going to get started with the next talk. And this talk is our great friend, John Cable. I forgot to tell you, if you can't figure that out, John ain't from these parts. He's from Massachusetts. So, and how appropriate is this? Because the John J. Cahill Memorial Lecture in Aerospace Medicine, this prestigious lecture is given each year in honor of John J. Cahill, fellow of the American Ossetia of the College of Occupational Event of Medicine. He was a founding member of the College and Division of the Aerospace Medicine. He was born on June 6th, 1920 in Roxbury, Mass, and died on February 12th, 1995 in Keller, Texas. While serving in the Navy during the Korean War, Dr. Cahill became interested in aviation. After completing his Navy tour, he attended the Kansas City College of Osteopathic Medicine. After graduation, he completed his residency in Nebraska and then moved to Arizona. In October of 58, Cahill obtained his Arizona osteopathic physician license and next went into private practice. During the summer of 1969, the FAA beckoned and Dr. Cahill moved to Kansas City to begin his career in aerospace medicine. From Kansas City, he moved to Boston, where in 71, he was the first New England regional flight surgeon. He served as president of the college in 1985 and was designated as a fellow that same year. He contributed greatly to the college, to osteopathic medicine, and to the field of aerospace. Established in 1991, the John J. Cahill Memorial Lecture in Aerospace Medicine is presented by an individual member or non-member who has demonstrated a desire to see the field of aerospace medicine excel for the public good. All right, here you go. Oh, you want to take it, here. She actually is looking catty in the room. That's right. There you go. All right, there you go. Speaking of catties or golfers, who in an aviation accident, not necessarily flying because they fell asleep, but flying because what happened to the aircraft? Score. Correct, and this whole aircraft, I guess they got hypoxic, froze over, and sadly, they had an aircraft interceptor ready to shoot it down if, in fact, it was going to crash over a populated area, and I guess apparently went into the mountains, and so- I didn't see it. No, but at least unharmed, you know. Oh, God. So, you know, sad scenario, obviously, but once again, in aviation, there are risks involved, and again, the pilot's, you know, an unrecognizable process. I think one of the four people on board, they'd all just fallen asleep based on the hypoxic scenario. So once again, thank you, and thank you for the award, and I guess appropriately, as I said, I do know that the New England Regional is in Burlington, Mass., which is right next to where I grew up, Wilmington, Mass., so I think we used to beat them in Pubwana football, so on that, pretty good, but again, thank you for that award. I truly appreciate it. Real quick, I'm gonna be talking about United States Army Aeromedical Laboratory, kind of alluded to it earlier when we talked about the study we had done. What a valuable resource. Anyone military-wise outside the aeromedical community that comes here, a lot of our aviation brethren, the commanders and that, even some of our local population come there, and they're just amazed what we have available. Of course, I know the Air Force and Navy have their own labs as well. However, this is more dedicated to rotary wing, per se. We do do some fixed-wing issues and operations that we look at, but one of the things that's unique, or we kind of evolved, is also taking care of some of our ground troops, and because one thing, and we'll talk about this, certainly a lot of stuff we study as far as impact, equipment, helmets, and that, certainly go throughout our military as far as tank drivers, ATVs, and even to include like Coast Guard and Navy, some of the impact on those vehicles or the boats they use on high surfs and things. I mean, you're getting the same type impacts. A lot of our craft impacts occur. So once again, let me just read the objective real quick. Again, for this, participating in the lecture, identify unique capabilities available at the U.S. Army Aeromedical Research Lab, USAREL, explain the mission and vision of USAREL, including not only aviation, but ground warriors as well, and also, I think Dr. Silverman may have been there at one point. We just had our 60th anniversary this past December, so 60 years old since the inception of this for the Army, and who, history-wise, Mr. Dan, who was the first originator of the U.S. Army Aeromedical Research Lab? It is now named after that person as well, Robert. Close, but no cigar. He was a confederate who now, Rutger is no longer gonna be Rutger. No, again, good ideas. Spurgeon Neal, Spurgeon Neal. So Spurgeon Neal was Aeromedical Occupational Medicine. He actually, did you have him as a mentor? He was my counselor. Yes. Went to Taco Ted. As did I. So, great guy, and if you don't know of USAA as far as insurance and everything else, he actually was their first occupational medicine physician there, and their program, if you, we've got a tour of being down there in San Antonio. It is amazing the things he thought about back then from an occupational worker performance-type process. He literally, in ergonomics, didn't take, didn't throw the person into a workstation. He made the workstation fit the worker, and, you know, because they were there literally years ago now, too, sitting in that particular spot, anywhere from, you know, eight to 10 hours a day, based on your computer way back when, and he also created fitness programs where you're doing points. He'd go to the little commissaries they have, and the building itself there in San Antonio, they say it's about the same square footage as the Pentagon. It's a huge conglomerate of buildings like A through G or H, but he was the first person into that, and then, sadly, over the years, he developed macular degeneration, which really thwarted him, his