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Technical Reports
Technical Reports
A technical report is a technical document that records and disseminates methods and results from research studies and research,
development, test, and evaluation (RDT&E) activities. Technical reports are USAARL's principal method of in-depth reporting on
technical subjects that are of interest not only to the department, agency, or command sponsoring the work, but also to external
groups and laboratories in government, academia, and industry. Technical reports may vary in type, to include technical reports
that present the findings of research or analyses or that provide guidance or instruction on matters important to the DoD, journal
articles (open access and embargoed text) that have been published under an open access agreement with the publisher or published
under a Creative Commons license, conference proceedings that include whole collections of papers presented at a symposium or
workshop, and conference papers that could include an individual paper, briefing charts, or a poster presented at a workshop or
symposium. For inquiries related to USAARL's technical report(s), contact
usarmy-usaarl-library@health.mil.
Featured Reports
For more reports, please visit the technical reports archive page.
SIZE:4.1 MB
DTIC #:AD1314714
TITLE:Holistic Situational Awareness and Decision Making Operator State Monitoring Final Report
AUTHOR(s):Godfroy-Cooper, M., Miller, J. D., Alicia, T. , Yue, X., Bachelder, E., Turovets, S., Mackie, R., Feltman, K., Mielcarek, N., Szoboszlay, Z., Takahashi, M., Whalley, M., Goerzen, C., Lusardi, J., Fujizawa, B., & Shivers, M.
ABBREVIATED ABSTRACT:The Operator State Monitoring (OSM) study is one component of the Holistic Situational Awareness and Decision Making (HSA-DM) program. The HSA-DM program is focused on identifying cognitive workload (WL) drivers and developing cognitive workload management capabilities. The OSM effort was utilized to explore the validity and reliability of metrics selected for the monitoring of pilot WL and to provide recommendations for operationalization in future Army aircraft. The U.S. Army Combat Capabilities Development Command (DEVCOM) Aviation & Missile Center (AvMC) recruited 24 volunteer participants with relevant experience to complete challenging aeromedical evacuation (MEDEVAC) scenario vignettes in reconfigurable rotary-wing flight simulators. Over the course of two evaluations utilizing advanced cueing and autonomy design solutions, the pilots' workload was assessed using a variety of techniques. The findings indicate strengths and limitations of each assessment in an operational setting and recommend a hybrid approach of complementary assessment techniques to provide a holistic view of workload and the subsequent impact on Warfighter performance.
KEYWORDS:operator state, situation awareness, cognitive workload, workload models, autonomy
SIZE:1.1 MB
DTIC #:AD1313907
TITLE:Optimizing Adaptive Automation in Aviation: A Literature Review on Dynamic Automation System Interaction
AUTHOR(s):Vogl, J., D'Alessandro, M., Wilkins, J., Ranes, B., Persson, I., McCurry, C. D., & Bommer, S.
ABBREVIATED ABSTRACT:This literature review examines the evolution of adaptive automation in aviation, comparing foundational research with modern advancements (2013-2023) to identify best practices for future automated systems. Automation has been pivotal in reducing pilot workload and enhancing safety; however, it also introduces challenges such as over-reliance, disengagement, and diminished situational awareness. With the growing complexity of modern military aircraft systems and increasingly dynamic operational environments, adaptive automation offers a promising solution by dynamically adjusting to the pilot's workload and environmental conditions. Key areas explored include automation activation processes-static, adaptable, and adaptive-and their respective impacts on safety and operator performance. Literature review findings emphasize the importance of maintaining situational awareness, particularly during automation handoffs. Transparency in automation interfaces is crucial, ensuring pilots remain informed about system decisions and actions both in real-time and in near-future projections. This is especially important in high-stakes environments, where failure to properly manage automation transitions can lead to catastrophic outcomes.
KEYWORDS:adaptive automation, operator state monitoring, aviation
SIZE:1.1 MB
DTIC #:AD1313904
TITLE:U.S. Army Aeromedical Research Laboratory Fiscal Year 2024 Annotated Bibliography
AUTHOR(s):Science Information Center
ABBREVIATED ABSTRACT:Open literature publications, technical reports, technical memorandums, oral presentations, and poster presentations by the U.S. Army Aeromedical Research Laboratory (USAARL) are included in this annotated bibliography, this edition dated October 2024.
