance in C. difficile isolates and determine whether single nucleotide polymorphisms associated with increased FDX MIC aligned with the RNAP binding pocket interacting residues. A systematic literature search was done in PubMed (1991-2023) with identified articles and their bibliographies searched for papers that included C. difficile genetic mutations and increased FDX MIC. Visualization of FDX-RNAP interactions was performed on Schrödinger Maestro using the publicly available C. difficile RNAP with fidaxomicin sequence (code 7L7B) on the Protein Data Bank. Seven articles were identified after applying inclusion and exclusion criteria. The most common mutation in clinical and laboratory isolates was at position V1143 of the β subunit, which accounted for approximately 50% of the identified mutations. Most other mutations occurred within the β' subunit of RNAP. Approximately one-third of the identified mutation aligned directly with FDX interacting residues with C. difficile RNAP (7/20) with most of the remainder occurring within 5 Å of the binding residues. C. difficile strains with elevated FDX MIC align closely with the known RNAP binding residues. These data demonstrate the potential to identify genomic methods to identify emerging FDX resistance.

Possibilities and limitations of computer assisted chiral HPLC method development for ozanimod on polysaccharide based chiral stationary phases.

In this study, a direct HPLC method was developed to determine the enantiomeric purity of the immunomodulatory drug, ozanimod. A systematic method development process was followed, incorporating risk assessment, identification of critical analytical procedure parameters, initial screening of stationary phases, and software-assisted optimization of method parameters. Eight different polysaccharide-based chiral columns were selected to assess chiral separation of enantiomers under polar organic elution mode. The most promising results were obtained using a methanol:2-propanol mixture on the amylose-based Chiralpak AD column. Following this, systematic modeling was conducted using DryLab software to optimize method conditions, including isocratic eluent composition, temperature, and flow rate. Baseline separation was achieved within fifteen minutes using the optimized parameters: Chiralpak AD column thermostated at 10°C, and a mobile phase of methanol:2-propanol: diethylamine, 70:30:0.1 (v/v/v %), delivered at a flow rate of 0.8 mL/min. The developed method was validated according to current guidelines and in silico robustness testing was conducted to determine tolerance limits for critical separation parameters and their impact on enantioresolution. Our findings demonstrate the utility of DryLab, typically employed for reversed-phase achiral separations, in optimizing chiral methods even in polar organic mode. Limitations of the selected approach the development of chiral separation methods are also highlighted.

Optimizing Railway Tribology: A Systematic Review and Predictive Modeling of Twin-Disc Testing Parameters

Twin-disc testing is crucial for understanding wheel–rail interactions in railway systems, but the vast array of testing parameters and conditions makes data interpretation challenging. This review presents a comprehensive analysis of the twin-disc literature experimental data, focusing on how various parameters influence friction and wear characteristics under stationary contaminant conditions. We systematically collected and analyzed data from numerous studies, considering factors such as contact pressure, speed, material hardness, sliding speeds, adhesion, and a range of contaminants. This research showed inconsistent data reporting across different studies and statistical analyses revealed significant correlations between testing parameters and wear rates. For sand-contaminated tests, a correlation between particle size and flow rate was also highlighted. Based on these findings, we developed a simple predictive model for forecasting wear rates under varying conditions. This model achieved an adjusted R2 of 0.650, demonstrating its potential for optimizing railway component design and maintenance strategies. Our study provides a valuable resource for researchers and practitioners in railway engineering, offering insights into the complex tribological interactions in wheel–rail systems and a tool for predicting wear behavior.