outgoingness and that, and, you know, he has long since passed, but anyway, so that he was the first one to introduce aerospace medicine research science to us Army aviators, and part of that from him, he came out of the Korean War, and everyone's seen Master, I'm assuming, so then the OH-13s and that, they would use man pods, but he was piece and parcel of that and thought what a great process to get wounded to wherever they needed to be, especially in the mountainous, you know, in North Korea, so mountainous, so he took those ideas. He actually, once again, the Huey aircraft, everyone knows what a Huey is for the Army. Guess why the width is what the width is of the Huey airframe or the cargo area? Size of the litter. Size of the litter. The distance of the litter, that is standard NATO litter, they asked him, how wide? He goes, I don't know, but I at least need to fit this litter in there so you guys figure it out, and so he was very instrumental because it actually was a medevac platform before it became a utility aircraft, you know, hauling troops and everything else, but the original design was spearheaded by him, so again. Exactly. Yeah, that was the front seat there, Jeffrey. So anyways, we'll get moving, but again, a wonderful person and it's a pleasure to have known him. Okay, let's see. Again, disclaimers and reviews, you can see right up there, these, from putting this together, again, they're my views, not necessarily the units and that, but there's a lot of stuff that we'll be talking about that nothing secretive that I'll be saying or that, nothing DOD specific, and then again, we don't have any conflicts in these activities, but you can see the title there, Emerging Science of Aviation Medicine to Optimize Human Performance and Protection certainly is what we look for because again, years ago, we all know about who was the first aircraft person killed, Lieutenant Selfridge, and what happened, what he died of ultimately, so we think head injury. So again, they were, they had one of these flying backwards, there's a couple of pictures of Orville Wright and his brother, old Wilbur there, with a kind of scaly cap on. So that was their head protection. So when they crashed, ultimately he had died of that. So that instance, and that certainly developed aircraft protection and we've fallen in suit with that over the years as far as the increase of safety. And we have, as we'll explain here, all kinds of neat stuff as far as helmet drop labs. We have actually different times that work with the local sports for football and head injuries. We do a lot of drop testing on motorcycle helmets. So a lot of these civilian companies know when we have that ability to do research, come in and keep our research going. There's a lot of outside monies involved because we in the Army don't necessarily have quote a lot of money to do some of that on our own. Again, merging that and optimizing kind of our logo. Our mission, just as it says is, to deliver scientific solutions that your lives increase the performance of Army aviators, airborne soldiers, ground warriors. With the airborne soldiers, we actually just did a recent study again. I think it was just at the end of the year, Fort Benning is the home of the airborne. And so from the helmet head protection, they have a new helmet design and looking at being a little lower than it currently has been to help protect the neck, adding a different pad in the back. Because a lot of times in the airborne operations, as much as we like to think you're gonna land nice and gentle on the ground, you're not. You're going backwards, forwards. Typically the head, you don't want it to be one of your point of contacts, but it becomes the last point of contact. And there's a lot of concussions. We had talked about that earlier today and a lot of neck injuries. They did a study on the newer helmet and the results aren't in yet, but they think the helmet definitely has added protection for our soldiers that are in the airborne operations. So we do quite a bit of that in addition to the aviation part. Again, mentioned earlier, the helmet itself is still heavy from a neck perspective, i.e. us as osteopaths can lend quite a bit of pre-mission comfort, doing some HVLA, soft tissue, whatever it would take, help that AVA have a little bit of concentration, less elements, less pain in the neck. And then the vision, again, to recognize the Army's focal points. And that's what we're doing now. I mentioned the electrical large-scale combat operations, mentioned future vertical lift. All those things, again, in our focus going forward is just that. What are the nuances of both these environments that we need to think to help protect both the soldier, the aviator, and just keep going forward? And then part of it, again, where aeromedical is the evacuation piece. And I'll show you here in a minute the way we're divided from a research perspective and kind of a focus perspective at the unit itself. So again, the vision used in some of that, consult biomedical, physiologic. And we have literally the ability to reach out to scientists all over the world, literally, but also tri-service. We do work in conjunction with our brothers and sisters in the Air Force and Army, even Coast Guard. I don't know how many of you remember Mark Tedesco, but he was Army originally and then became a two-star there in the Coast Guard. But he was, one of his assignments was a safety person, you know, medical safety there in the Coast Guard. But he remembered, and we partnered with him quite a bit during his years there at command of the Coast Guard. So, Warren, you may remember that picture up on top, maybe. I know probably Dr. Mills would, but that's the old Lister Army Hospital at one point in time. And they claimed the fame at that point was it had the most mileage of connectivity under like wooden boardwalks versus, so that was the original hospital there at Fort Rucken from the early 50s. I had, in 81, had