{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:23:04Z","timestamp":1786123384031,"version":"build-2736575974"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp;amp; Neck"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Surgeons performing open thyroidectomy are prone to ergonomic strain due to head\u2010mounted lighting, prolonged static posture, and repetitive fine\u2010motor activity. Limited objective data exist on ergonomic stress in endocrine surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This prospective observational pilot study was conducted in a tertiary endocrine surgery department. Thirty\u2010two open hemithyroidectomy cases were evaluated. Surgeons were divided into operating and assistant cohorts. Pre\u2010 and post\u2010operative assessments included salivary biomarkers (AST, CK, LDH), hand grip strength, and Rapid Upper Limb Assessment (RULA) scoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Operating surgeons demonstrated significant rises in salivary CK (3.5\u2009\u2192\u200911\u2009U\/L), AST (3.8\u2009\u2192\u200915\u2009U\/L), and LDH (102\u2009\u2192\u2009370\u2009U\/L) (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with a modest, non\u2010significant decline in grip strength. Assistant surgeons showed significant increases in CK (4.9\u2009\u2192\u200916.85\u2009U\/L) and AST (19\u2009\u2192\u200932.8\u2009U\/L), a slight reduction in LDH, and a significant improvement in grip strength (201\u2009\u2192\u2009535.5\u2009N,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). RULA scores indicated greater ergonomic strain in operating surgeons (median 4) compared to assistants (median 3,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Open thyroidectomy imposes considerable ergonomic and physiological stress, with operating surgeons bearing higher strain from static posture and awkward positioning. Assistant surgeons experience different but measurable patterns of muscular activation. This study highlights the feasibility of combining salivary biomarkers, grip strength, and RULA scoring for ergonomic assessment and emphasizes the need for ergonomic awareness in surgical training.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70266","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T09:11:27Z","timestamp":1775639487000},"page":"2483-2490","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prospective Evaluation of Surgical Ergonomics Among Endocrine Surgeons in Open Thyroidectomy: A Pilot Study"],"prefix":"10.1002","volume":"48","author":[{"given":"Rajni K.","family":"Sah","sequence":"first","affiliation":[{"name":"Department of Endocrine Surgery Sanjay Gandhi Postgraduate Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2621-394X","authenticated-orcid":false,"given":"Mayilvaganan","family":"Sabaretnam","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery Sanjay Gandhi Postgraduate Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyan","family":"Chand","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery Sanjay Gandhi Postgraduate Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjali","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery Sanjay Gandhi Postgraduate Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4194-2670","authenticated-orcid":false,"given":"Gaurav","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery Sanjay Gandhi Postgraduate Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Raghvendra","sequence":"additional","affiliation":[{"name":"Department of Pathology and Biochemistry Sanjay Gandhi Postgraduate Institute of Medical Sciences  Lucknow India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"e_1_2_15_2_1","first-page":"1","article-title":"The Discipline of Ergonomics and Human Factors","volume":"27","author":"Karwowski W.","year":"2006","journal-title":"Handbook of Human Factors and Ergonomics"},{"issue":"6","key":"e_1_2_15_3_1","first-page":"1321","article-title":"Robotics and Ergonomics","volume":"1","author":"Stylopoulos N.","year":"2003","journal-title":"Surgical Clinics"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2009.10.017"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2017.12.013"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/01945998221117095"},{"issue":"6","key":"e_1_2_15_7_1","first-page":"1243","article-title":"Ergonomics and Musculoskeletal Disorders Among Health Care Professionals: Prevention Is Better Than Cure","volume":"72","author":"Mansoor S. 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