In RS5, the kernel introduced a new arbitration layer. The Memory Manager was updated to work with the Hypervisor (Hyper-V microkernel) to restrict DMA access.
MRI machines and patient monitors require absolute predictability.
Driver/firmware exploitation
Reconnaissance
Later builds removed these entirely, forcing businesses to either virtualize or stay on 1809. For industrial controllers running custom DOS-era hardware interfaces, the 1809 kernel is because no newer Windows OS supports them without expensive hardware upgrades.