my physical in that particular building. And then finally they opened Lister Hospital, which is now what it's been there. So that's been there since like 85, is Lister Hospital. And then the lower picture, you can see that's, again, now called the Neal Laboratory Building, but it's our home, been named after Spurgeon Neal. So you can see the direct research, both the medical access we have to all the pilots, all the records and things. You know, Dan was talking about having data available to talk about accidents, talk about different things, but also we have very close access to a lot of the physical medical pieces that we can add to research. And then, oh, by the way, we have very quick access to aviation. If you don't know, Fort Rucken is a home of Army aviation. Again, everyone in the Army gets trained rotary wing helicopter-wise. And then from that point, few, but there is a fixed wing program that go into the fixed wing and they'll fly some of our C-21s and C-23s. Again, that's typically more of the warrant officer program that goes to fixed wing, but there are a few commissioned from a lead leadership and a unit command, but they're dual rated. Not everyone gets that dual rating. And then the helicopters, the way the school works currently is, now we have what we call the TH-72, the training helicopter 72, which is the Lakota aircraft that was off the shelf buy. We didn't like that, the research world and medical, because anything military gets off the shelf, if you think of it, you've got it. I mean, if it isn't in there when we buy it, too bad. And we knew from the get-go that the seats and the stroking capabilities and a lot of the downward accidents, stroking of the seats we had worked so hard to do in our more formal, developed aircraft, Blackhawk, Chinook, Apache, had that. This didn't, the training helicopter, and still doesn't. It's such a costly retrofit that the Army's saying, hopefully we won't crash. Sadly, it's literally their decision-making. And we had an accident here not too long ago, a year now, maybe a little more than a year, of the Lakota. It was both two IPs. One was a, both were CW3s. They both had almost 2,000 plus hours in that, not in that aircraft, but total, but in the aircraft, at least a couple of 300, 400. And they shut off the wrong engine and they came down and they had a hard landing. Both of them have been, they're recovering. They both have spinal injuries. One's wheelchair bond will be forever. The other is still going through therapy and surgery. But again, could that have prevented having the right stroke and seat prevented? Don't know for sure, but it certainly would have helped. You know, they just know. And so we do also, and it's called ALSERT, but it's a program that we recover aircraft from accidents to do just that, you know, analyze it back, how the injury occurred, looking at injury patents, both of the pilots and the crew members and things. And we go through all the details of the seats. Did they stroke correctly? The back seat for the cargo carrying area for carrying the soldiers? What happened? You know, did people stuff under, stuff things under the seats that didn't allow them to stroke properly and then get injured on an impact from that? Did people have their legs underneath the seat when it hit and broke their legs? A lot of things come out of this. Sadly, a bad accident or a good accident, if you will, but that research, we continue on here at Fort Rucker. Let's see. Again, it's now 60 years old and still going. Again, on the Virgin Hill, kicked it all off. Here's how we're headquartered, at least at UCIRL, and I'll talk about how we're positioned in the big army in a second. But we're in three different type categories, and of all these three, specialists are in those accordingly, as far as engineers, physiologists, ophthalmologists, audiologists, you name it, we have every out there. But in the performance, we're looking at how to integrate the teams, especially now with the future vertical lift and other bombardment of information, possibly. When is we, the pilot or the crew, overwhelmed with information? When are we the red light and need to have the aircraft either take over for us, based on any kind of mission we're doing? So we look at a lot of the physiologic performance of a human, i.e. your heart rate, temperature. They're looking even at some EEG information that will fit comfortably in the helmet, or almost like a, what we call a skull cap, where the Air Force put that skull cap on, that has different sensors in that, positioned accordingly based on different kind of brainwaves that we want to get, and just oversaturate these pilots in the aircraft and say, when is when and what did you miss that was critical? Either a warning light or an instrument, you know, warning sounds. And we were talking earlier about the color, the number, and the shape. We have redundant systems as well from noise, visual colors, that from warnings, but even then they're missed based on that fast saturation. And I said they're trying to add virtual reality into this process. The, one of the models for the future vertical lift, they had, we had an industry day just before Christmas there at Rucker, and the one that didn't get picked, Sikorsky's aircraft, they had a neat simulator that allowed both the pilot to fly in there, but also had a smaller portion for a couple crew members. But even with a solid wall on the aircraft, with virtual reality and the cameras and sensors on the outside, you could be in the aircraft with your virtual headset on and see 360 of the aircraft, see the terrain below. I mean, it was amazing and pretty neat, and you're protected within the aircraft. But some of the nausea, some of the motion sickness comes in too, because these guys now as crew chief, rather than looking out the small window and feeling and sensing and watching the aircraft, they don't see the lead in, and it's thrown again that mismatch of vision and