Two methods to analyze radial diffusion ensembles: The perils of space- and time-dependent diffusion

Particle dynamics in Earth's outer radiation belt can be modeled using a diffusion framework, where large-scale electron movements are captured by a diffusion equation across a single adiabatic invariant, L*(L). While ensemble models are promoted to represent physical uncertainty, as yet there is no validated method to analyze radiation belt ensembles. Comparisons are complicated by the domain dependent diffusion, since diffusion coefficient DLL is dependent on L. We derive two tools to analyze ensemble members: time to monotonicity tm and mass/energy moment quantities N,E. We find that the Jacobian (1/L2) is necessary for radiation belt error metrics. Components of ∂E/∂t are explicitly calculated to compare the effects of outer and inner boundary conditions, and loss, on the ongoing diffusion. Using tm, N, and E, we find that: (a) different physically motivated choices of outer boundary condition and location result in different final states and different rates of evolution; (b) the gradients of the particle distribution affect evolution more significantly than DLL; (c) the enhancement location, and the amount of initial background particles, are both significant factors determining system evolution; (d) loss from pitch-angle scattering is generally dominant; it mitigates but does not remove the influence of both initial conditions and outer boundary settings, which are due to the L-dependence of DLL. We anticipate that this study will promote renewed focus on the distribution gradients, on the location and nature of the outer boundary in radiation belt modeling, and provide a foundation for systematic ensemble modeling.

Unraveling the Potential of Blockchain Technology in Enhancing Supply Chain Traceability: A Systematic Literature Review and Modeling with ISM

Unraveling the Potential of Blockchain Technology in Enhancing Supply Chain Traceability: A Systematic Literature Review and Modeling with ISM

Multiscale-informed irradiation growth model of Zr-Sn-Nb alloys

A systematic multiscale-informed model is developed to predict the irradiation growth behavior of Zr-Sn-Nb alloys, which considers the anisotropy and temperature dependence of both plasticity and irradiation, as well as the alloying effect of Zr alloys. This model consists of a cluster dynamics submodel to consider the kinetics of irradiation defect, an alloying effect submodel informed by atomic simulations and experiments, a microstructure transition submodel derived from discrete dislocation dynamics, and a continuous irradiation growth submodel based on crystal plasticity. It effectively captures the irradiation-induced coevolution of multiple microstructures, including point defects, mobile clusters, dislocation lines and irradiation loops on the prismatic and basal plane, as well as Nb-induced precipitates. It is suitable for high-dose irradiation conditions as it reasonably considers the transition from high-density irradiation loops to tangled dislocation network. The predicted irradiation growth strain, as well as the density and size of irradiation loops, are in good agreement with almost all the available experiments for pure Zr, Zr-Sn, Zr- Nb, and Zr-Sn-Nb alloys at different irradiation doses in the temperature range of 473 - 673 K. This work is hoped to provide a powerful tool for developing irradiation resistance cladding materials.

Comprehensive theoretical study of the effects of facet, oxygen vacancies, and surface strain on iron and cobalt impurities in different surfaces of anatase TiO2.

We report the results of systematic ab initio modelling of various configurations of iron and cobalt impurities embedded in the (110), (101), and (100) surfaces of anatase TiO2, with and without oxygen vacancies. The simulation results demonstrate that incorporation into interstitial voids at the surface level is significantly more favourable than other configurations for both iron and cobalt. The calculations also demonstrate the crucial effect of the facet as well as the lesser effects of other factors, such as vacancies and strain on the energetics of defect incorporation, magnetic moment, bandgap, and catalytic performance. It is further shown that there is no tendency towards the segregation or clustering of impurities on the surface. The calculated free energies of the hydrogen evolution reaction in acidic media predict that iron impurities embedded in the (101) surface of anatase TiO2 can be a competitive catalyst for this reaction.

Construction Project Organizational Capabilities Antecedent Model Construction Based on Digital Construction Context

In the context of high-quality development and the digital age, digital technology-enabled construction projects have become the only choice to promote organizational capabilities and innovation. However, the micro foundation of the organizational capabilities of construction projects has not been clarified, and its formation path is even less clear. This paper focuses on the characteristics of the times when digital technology and engineering construction are deeply integrated, conducts in-depth research on typical projects in the context of digital construction, and uses the qualitative research method of grounded theory to explore the antecedents of the formation of organizational capabilities. The results of the study establish a systematic antecedent model framework, including value integration, data traction, resource integration, technology integration, digital collaboration, and digital routines, and find out the “black box” process of the formation of construction project organizational capacities under the digital construction context. The conclusion of this study provides a theoretical basis and practical enlightenment for the construction of organizational capabilities of construction projects to cope with technological turbulence.

