Dr. Cory Smith has an ambitious dream — one of his primary goals is to develop a next-generation warfighter monitoring system to optimize performance and safety for military personnel operating in austere conditions.
“My mission and passion are very much to develop the next-generation warfighter monitoring system,” Smith said. “I want to create the systems, machine-learning algorithms, and sensors that are embedded within our warfighters’ uniforms and helmets to be able to optimize their performance and safety. I want to provide feedback so they can perform better, and, if they become a casualty, have medical equipment attached to them via these sensors to monitor them and improve their survivability.”
But with the use of high-technology research tools, the technology going into the modern warfighter’s supersuit isn’t so far off.
Smith has been an assistant professor in the Robbins College of Health and Human Sciences at Baylor University since August 2022. Just three years later, he was nominated by his peers for the Gold Standard Award for Outstanding Tenure-Track Faculty for his exceptional contributions to Robbins College, including research, teaching excellence, effective service, and his role in building a positive college culture. That’s just the tip of the iceberg when considering Smith’s portfolio of research into optimizing the performance of servicemen in extreme conditions.
Cold In the Extreme
Much of Smith’s research is conducted in extreme weather conditions, defined as environments that are difficult for humans to survive in, specifically cold weather. The military requires warfighters to be ready to operate in hostile environments, including temperatures as low as minus 51 degrees Celsius (minus 60 degrees Fahrenheit), and to work independently.
“The overarching purpose of my research is to develop the next generation warfighter for extreme cold weather operations; to improve their ability to perform their jobs correctly, whether it’s tactical or medical tasks; and improve their effectiveness at their jobs and their safety,” Smith said. “We’ll bring warfighters into Baylor and test them here, or we’ll go to them. We travel quite a bit for our projects.”
Although his research is concentrated on all military personnel operating in hostile environments, Smith’s most recent focus has been on those responsible for treatment.
“Medical providers have some of the most complex jobs in the military because they are oftentimes in extremely stressful situations, making life or death decisions, and performing life or death procedures to save our soldiers. And yet our focus, until now, has almost exclusively been on the patient,” Smith said. “My viewpoint is let’s keep advancing patient care quality, but at the same time, let’s optimize the performance of the medical provider.”
Smith began his career in 2008 as an EMT at Loma Linda University Medical Center in California. He worked in Level I trauma centers as part of trauma teams and as a flight paramedic for search and rescue entities in the field, giving him a firsthand look at the difficulties medical providers in high-stress environments face.
“I got a lot of experience looking at how humans are injured in traumas and what occurs when they’re in those states, and the fatigue and impact that can have on the medical providers as well as the patient,” he said. “I began to notice a growing gap between the care provided to the medical providers and that ministered to those injured in extreme environments. And that was one of the things that really got me going to get my Ph.D.”
The U.S. Department of Defense has published data based on the most recent series of conflicts, indicating that one in every 12 deaths in the field was linked to poor tactical combat casualty care.
“We’re starting to study where the decrements are occurring in cold-weather operations like up in the Arctic,” he continued. “When you’re providing care in these extremely uncomfortable, hostile environments to another person, you have to ask where those deficits are, and how can we predict them ahead of time so we can create and implement our countermeasures to reduce the chance of making errors? We’re looking for the ‘hurt points’ so we can create better standard operating procedures.”
The Bears at ARKTOS
The ARKTOS Research Laboratory is a newly established, congressionally appropriated cold-weather operations research facility at Baylor that will conduct advanced research on rapid acclimatization, combat casualty care, tactical decision-making, sleep optimization, and field-based biomedical device testing. The establishment of this laboratory aims to not only support Baylor’s research but also to provide the Department of Defense, industry, and academic collaborators with access to capabilities, resources, and field-specific experts that would otherwise be cost-prohibitive.
The project’s cold-weather chamber measures 18 feet by 22 feet by 10 feet high, and the temperature inside can be lowered to minus 35 degrees Celsius (minus 31 degrees Fahrenheit).
“We can also carry out high-fidelity medical simulations and tactical simulations while also changing the altitude,” Smith said. “We have an altitude generator that can take us up to 28,000 feet to simulate being on the back of an aircraft that has lost decompression or up on the top of mountains.”
Simulating the altitude change from sea level to 28,000 feet is accomplished by a pump that draws air from the cold-weather operations chamber, removes some oxygen molecules, and replaces them with nitrogen before the air is recirculated.
Incidentally, the name ARKTOS was Smith’s suggestion.