sensation and that. So, but that's right there in the pilots. Same thing, they could be completely blacked out, and they had demonstrations with multiple pilots landing in dark clouds, dust, dirt, all the things that we've always said, what's called degraded visual environment. That's what kills a lot of us in the rotary wing environment, that we're trying to land during that craziness. Once again, instruments are good, and they'll get you down, you know, maybe safely 10 feet, but it's really up to you, the pilot, to land that last bit. And some of it is by feel, by experience, you know, you just keep coming down at that same rate. Nowadays, though, with this aircraft, it will, you can push a button and it'll do it itself, almost like the UASs and UAVs return to the location, come to a hover, two-foot hover, and then go down from there. So, the systems are really catching up with our technology. There's less and less mismatch. Some of the communications that he didn't mention earlier on the UASs and stuff, it's that time lag going up, he mentioned that, but that has become less and less as well. So, the timing is getting more genuine and almost instantaneous, based on some of our systems. But again, that's making sure our satellite's intact, making sure a lot of things, because if I'm a bad guy, guess what? I'm going to take all your communication satellites, in addition, and some of our space warfare, so then I can really have a functional fight against you or eliminate some of that for you as an advantage. The next one is protection, the biodynamics research. We have, like I said, an accelerated injury team. We look at musculoskeletal injuries. We now have a, it's called the VAT, the vertical aviation tower, and it's probably a 40-foot tower that has the ability to put different seats, different litters on there, kind of rescue litters, and drop people, drop cadavers. I shouldn't say people, cadavers, and then ultimately test for injury, musculoskeletal injuries, both neck, back, even in a kind of recumbent patient, you'll see what happens on one of the aircraft litters as that lands hard. So, they have, once again, they wire up the cadaver and things, and you'll look for that. They actually do some, I guess I won't call it an autopsy, what do you call when? Necropsy. Necropsy, thank you. Necropsy that you'll look at, and then the mechanical, they have the ability to do x-rays there, and then look at the injury patterns based on the g-forces that they have programmed in there, based on the angle of an aircraft crashing. So, it's pretty advanced. It really is neat, and like I said, a best-kept secret, both from my personal work experience, but also to the community. It's not that we're hiding it, it's just, you know, it's not out there. Some of us need information. Certainly, train tracking, you know, blunt impact, kind of already mentioned, and we have, again, both with the helmets and the protective equipment, the restraint systems, all piece and parcel of that, you know, how do we keep an aviator safe, crew members safe in that aircraft? And then the next one, en route care. Certainly, we're looking at all the bits and pieces and parts of an evacuation. It works both in ground, but, you know, we're more focused in aerospace than aviation, but we're looking at any and all of the equipment that would go in the aircraft. You know, I know we have AEDs in this building somewhere. You know, Zoll typically is one of the brand names that the military has bought into, so that's a very good AED, and we want it to work, but how do we know if it'll work in the aviation environment based on humidity, altitude, pressure, as well as will it impact any of our instrumentation with this aircraft? So, we run that. We have the ability in one of our labs to do hot, cold, dust, you name it, environmentally. I think from a minus 50 up to 120, we have the ability to do sand dust, bar the piece of equipment with that. So, it's pretty neat, and it keeps them busy. A lot of those are commercial investments because they want their piece of equipment maybe to be on or in the military system, so they take it out of their pocket versus kind of direct military governmental money, but important to do both, you know, aircraft testing. So, we have what we call in these any piece of equipment, and a lot of it's the extra aeromedical equipment, something called airworthiness release. So, without us at Fort Rucker testing it and ultimately blessing it and saying this piece of equipment has received an airworthiness release, that should not be used in our environment. Now, sometimes we have, you know, I guess agreements among the services. If they've done one piece of equipment similarly in their aircraft, then we just accept that information. If there's something unique beyond that, then we test that accordingly, but again, we try to share before, you know, wasting money and wasting effort. But a lot of it has to go through those rigors. So, you know, hey, you know, I just saw this neat best thing out there, you know, let's get it, let's bring it on the aircraft. Yeah, but no, you know, it has to go through the proper processes. And do we lag behind a lot of times? Yes. So, we don't necessarily have the best equipment or the most recent up-to-date technology equipment, but we have very good equipment that will help our soldiers and help our aid men and medics get through that. Let's see, you know, and I've been on some studies, you know, you think of it from a OMT, occupational medicine perspective, the lifting. So, we have soldiers, male, female, big, tall, short, transgender, you name it, we have them in the military. And a single or two people on a litter is supposed to be able to lift anywhere from a 240 to a 300-pound person on that litter. That's not happening lately on some of our soldiers today, sadly. They can't even lift 100 pounds. So, a lot of times they do have four people, but guess what? In a combat scenario, it's