The Influence of Temperature Disturbance on Space Inertial Sensors.

The TianQin program is an independently proposed space-borne detection initiative from China. The inertial sensor, as a crucial component, is susceptible to disturbances from temperature fluctuations, the impact of which on acceleration measurements remains elusive. Therefore, a comprehensive analysis on the influence of temperature disturbance is necessary to avoid errors in acceleration measurement. In this study, we proposed a complete scheme for calculating the level of acceleration noise. Based on the traditional temperature control scheme of using a heat pipe, we developed a systematic heat transfer simulation model to obtain the temperature signals. These signals can then be converted into the frequency domain and used to calculate the acceleration noise level within the target bandwidth. Our results indicate that, with a temperature control of 0.13 K/Hz1/2@1 mHz, the largest contributions to acceleration noise come from the outgassing effect, radiometer effect, and radiative pressure effect, in descending order. The total noise peak is 3.6×10-12 m/(s2⋅Hz1/2) at 1 mHz, which is more than three orders of magnitude higher than the TianQin target of 10-15 m/(s2⋅Hz1/2). This study provides new avenues for evaluating measurement errors and solutions for the TianQin program.

Development of a systematic referral model to primary care health interventions for patients with atrial fibrillation. a delphi study

Abstract Background The European Society of Cardiology (ESC) guidelines for the management of atrial fibrillation (AF) recommend integrated care in AF, combining medical treatment with lifestyle modifications and psychosocial management in a multi-disciplinary set-up. Research show that patients with AF can benefit from lifestyle interventions and psychosocial management, like patient education. According to World Health Organization recommendations, these health interventions are moving from hospitals to primary healthcare settings. Therefore, patients with AF should be systematically referred to these interventions. Yet, an evidence-based referral model that can support this transition is lacking. Purpose The purpose is to develop a systematic referral model for primary care health interventions for patients with AF. Methods We used the Delphi-technique with three rounds of questionnaires (figure 1). International and national clinical experts in AF across disciplines and health sectors were invited to participate. In the first round, the expert panel evaluated items that could be part of a referral model on relevance, improvability and self-reporting. In the second round, the expert panel evaluated each item as either an inclusion or exclusion criteria, important knowledge to have, or not relevant. In the third round, the expert panel evaluated the items according to data source and outcome status. A final model was drawn based on items reaching consensus. The study was reported according to the guidance on conducting and reporting Delphi studies (CREDES). Results In total, 69 of 139 invited experts accepted to participate (50%). These were mostly academics or clinicians (90%), stemming from primary sector (16%), secondary sector (35%) and research (32%). Most were medical doctors (36%) and nurses (35%). However physiotherapist, psychologists, dieticians, and other disciplines along with six patients with AF were also represented. The expert panel (60% females) had a mean age of 50 years, and 65% were from Denmark. For the final referral model (figure 2), AF symptom burden and impaired health-related quality of life, anxiety and poor medicine compliance combined with a risk factor profile were the main inclusion criteria. Furthermore, it was important to know about the patients’ mental well-being, self-management abilities and comorbidities. Conclusion Consensus was reached for a generic referral model, which can be further adjusted in the appropriate clinical context. The model includes inclusion criteria which closely correlate with guidelines for AF management focusing on reducing the patients’ symptom and risk factor burden. The referral model is expected to increase the number of patients with AF referred to primary care health interventions, which could lead to better quality of life, fewer hospital admissions and lowered health care costs in AF.