KEYWORDS:USAARL, annotated bibliography, FY24, aeromedical research
SIZE:9 MB
DTIC #:AD1310953
TITLE:Arctic Testing & Evaluation of Medical Equipment Set & Blood Fluid Warmer performance for En Route Care
AUTHOR(s):Lawson, C. R., Black, R. A., Cupples, M. W., & Snyder, S. B.
ABBREVIATED ABSTRACT:Arctic operations are typically defined as those that occur in subzero degrees Celsius (°C) operating environments. The operational, environmental, and logistical challenges faced by U.S. Army rotary-wing medical evacuation (MEDEVAC) units supporting remote patient evacuation efforts in these settings are formidable. The current Joint En Route Care Equipment Test Standard guidance for climatic - low temperature testing of electronic medical equipment set (MES) items used in en route care (ERC) is inadequate for MEDEVAC operations in the Arctic. Overall, critical care flight paramedics in Alaska are performing MEDEVAC missions with a low temperature operating goal of -40 °C (-40 degrees Fahrenheit [°F]). The Enroute Care Group Testing & Evaluation team completed a test plan to address climatic-low temperature testing gaps for several electronic patient movement items (PMI) in the U.S. Army's air ambulance MES. All test articles were evaluated using battery life to a low temperature testing threshold of -40 °C (-40 °F). Electronic PMI tested included the Hamilton Medical T1 Ventilator, ZOLL Medical Propaq MD, and the Belmont Medical Technologies Buddy Lite AC. Additionally, several commercial-off-the-shelf blood fluid warmers were tested in this project, to include the Buddy Lite XP AC, EMIT Corporation HX100 and LG, and °MEQU °M Warmer System.
KEYWORDS:en route care, ERC, blood fluid warmer, patient movement items, PMI, medical equipment set, MES, Joint Enroute Care Equipment Test Standard, JECETS, medical evacuation, MEDEVAC, arctic operations, military standard, medical device testing
SIZE:2 MB
DTIC #:AD1310949
TITLE:A Replication Study of Psychophysiological Indicators of Aviator Flight Performance for Operator State Monitoring
AUTHOR(s):Mackie, R., Yue, X. , Melton, J., Basso, J., & Feltman, K.
ABBREVIATED ABSTRACT:The current study replicated the methods used in a previous 2021 study where workload was individualized to the aviator. In the present study, 12 participants completed two visits. The first visit included four flights that allowed the research team to determine individualized workload manipulations for the second visit. In the second visit, participants completed first a baseline flight that consisted of a low, manageable workload, while the second flight consisted of a high workload flight tailored to the individual aviator. Several physiological measures, subjective measures, and performance measures were collected. Despite the larger sample size in the current study compared to the 2021 study, no significant differences in flight performance measures were found between the baseline and high workload flight on the second visit. Several differences in physiological and subjective measures were found. The findings of this study suggest that operator state monitoring efforts will need to take into account individual differences in physiological responses to increased task demands.
KEYWORDS:workload, operator state monitoring, aviation, individual differences
SIZE:3.9 MB
DTIC #:AD1313903
TITLE:Methodology for the Development of Realistic Simulated Patient Scenarios for Research Applications
AUTHOR(s):Kroening, L., Snyder, S., Lloyd, A., Molles, J., Toelle, R., Kinsler, R., & Ravelli, A.
ABBREVIATED ABSTRACT:The U.S. Army Aeromedical Research Laboratory's Enroute Care Group (ECG) Research Team has performed several research studies that require participants to provide care to simulated patients during data collection. These simulated patients must mimic human anthropometry, display recognizable injuries and symptoms, provide real-time vital signs monitoring, and respond to treatments as expected. To meet these requirements, ECG has iteratively developed a methodology for creating these patient scenarios. Several organizations, such as training centers, also use simulated patients but there is no standard method of generating patient scenarios. They are frequently generated by experienced medical personnel who rely on their expertise to create patient conditions, vital signs, and such. While this expert input is invaluable, the methodology described in this paper is created with expert input and is based on real patients, including their injuries, prior treatments, and initial vital signs, and so are the representations of what the Critical Care Flight Paramedics have seen in actual medical evacuation (MEDEVAC) scenarios, enhancing realism and immersion. The specific application of this methodology shown in this paper was for the upcoming "Effect of Tier 2 Responder Assistance on Flight Paramedic Task Saturation during Medical Evacuation" study that ECG will be performing in fiscal year (FY) 2025. This methodology is used for research purposes but can also be adapted for use at training facilities that use simulated patients to train medical personnel.