like, you know, a sniper does what to, say, a unit. If someone snipes one guy, how many does that impact, say, in a unit traveling through? A whole bunch of them. So, now it's going to take four or five maybe to take care of this single person and whatnot. So, same way with that. So, a wounded person, based on that, not having the ability, agility to carry, it's going to take five people anyways to get into the aircraft. So, we look at that, both the bending technique of the aid men or anyone else that would be carrying a litter, but also that person in the aircraft, i.e. that flight medic or crew chief, they're already in a bent-over position based on the space that they're loading into the Blackhawk. And then, now they're handing off typically singly. So, he's accepting a two-person lift on the front by himself, scooting back as the other two push forward. So, very awkward. So, we've been looking at studies just in that as far as mechanics, how we can either develop and or use litter carry, litter lifts that are out there, bring the litter to the close edge of the Blackhawk, hook on a litter lift, lift it up, move it in, coordinate. So, again, the weight and the agility of that two-person is relieved. So, we did a good study on that here recently. And some of the graphics and dynamics they were getting, they literally took the person, put 30 probes throughout them all over to look at a biomechanic process and try to look at where injury is. And once again, these people were experienced. So, if they had injury, we knew previously, but they would then report this helped, this didn't help, this, you know, what the delays were. So, we use that information plus the body biomechanics to justify that, hey, we need to do something else. And we've known it for years. But again, until we have the science backing up some of these decisions, we're not going to get anywhere. It's like, yeah, you hurt your back doing that. Okay. So, what everyone does, get over it, drive on, do more push-ups, sit-ups. So, our answers sometimes aren't very good, but we do have good science saying we need to do something different because this is hurting everyone. And that's one of the number one claims of any of our aviation post-military, never mind retirement, into the VA system is just that back injury, upper body injury, neck injuries. So, we got to figure out a better way to reduce these. So, here we go again, our capabilities and facilities is there at Fort Rutger. One of the neat things is we do have a lot of direct access. Right now, once again, the system, when I went through flight school, we only had three type aircraft for your training. And then from there, you specialized. So, that took nine months. Nowadays, these people come in and it's almost two years before they get through it based on a lot of things. Some of it being COVID more recently as far as trying to fly. Secondly, the aircraft maintenance, the amount of people we're trying to push through. So, what used to be nine months and then you're an aviator and maybe you could have kept that aircraft in a unit or you would do an advanced aircraft. I ended up doing Cobras and that was considered an advanced aircraft back then. So, now though, they track after a basic and then go to either the Apache, the Chinook, or the Blackhawk. And then when they finish those, some lucky people get to do a fixed wing beyond that. But now that's taking most of our soldiers two years to get through. So, they're already a first lieutenant with the Army rank system. You're a second lieutenant, go autobars, they called it. And normally in about 18 months, just for being alive, you'd get put on your first lieutenant of the sober bar. But these guys and ladies are getting now, we used to get out as second lieutenants. Now they're getting out as first lieutenants, almost a captain, some of them. And the research lab, like I said earlier, we have all kinds of visual optics. We were there and helped design some of the night vision goggles. We did a lot with different focal issues as far as they did bifocals looking at flying. They also had trifocals. They had trifocal contact lenses that we tested. Because if you're thinking of it in an aviation environment, what type of visions do you have as far as near, far? You have all three really. You have a near vision for then, we used to read maps at one point, but to read something close, either your checklist or your map, you need a reading process. Your instrument's just almost like a computer now, 18 to 20 inch of distance, and then you need distant distance. So, like I said, they designed and it worked pretty good. What happened, I don't think they ever perfected the transition pieces between those lenses. And again, it induced some kind of optic changes, sometimes dizziness and nausea and that. So, it was a good idea to not have the glasses on. However, it didn't work that good, but it's something we were able to study. And then same way with our night vision goggles, anyone remember, who was my infantryman out there other than John Mills? But we used to have full face goggles that it was on your face, you had less than 40 degrees peripheral vision and they were bad. But they figured if the infantry guy can use them on the ground, aviators should be able to use them, sure. So, we just grabbed them off the infantryman, put them on our aviators and flew. And I'm happily surprised that there wasn't as many accidents as it should have been. Because these guys, they flew and they were brave, but then they realized, this is crazy. Why don't we cut some of this away, both from weight, but also as far as vision and be able to see? Good idea. But then when they started testing, the lighting in the cockpit didn't match because you have to have a certain light for the night vision goggles to manifest and see then kind of the sea of green. So, then they helped with the lighting. And like on our Cobras, we used to have a light to give us light