In development intervention, professionals aim to enhance working practices and interaction

Abstract Background The social services and healthcare professions are experiencing a global labor shortage. Enhancing the appeal and retention requires the development of work and processes through community-level interventions that reduce workload and bolster resources. Further research into such interventions is necessary. This study focuses on a systematic community-based practice development model (Breakthrough Collaboratives) to evaluate the change in alignment with the development intervention’s objectives and the prerequisites for change. The evaluation will utilize the process evaluation model for well-being at work projects and health promotion interventions. Methods This qualitative process evaluation employs a multi-case study approach to depict the changes occurring during the development intervention. It assesses the development processes of fifteen workplaces across Finland. The research material includes recorded group discussions from the initial workshop, where professionals establish goals and development targets for their work. The qualitative data are analyzed using content analysis. The analysis is guided by questions such as: What goals and development objectives do participants set for their work? What workplace-specific characteristics inform these objectives? Results Preliminary findings indicate that the work units’ development objectives concentrate on updating the unit’s common rules, enhancing the induction process for new employees, improving work behavior, and refining meeting practices. Workplace-specific characteristics differ based on the work unit’s sector, the level of trust among professionals, and their willingness to critically evaluate management. Additionally, competence and professionalism emerge as prominent themes in group discussions. Conclusions In a workplace development intervention, professionals aim to enhance common working practices and interaction, with the goal of improving well-being at work. Key messages • Enhancing operational practices and promoting positive interpersonal conduct among colleagues constitutes a pivotal goal in advancing social and health care work units. • The Community based intervention provides workplaces with concrete models to support co-creation and permanent changes in working practices.

Prevention of sexual exploitation of children in sport clubs and social work in Switzerland

Abstract The Convention on the Rights of the Child, ratified in 1989, provides a clear normative basis for the protection of children from violence, abuse and exploitation. Despite efforts to protect children, many children and young people are victims of sexual violence. In the extracurricular sector, clubs offer great potential for preventing sexual exploitation. However, obstacles such as the taboo nature of the topic and the clubs’ limited resources make it difficult to develop and independently implement specific prevention offers. The aim of the project was to record the activities and competencies of sports clubs, youth associations and other youth organizations in the area of prevention of sexual assault among children and adolescents in the leisure sector and to determine the need for prevention services in the canton of Zurich in Switzerland. In addition, information was obtained on the impact of existing prevention services as well as information on their further development in terms of content and organization. Together, 979 participants from sports clubs, youth associations and youth organizations (e.g. board members, coaches, leaders) as well as the parents of children who are members of these clubs were surveyed. An impact model was developed for systematic modeling, as proposed by “Health Promotion Switzerland”. The prevention of sexualized violence is seen as a very relevant topic by sports clubs, youth associations, open child and youth work and parents. However, the current implementation of prevention measures also shows that there are still barriers to implementation and room for improvement in prevention work. Participants from all areas would particularly like support with advice on how to deal with suspected cases/incidents, the provision of information materials and the creation of a protection concept. Specific ideas for the further development of prevention work were also generated and will be discussed. Key messages • The prevention of sexualized violence is seen as a very relevant topic by sports clubs, youth associations, open child and youth work and parents. • The study reveals that prevention measures are only partially implemented and identifies barriers and facilitators for improvement.

Technology for preventing work-related musculoskeletal injuries in healthcare professionals: A scoping review

Background & Aim: This scoping review aims to identify and summarize how technology can help prevent work-related musculoskeletal injuries in healthcare professionals. Methods & Materials: We conducted a scoping review following the steps provided by the Joanna Briggs Institute. The PRISMA® - Preferred Reporting Items for Systematic Reviews and Meta-Analyses model was used to organize the information, following the recommendations described in PRISMA-ScR (PRISMA Extension for Scoping Reviews) for the article presentation. A search of PubMed, Scopus, and CINAHL databases was conducted for all articles in December 2023. Results: Of the 964 initial articles identified, 7 met the inclusion criteria. The reviewed studies highlight the effectiveness of various technological interventions in reducing musculoskeletal injuries among healthcare professionals. Wearable technologies, such as inertial measurement units, have been effective in promoting correct posture and reducing the risk of musculoskeletal disorders. However, the studies also identified significant challenges, including the generalizability of findings, the need for more robust empirical evidence, and issues related to the long-term sustainability and cost-effectiveness of these technologies. Conclusion: The conclusion of this analysis highlights the need for scalable, effective, and customized therapies and calls for more study and development in gamification, wearable technologies, and tailored mobile applications.