Patient requirements are determined during early development of the research protocol, such as casualty evacuation category (i.e., urgent surgical, urgent, priority, or routine) and number of patients needed in each category. This decision is made with the input of a subject matter expert (SME) such as a critical care flight paramedic or flight surgeon to determine realistic patient configurations in the medical evacuation platform being used. A data request form is submitted to the Joint Trauma System (JTS) Department of Defense Trauma Registry with detailed patient parameters. After receiving de-identified patient records from the JTS registry, the SME down-selects the records, extracts the essential clinical information, then uses it as the basic structure for the simulated patients. The team then designs the scenarios (e.g., decompensation events, alarm causes and timing, responses to interventions) using available technology that meet the study objectives, and program them into the patient simulator software. The simulated patients are dressed with mock injuries to match the injury patterns from the JTS record summary, and tactical combat casualty care (TCCC) cards (also known as DD Form 1380) are created for each patient. Participants review the TCCC cards just prior to the start of data collection and begin treatment based on the TCCC information, injuries presented, and the live vital signs displayed on patient monitors. Treatments given during data collection are input into the simulator program by research team members remotely monitoring the scene so that patients respond to the treatments in real-time. Medical SMEs on the research team oversee data collection to communicate non-replicable patient conditions to participants, such as skin pallor and type of bleeding, and to advise patient simulator operators on realistic patient responses to treatments.
This methodology is an adaptable model for creating realistic simulated patient care scenarios based on the specific patient types and equipment available to the study population in the course of their real-world duties. This report provides a concrete example of the creation of high-fidelity patient scenarios for the purposes of patient-care-centric research.
KEYWORDS:methodology, realistic patient simulation, tier 2 responder, combat life saver, critical care flight paramedics, CCFPs, medical evacuation, MEDEVAC, research, U.S. Army
SIZE:1009 KB
DTIC #:AD1310946
TITLE:Examining the Effects of Head-Supported Mass on Cervical Spine Biomechanics and Injury Risk in Special Forces Operators
AUTHOR(s):Brozoski, F., & Madison, A.
ABBREVIATED ABSTRACT:Cervical spine injuries and neck pain are particularly problematic. These injuries and complaints of pain have been linked to head supported mass (HSM) including helmet, communications, and night vision technology. The Congressionally Directed Medical Research Program (CDMRP) Peer Reviewed Medical Research Program (PRMRP) funded collaborative effort "Examining the Effects of Head Supported Mass on Cervical Spine Biomechanics and Injury Risk in Special Forces Operators" is one of several dismounted Soldier HSM-focused projects at the the U.S. Army Aeromedical Research Laboratory. This study, conducted in collaboration with Atrium Health and Duke University, aims to examine the effects of HSM on c-spine epidemiology, strength/flexibility, and health in Special Forces dismounted populations. This report summarizes the progress made to the aims from August 2023-July 2024.
KEYWORDS:ground Soldier, special forces combat Soldier, SFCS, dismounted Soldier, head-supported mass, HSM, injury criteria, design guidelines, cervical spine, helmets and helmet systems, range of motion, CROM
SIZE:1.1 MB
DTIC #:AD1310944
TITLE:Examining the Effects of Head-Supported Mass on Cervical Spine Biomechanics and Injury Risk in Special Forces Operators
AUTHOR(s):Brozoski, F., & Madison, A.
ABBREVIATED ABSTRACT:Cervical spine injuries and neck pain are particularly problematic. These injuries and complaints of pain have been linked to head supported mass (HSM) including helmet, communications, and night vision technology. The Congressionally Directed Medical Research Program (CDMRP) Peer Reviewed Medical Research Program (PRMRP) funded collaborative effort "Examining the Effects of Head Supported Mass on Cervical Spine Biomechanics and Injury Risk in Special Forces Operators" is one of several dismounted Soldier HSM-focused projects at the the U.S. Army Aeromedical Research Laboratory. This study, conducted in collaboration with Atrium Health and Duke University, aims to examine the effects of HSM on c-spine epidemiology, strength/flexibility, and health in Special Forces dismounted populations. This report summarizes the progress made to the aims from August 2022-July 2023.