on the gun system so we could focus the light and help us fly and land and things with the night vision goggles. And then they did full cutaways. Once again, the lighting, something to deal with. But we test and research all this at USARO all over the years. And then we actually had multi-lens night vision goggles that gave you more peripheral vision to 120 degrees, which was significant from a safety of flight. How did you guys at USARO roll in what was done at the night vision lab in Fort Belvoir back in the day? We had one as well at Rucker. It was outside of our purview per se as far as the research, but we had access to it because at Rucker for the training piece, they had night vision goggles for the students and things coming in. But from a known research, I'm not positive, I know we probably shared, but I don't know that for a fact. And then again, especially same way with hearing, there was a guy, Ben Mozo, if anyone here knew of his name, he is one of our audiologists. He developed something called the CEP, the communication earplug. So me as a brand new young soldier at 21, guess who was flying me as an instructor pilot? Those old Vietnam guys that couldn't hear a word of shit and they were yelling. And so it hurt us, the young pilots, because they would crank up the volume and you're sitting in there just with your helmet on, but it was loud as heck. And every flight, all of us young people that had normal hearing at the time was like, oh my God, sir, you know, there's any way, he said, I can't hear anything. So no, you're going to have to suck it up and just have loud volume. And we did. So Ben Mozo said, wait a second, we need protection. So what he did, the old little foamy earplugs, he developed one that would fit in different sizes into the air canal, but he had a transducer or a speaker there. So you could then control your own volume and minimize the blast from the instructor pilot. And like everything, they had resistance initially from, oh, we don't need that. Well, once they got accustomed to them, it became the standard for the Army. But he developed that, and they actually still have a company in Enterprise, Alabama, that was an offshoot. He was able to do a patent on it, and so they have a company. But again, specialists in those areas that are truly interested in the science and what they want to do for those guys. Here's some decades, as you can see. Hopefully, it's not too blurry. But starting in the early 60s, you can see a little bit the night vision goggles, that guy in the red on the top. That was after they actually did a little bit of cutaways. So that's not even the full face piece that we started flying with initially. And you can just see some of the markers over the years coming down. You see that kind of final helmet to the right here? That's in the Apache aircraft. We had, it's a monocle. So in the Apache, you, the pilot, had to learn to be able to divide your vision. So you had to say, this eye is going to be concentrating on our eyepiece, and this eye is out for scanning and doing distance. Gave a lot of people headaches originally. They adapted and continued on. But it was a learning process, because normally, we don't do that in our normal vision. So that was something that we had to train out of the process to make them successful from that perspective. Now, I mentioned how we're structured as a unit. And something that I'm fearful of, we're under Army's future commands right now, which up until the beginning of the year, we in the research, MRDC, the Material Readiness Command, we fell under their research. So all the research in the Army, anyways, fell under this. But as of December of this past year, everything's supposed to fall under DHA, Defense Health and Safety. But what we're fighting, not fighting, saying, we're unique, we shouldn't go under there, we need to be autonomous. Us, and there's a research lab up in Natick, which does a lot of, they do MRE testing, they do soldier large group, i.e. up to a platoon, in heat, cold, different environmental issues. So we're trying to stay out from under DHA to show our autonomy and that, yes, we are unique. If we get sucked in there, we know we're going to lose that. And then my fear, personally, is that as much as I like the Air Force and Navy, we're going to become one blended process. And I'm afraid we're going to lose that autonomy, especially the focus of rotary wing and a couple of the other specialties that we have embedded at Rutger right now. So just, we'll see what happens. The Army's supposed to decide this month, or the Secretary of the Army's supposed to decide, yay or nay, and she is supporting to keep us separate, but then it goes to Congress and they can say, yep, thanks a lot, but you're going under where we said you were. So I hope that won't happen, but that's supposed to be decision complete by the end of the month. The other human link in the chain, as FAA, as every service, what is our number one killer? Where is it? Where'd it go? What's that 86%? That's a huge number. Now, it's not always the pilot. It could be that crew chief that was mad at the wife that morning and forgot to get his tool out of the cowling of the rotor blade or whichever else, and something happens. That's still a human factors error. So we always call it the Swiss cheese model. So it's not necessarily that one thing, but if you, one of those holes are going to line up and say a block of Swiss cheese and ultimately end in an accident. So we look at those human factors models and some of it is overuse, overstimulation in that, that we have the ability there to do that and monitor it and see where, when, what type of alert systems, again, alarms and alerts to say, hey, you're going low, too low. You're going too fast. You're exceeding your physical capabilities. So the system's going to take over again if we're tying in the human physiology into the aircraft science. And let's see. And again, we remain the