## 1 Introduction
### Medical Screening and Certification Prior to Space Travel

Table 1: _Cont._Below we discuss potential Space Hazards for each organ system along with possible countermeasures (Table 2). Table 3 lists prospective opportunities for artificial intelligence (AI) implementation. \begin{table}
\begin{tabular}{c c c} \hline \hline
**Tread/Hazards** & **Health Risks** & **Current Countermeasure** \\ \hline \multicolumn{3}{c}{**Microgravity**} \\ \hline Musculoskeletal & Muscle and bone atrophy [19] & A combination of adequate exercise and antiresorptive medications [20,21] \\ \cline{2-3}  & Impaired wound healing [22; 23; 24] & No specific countermeasures exist \\ \hline \multirow{4}{*}{Neurology} & Space motion sickness (SMS) [25] & Scopolamine administered orally or via transdermal patch with or without an amphetamine (to counteract drowsiness), or intramuscular Promethazine [26] \\ \cline{2-3}  & Alterations of smell and taste [27] & No specific countermeasures exist \\ \cline{2-3}  & Self-reported congestion [27] & Lower body negative pressure may help, but the effects are transient \\ \cline{2-3}  & Internal jugular vein thrombosis [28; 29] & No specific countermeasures exist \\ \cline{2-3}  & Post-flight motion sickness [30] & No specific countermeasures exist \\ \hline \multirow{4}{*}{Immunology} & \multirow{4}{*}{Reactivation of latent viruses [31; 32]} & Preflight vaccination [32] \\  & & Treatment with polyclonal immunoglobulin (IG) and Interleukin-2 (SC) [33] \\ \cline{2-3}  & & Adequate exercise and nutrition [33] \\ \cline{2-3}  & \multicolumn{2}{c}{Hypersensitivity [34]} & No specific countermeasures exist \\ \hline \multirow{4}{*}{Gastroenterology} & Gut microbiota dysbiosis [2] & Probiotics, synthetic peptides, synthetic biology [35; 36; 37; 38] \\ \cline{2-3}  & &
\begin{tabular}{c} Inflight medical management or minimally invasive \\ procedures (e.g., ultrasound guided percutaneous \\ drainage) of traditionally “surgical” conditions. [39] \\ \end{tabular} \\ \cline{2-3}  & Acute appendicitis and cholecystitis & Alternatively, can consider prophylactic minimally invasive surgery prior to prolonged space flight in at-risk individuals [40] \\ \hline \multirow{4}{*}{Cardiovascular} & Orthostatic intolerance [41] & Regular exercise training and adequate hydration prior to landing \\ \cline{2-3}  & Cardiac myocyte atrophy [42] & Restores back to baseline after returning from spaceflight \\ \hline \multirow{2}{*}{Ophthalmology} & Spaceflight-Associated Neuro-Ocular Syndrome (SANS) [43] & The lower body negative pressure device has been proposed as a countermeasure but is currently unproven \\ \hline \multirow{2}{*}{Dermatology} & Skin tinning, dry skin, delayed wound healing, or skin infections [44] & No specific countermeasures exist \\ \hline \multirow{4}{*}{Traumatology} & Increased risk of traumatic injury with construction, inadvertent acceleration of large masses when in zero gravity, impaired physiologic responses to hemorrhage and shock in zero gravity, bone demineralization increases risk of traumatic fractures, micrometeorites in EVA activities [45; 46; 47] \\ \cline{2-3}  & \multicolumn{2}{c}{**Radiation**} \\ \hline \multirow{2}{*}{Most systems} & \multirow{2}{*}{Cancer induction} & Shielding, including advanced shielding options. [48; 49] \\  & & Optimize mission according to solar cycle [48; 49] \\ \cline{1-1}  & & Sex- and age-based selection criteria for astronauts [48] \\ \hline Musculoskeletal & Bone cell remodeling [6] & Shielding [7] \\ \hline \hline \end{tabular}
\end{table} 
Table 2: Summary of Space Hazards to each organ system and potential countermeasures.