KEYWORDS:ground Soldier, special forces combat Soldier, SFCS, dismounted Soldier, head-supported mass, HSM, injury criteria, design guidelines, cervical spine, helmets and helmet systems, range of motion, CROM
SIZE:9.9 MB
DTIC #:AD1310924
TITLE:The United States Army Aeromedical Research Laboratory Virtual Reality Vection System (Reprint)
AUTHOR(s):Temme, L., Nagy, R., & Persson, I.
ABBREVIATED ABSTRACT:The present report describes and documents the USAARL Virtual Reality Vection System (VRVS), a versatile, inexpensive tool to investigate, demonstrate, and characterize vection as a representative example of or type of spatial disorientation (SD). In aviation, SD refers to a pilot's failure to correctly sense the position, motion, and/or attitude of the aircraft with respect to the fixed coordinate system the Earth's surface and its gravitational vertical provide. That is, SD refers to the potentially catastrophic situation in which a pilot does not know where the aircraft is heading relative to the surface of the Earth. One example of SD is vection, which is the illusion of self-motion in an individual who is not moving. Since vection is a form of SD that can be reliably generated under controlled laboratory conditions, it is a convenient SD example for demonstrations as well as a powerful tool to study and characterize SD and its effects in general. The VRVS as described includes its components, software, hardware, and user interfaces. Tests and evaluations, conducted while creating the VRVS and reported here, demonstrate that the system does reliably provoke vection and thus SD. The VRVS includes two complementary methods for quantifying the presence and magnitude of vection. Moreover, the VRVS enables the simultaneous measurement of vection and symptoms of cybersickness, such as nausea.
KEYWORDS:vection, spatial disorientation, visual-vestibular interdependence, illusion, aviation, aviator
SIZE:2.4 MB
DTIC #:AD1306504
TITLE:Preliminary Field Evaluation of Assistive Devices on Carry Distance and Time During Two-Person Litter Transport Scenarios
AUTHOR(s):Stewart, A. S., Ballard, M. T., Robinette, A. M., Perkins, S. M., Prusia, M., Fjerstad, M., Watts, L., Oldham, R., Wagner, C., Arntzen, S., Brozoski, F., Barazanji, K., Madison, A. M., & Chancey, V. C.
ABBREVIATED ABSTRACT:Background: Evacuating casualties often relies on dismounted litter transport, a physically demanding task that can quickly drain a Soldier's grip strength. Assistive devices could shift the load to larger muscle groups, reducing muscle strain by distributing weight more evenly along the body. Previous USAARL lab-based research demonstrated assistive device use can allow simulated dismounted litter transport over farther distances in 2-person assisted litter carries than 4-person unassisted litter carries. As a follow-on effort to the lab-based simulated litter transport study, USAARL conducted a preliminary field-based study to evaluate assistive device use on litter bearer performance during 2-person litter carries.
Methods: U.S. and Dutch Service Members (SMs) participating in the Army Expeditionary Warrior Experiment were recruited and enrolled under a USAMRDC IRB approved protocol. Subjects (n = 12; 10 male, 2 female) were gender and height paired into 6 litter teams (2 subjects per team) to complete carries around a 160-meter (m) long course. Three litter carry conditions were tested: unassisted (UA), shoulder harness (SH) assisted, and wrist hooks (WH) assisted. Carry conditions were counterbalanced and separated by rest periods. Each attempt ended after 20 minutes (min) or upon releasing the litter due to fatigue of either subject. Total carry time and distance were measured and recorded at the end of the carry attempt.
Results: Average litter carries were 158.6 m and 2.36 min for UA, 1071.3 m and 15.8 min for SH, and 303.6 m and 4.34 min for WH. These 2-person carries showed similar trends as the previous lab-based study: both assistive devices showed improvements during assisted carries over UA carries; however, only SH was statistically significant compared to the other carry conditions.
Conclusions: This study built on the previous lab-based study, showing litter carry distance and time can be increased with assistive devices like the SH and WH by more than 6.5 and 1.8 times, respectively, in 2-person field litter carries. While these findings suggest assistive devices could benefit SMs, additional field testing and analyses are needed to fully evaluate the feasibility and practicality of the devices in operational settings through use of subjective, biomechanical, and physiological data. The next steps of this research aim to inform the development of solutions that reduce fatigue and ultimately enhance SM well-being and combat readiness.
KEYWORDS:litter carry, litter carriage, casualty transport, medical evacuation, stretcher, grip strength, litter bearer, assistive devices, CASEVAC, MEDEVAC
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Last Modified Date: 2023-04-14