most vulnerable. You see that? Who knows what type of aircraft this is? Anyone, anyone? Yeah. 086. That's some of our special forces, our special ops 160th. Actually, I don't know how many of you know General Volpe, Major General Volpe, the DO, Phil Volpe. He actually was at the AMOPS. I didn't know. He told the story. He was the flight surgeon during Black Hawk Down. He had the ranger unit that was part of the Peace and Parcel Act, as well as the aviation unit attached to him when he went there. So he was a major. He said, I learned quick, and now they minimized. But what happened, what should have been a eight-hour, not even a four-hour mission, ended up being a two-day mission. And they had all the casualties. So he said Black Hawk Down, the movie itself, portrays the chaos. Some of the process went on. And still a guy, Mike Durant, he actually ran for one of the state representatives here in Alabama. So he's still alive. He comes down to Rutger. Good guy. He's trying to stay with aviation. So sad scenario. A lot of stuff went on. But again, that's how these guys deploy themselves. Under a secret scenario. Current challenges, we're looking at, again, the complexity of both the aircraft, the mission. You saw all the information, especially with UAS, is the different levels of communication that we have or are expecting to have between communicating back and forth to our aircraft, to the pilots, the ground soldiers. Every infantry commander wants sight over that hill. Just like the old days, they used the balloons to look over that hill in the Civil War and things like that. They still want that. And all those UAS from a literally suitcase packed one, if I can have one of my soldiers fly that, it's still not necessarily recorded. And it's in this aircraft's airspace. If I'm coming in and landing as a medivac or something, and you just happen to have that UAS there floating around, unbeknownst to the rest of the world, because it is a suitcase one, doesn't necessarily have to get to the system, it could take it out. I mean, it's as simple as that. So, communication and complexity. Again, abnormal human versus abnormal environment is happening. And from a medical perspective, our guys are pretty sharp, they're doing good things, but we're allowing, because of need and things, adjusting, just like the FAA, adjusting or loosening some of the stringent standards that have been out there to get applicants. One of the main things was just vision correction with LASIK or PRK and things. That was something years ago, but now it's an accepted standard. And most kids coming out of high school, if they have any interest in being in the military as an aviator, they're getting it done during high school. They don't want to mess with it. Yep, perfect eyesight now, and we're allowing that in the services. Not a bad thing, but it's just somehow we have a different person coming in at that level nowadays. They've been, I guess, improved, repaired, whatever you want to call it, but they're not perfect when they come in the door. Performance research. Again, you can see the dust dirt. We look at all that. Artificial intelligence, it's coming. It's out there. We're trying to stay ahead of the power curve and teach and or learn the impacts that create sensory and protection. Again, that Chinook you see lowering something right there, they're good where they're flying, but you're now 20 feet below that. There's people down there. There's ground. There's something that could take them out. So we need to, again, use our abilities to keep the aircraft flying in those degraded visual environments. From protection, mentioned VAT, the vertical acceleration tower. Obviously, you can see the skeletal system in there, but they have the ability to look at all that from an impact and a research process, and it's really lending to, again, the equipment we use, the weight of the helmets, the protection. When do you say when? You put a huge metal block in your head that may protect you, and now it's going to break your neck. So we're in the in-betweens of trying to figure out what's best, both in hearing protection for the helmets that we use, as well as the impact injuries and things. In route, I mentioned a little bit of this already, limited space, especially for the crew chief and the flight medic to be working in there. In the Blackhawk, typically, we're going to have potentially six patients. There's three little stanchions on each side that we look at, but the focus, once again, in this new Lesko, the large-scale combat operations, we're going to be flying maybe longer, further than we have. We used to call it the golden hour. Now we're saying, package them better, because we may have to fly further backwards based on, again, that combat operations. They're going to be reaching out. They're going to be hitting us. While we were not doing so much in air defense and field artillery, because of the war, we had air superiority. Guess what the bad guys were doing? They were concentrating on air defense artillery and field artillery all these past 10, 12 years, and we, the Army, are definitely way behind in that. They have an advantage in that regard, and they're going to bomb the heck out of us at close quarters. The future vertical lift, this is not an aircraft. I have a picture of it eventually, but that ultimately, looking at some of the things that we know is not necessarily bad or wrong now, but that could be an issue in the future as we're looking at our combat operations, the amount of people we're going to be taking, how far this particular aircraft is going to have to fly, how high. Those are some of the things that the system has asked the aircraft manufacturers to fly faster from an Army's perspective, faster up to 240 plus knots, which is unheard of in an Army pilot. Maybe hit 160, and you're going steep down 10,000 feet, you don't hit those speeds. And then ultimately altitudes, once again, we don't know where and