Transmembrane Domains of Bitopic Proteins As a Key to Understand the Cellular Signaling

This work presents in a systematic manner key modeling results corroborated by experimental biophysical data and obtained by the authors during long-term research on bitopic (single-pass) membrane proteins (BMP), which are the crucial elements of cell signaling. The manuscript does not claim to be a comprehensive review on the topic, whereby the authors did not aim to describe accurately the current state of the art, given the numerous reliable publications. Rather, it is an essay illustrating the authors’ understanding of the basic principles in organization of transmembrane protein domains (TMD) and their contribution to the cell functioning. Among the key topics highlighted in the present work are the fine-tuned processes of TMD oligomerization and direct contribution of the dynamic membrane environment to this process, the key role of TMD in the functioning of cell receptors and mutual relations between all components of protein-membrane complexes during the signal transduction in normal and pathological conditions.

MEDEA: A New Model for Emulating Radio Antenna Beam Patterns for 21 cm Cosmology and Antenna Design Studies

In 21 cm experimental cosmology, accurate characterization of a radio telescope’s antenna beam response is essential to measure the 21 cm signal. Computational electromagnetic (CEM) simulations estimate the antenna beam pattern and frequency response by subjecting the EM model to different dependencies, or beam hyperparameters, such as soil dielectric constant or orientation with the environment. However, it is computationally expensive to search all possible parameter spaces to optimize the antenna design or accurately represent the beam to the level required for use as a systematic model in 21 cm cosmology. We therefore present the Model for Emulating Directivities and Electric fields of Antennas (MEDEA), an emulator that rapidly and accurately generates far-field radiation patterns over a large hyperparameter space. MEDEA takes a subset of beams simulated by CEM software, spatially decomposes them into coefficients on a complete, linear basis, and then interpolates them to form new beams at arbitrary hyperparameters. We test MEDEA on an analytical dipole and two numerical beams motivated by upcoming lunar lander missions, and then employ MEDEA as a model to fit mock radio spectrometer data to extract covariances on the input beam hyperparameters. We find that the interpolated beams have rms relative errors of at most 10−2 using 20 input beams or less, and that fits to mock data are able to recover the input beam hyperparameters when the model and mock are derived from the same set of beams. When a systematic bias is introduced into the mock data, extracted beam hyperparameters exhibit bias, as expected. We propose several extensions to MEDEA to potentially account for such bias.

Retrospective Analysis of Cerebrospinal Gushers in Cochlear Implant Surgery: Incidence, Risk Factors, and Outcomes-A Systematic Review and Meta-analysis.

Background: Cerebrospinal fluid (CSF) gusher is a common complication experienced during cochlear implantation in patients with structural deformities in the inner ear. Objectives: This study aimed to investigate the incidence of CSF gusher, risk factors, and outcomes in patients during cochlear implantation. Methods: This systematic review and meta-analysis were guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses model. Studies used in the analysis were identified through a comprehensive search in Google Scholar and PubMed. Results: The analysis was performed using 13 retrospective studies. The incidence of CSF gusher was 5% (95% CI: 3%-9%). CSF gusher was more prevalent among patients with inner-ear malformation (IEM) than without IEM odds ratio = 63.01 (95% CI: 9.85-403.11, P < .00001, I2 = 88%). For incomplete partition (IP), CSF gusher in the IP-I group was 48% (95% CI: 25%-71%, I2 = 0%), 19% in IP-II, 86% in IP-III, 40% in the common cavity, 26% in cochlear hypoplasia, and 27% in patients with enlarged vestibula aqueduct. Conclusion: The CSF gusher incidences were determined to be 5%. Patients with IEM are at increased risk of experiencing CSF gusher during cochlear implant surgery. Therefore, precise scanning reports should be produced in preoperational phase to inform proper management techniques to reduce the chances of intraoperative complications, including CSF gusher.