“It’s not an acronym. It’s actually an old Greek word that has two meanings: ‘the Arctic’ and ‘a bear.’ So, of course, we chose it because we are the Baylor Bears carrying out research in Arctic conditions,” he explained.
Dressing for Survival
Smith’s team also collaborates with the U.S. Department of Defense on clothing for military personnel worn in hostile environments.
“Clothing is extremely important, assuring the right layers and that they are outfitted correctly, especially when you factor in the limitations of the textiles and materials,” Smith said. “A really great example of that was highlighted during a recent study we conducted. We had trained military personnel come to Baylor, and we put them through a scenario where they performed a tactical engagement and then had to provide medical care to a downed patient. Even though we told them, ‘Hey, it’s cold out, make sure you take all your precautions,’ they all removed their gloves because you can’t start an IV while wearing the big, thick mittens.
“So what can we do to mitigate that?” he continued. “Yes, the clothing is a big issue, but another is the fact that we know the military is very physical. You experience big bursts of high energy, high physical demands, and fatigue, then drop to very low activity, where you must be still, quiet, or not moving. And as you start to get active, you start sweating, and then as you stop activity, if you sweat inside your clothing system, you can actually go hypothermic, which sucks the heat out of you even further. Even though you’re bundled up, you have a cold-weather injury occur, and you can go into shock. So even though you’re paying attention to all of those things, even if you have the right clothing, you’re still at risk.”
Ready, Take Aim, Fire!
On a related topic, Smith published a paper on the impact of cold, hypoxia, and physical exertion on pistol accuracy and tactical performance in the Journal of Thermal Biology in October 2023.
“When we’re looking at marksmanship performance, that translates to a unique skill that’s primarily for law enforcement and military, and we’re one of the very few labs in the world that are doing this,” Smith said. “One of the things that we’re specializing in is real-time neural imaging while they’re performing these marksmanship tasks. We’re measuring brain activation patterns in real time and comparing them with those when they perform the same task in a more comfortable environment.”
As Smith pointed out, very few people like the cold.
“Most people become more aggressive, angry, and impulsive. They make poor decisions, grow more desperate, and lose empathy,” he explained. “As a result of all these different emotions and feelings and discomfort, their ability to carry out complex tasks like marksmanship is directly impacted.
“We are quantifying what happens to the brain when it’s operating in cold environments, and we’re limited to the technology we can warm them with. Our job is to identify countermeasures and training techniques that help people regulate themselves to maintain optimal brain function.”
Working with the DoD
Landing a contract to work with the U.S. Department of Defense can be a battle in itself.
“Absolutely,” Smith agreed. “Our first congressional appropriation was led by Dr. Jason Carter, the dean of Robbins College, who mentored me through the process and learning how these procedures work, how to communicate these complex research questions and issues to a level that can be understood and applied to benefit the world, and benefit the United States.”
They began developing their vision, identifying a gap in current research, and highlighting why their study strategies were sufficiently unique to warrant funding.
“Dr. Carter and I are both co-directors of ARKTOS, and so he’ll cover a lot of the leadership administration and sleep optimization, while I focus a lot on the military performance side of it,” Smith said. “So it’s very much about working in tandem to achieve these appropriations and communicate with the politicians so they see our vision, and ensure there’s an alignment with the needs of the United States, and then we can garner and get that support.”
Civilian Solutions, too
Although most research focuses on the military, its findings are having a significant impact on the civilian population. Smith’s current projects include the development of neurophysiological assessment methodologies for patients with neuromuscular diseases, including children with autism spectrum disorder, cerebral palsy, and Parkinson’s disease.
“To give you a really good example, part of the research I’m involved in is looking at pediatric neural imaging during treatments,” Smith said. “We’re studying the brain’s adaptations in children with cerebral palsy and autism, and looking at how treatment and therapies benefit them while they’re doing the therapy. We actually have neural imaging on these children during physical therapy, rehabilitation, or equine-assisted services. Monitoring how those treatments are impacting the brains of those children, we can make more informed decisions that would be impossible without having the skills, knowledge, and experience from the military side of my research.”
Other research possibilities are literally out of this world.
“Ultimately, when the astronauts are up on the moon, and it’s beginning to be colonized, they’re going to be out there doing an immense amount of work inside their suits, but in an environment with extreme temperature swings,” Smith said. Even though their suits do control for climate, “it’s very likely that we are going to go through some of the same issues we have been researching in our labs and in the middle of the Arctic.
“There’s a sense of isolation and extreme cold, and these stressors affect the body and trigger physiological responses. The sensor systems and approaches our team is developing can be directly implemented and integrated into work for astronauts, whether at NASA or SpaceX.”