what. From the Vietnam War, we started high, came lower, and flew nap of the earth flying. Well, now we know they all have handheld something to take you out. So where is the altitude we're going to have to be looking at? Do we pick up patients and immediately go to 15,000 feet, put oxygen on everyone and fly that? But that has not been our tactic, but it may become that based on our expectations of the bad guy and their ability to take us down. Then operational medical research, next generation combat vehicle. Once again, we are looking at the warrior in that that's on the ground, both in medevac transportation, but also how that vehicle goes across the ground. They too will be going faster, meaning they're going to take more impact as crew members in there. Same issues with your neck, back. So what the research we do, we can extrapolate down into there. And once again, same type, we're looking at provider performance, how well and how much do we teach? All our flight medics in the Army now are all paramedic level trained. It used to be they just went to the paramedical flight medic course, which is a four-week course. They got ACLS there, which not the other medics did not necessarily get that. So they got a higher education, but not the same. And then now that is the standard for us anyways. And that's a pretty good level to be at, but they're not necessarily going to be the ones that are packaging the patient. And they have combat buddy pairs and that to help with the medicine. So they may be on a litter and maybe an IV going when that medic gets there or the flight medic gets there. And then from there, they have to go further. And so there's just some of our things we're looking at, addressing the multiple causes of excessive workload. We have, again, monitoring systems. We have some of our human psychologists now look at work overload, work saturation and things, and then to managing the workload within a scalable autonomy. And then looking at, again, protecting the future vertical lift occupants. Some of the things, like I said, faster, higher oxygen, more maneuverable. Oxygen, more maneuverability. That may add, I mentioned earlier about the motion sickness or some other issue we heard about, concussions and traumatic brain injury. Where and when do we put oxygen on? Not knowing the altitude we might have to go to, if it's going to help protect or not further the injury. And finally, the safety and transporting the casualties. I mentioned this a little bit, the ALSERT recovery program. In accidents, we do look at everything from the seats to the helmets, based on the critical ness of that aircraft in an accident. How many deaths? No deaths, and that's a good thing. A lot of injuries, musculoskeletal. How could they have been prevented? Could they have been prevented? So we look at the helmets, the seat cushions. Invariably, coming from the war, every pilot, Apache, Blackhawk, Chinook, had somehow acquired some kind of back support system illegally. But I mean, they had back pain, mainly because of the armament they had. It forced them forward more so than ever before, and they were uncomfortable. So they online went to whatever, and they were using them, and we couldn't say no and didn't want to say yes. So we kind of turned a blind eye. But part of the actual investigation when they had it, that would be at least anecdotally saying assisted back support was used, and nothing good or bad has come out yet, other mainly it provided comfort for the pilot. You take comfort to the pilot, then they can maybe focus on the mission a little better. So again, we do look at all those things, how the aircraft crashed, under what circumstances. Every piece of equipment that's involved from a protection, seat stroking, and like I said, the current Lakota, our training one, does not have our standard of a stroking seat, just because it's too expensive to do otherwise. So this is the last slide. Hopefully, am I still on time? Conserve the flighting strength. Up to the top left is actually the aircraft that we are going to adopt. It's a Bell version. It looks, who's our Navy guys? Does that look like an aircraft the Navy might have? Like an Osprey kind of? So definitely different to a point, but same flight mechanics and things. One of the issues that we tested, even with the Osprey from the research world, was if you're trying to hover and you have a patient down below that you may want to use in a hoist scenario, guess what happens? The downdraft of those rotor systems is so significant. It rolled, and we use a 300-pound mannequin, and it rolled from the downdraft. So I don't know how we are going to adopt that if we have to use it in a hoist configuration. It does not do very well. Now, it could land, and you can load it, and you get more patients on there. But from a practical, pick them off the side of a mountain in an obscure area, I don't think that's going to happen. But that's the aircraft. They have currently announced that it's going to be one of our future vertical lift aircraft. A question on Blackhawk? Ultimately, yes, but the Blackhawk is going to be in another 10, 15 years anyways. And the Blackhawk, in the transition, they're looking to make it an unmanned vehicle, and they will fly it. However, whether it's someone on the joystick, like they were saying, or being operationally guided elsewise, bring that to the battlefield, have people load it with casualties, and combat unmanned. They're going to modify it, start advancements from electronically and everything else. But it's still one of our major workload aircraft, so they're keeping that. Howard, did you have a question, sir? Oh, thank you. Any questions? Well, thanks again. I appreciate the award as well, so appreciate it.

Aerospace Medicine

US Army Aeromedical Research Lab

Aviation Safety

Pilot Performance

Protective Equipment

Aeromedical Evacuation

Physiological Stressors

Future Vertical Lift Aircraft

Defense Health Agency