Recommendations by the Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and the Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) on vaccination in general and specifically against SARS-CoV-2 for patients with demyelinating diseases of the central nervous system.

The Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) provide recommendations in this document for vaccination of the population with demyelinating diseases of the central nervous system (CNS) against infections in general and against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. We emphasize the seriousness of the current situation in view of the spread of COVID-19 in our country. Therefore, reference guides on vaccination for clinicians, patients, and public health authorities are particularly important to prevent some infectious diseases. The DCNI/ABN and BCTRIMS recommend that patients with CNS demyelinating diseases (e.g., MS and NMOSD) be continually monitored for updates to their vaccination schedule, especially at the beginning or before a change in treatment with a disease modifying drug (DMD). It is also important to note that vaccines are safe, and physicians should encourage their use in all patients. Clearly, special care should be taken when live attenuated viruses are involved. Finally, it is important for physicians to verify which DMD the patient is receiving and when the last dose was taken, as each drug may affect the induction of immune response differently.

Supply-side Perspectives on Outdoor Tourism in the North of Portugal

Nowadays, the tourism sector presents many opportunities and challenges. Outdoor Tourism (OT), due to the unusual situation experienced by the pandemic caused by COVID-19, maybe one of the main opportunities to promote the local development of tourist destinations. Most of the literature developed in this context has focused the demand side. Therefore, the investigation intended to fill this gap, considering the perspective of the supply side, taking into account a vision of sustainable development. To meet this gap, the main objective is to contribute to the characterization of Outdoor Tourism (OT) in the North of Portugal, and understand the potential of OT in the perspective of supply., thirty-eight tourist entertainment companies (TEC) were interviewed to assess supply and perceived customers' motivations. Of the seven Nomenclature of Territorial Units for Statistical Purposes (NUTS), the Northern region was considered to be an area with enormous potential for Nature-related tourist). For the supply side, seasonality and climate were identified as important factors supporting environment preservation. Radical experiences, adventure and getting out of the routine were identified as motivating demand factors, as well as the contact with Nature and the landscape. We have also observed that if we consider the stimulation of the local economy by OT, there is still a lot to do. The evidence pointed to some social imbalance, namely related to employability. Employees were hired according to the evolution of demand, which favours unemployment and social instability. Also, the tourists/costumers are the main channels of communication of the activities;the word-ofmouth (WOM) of costumers' experiences, personally or through online social media, takes on a prominent role. In this sense, tourists' online reviews, testimonies and word-of-mouth can be optimized through social networks and digital marketing. Finally, to evaluate the region's potential for the OT, the interviewees suggested integrating the players involved with the OT into a single network, supporting the activities and promoting the region.

A Snapshot of a Pandemic: The Interplay between Social Isolation and COVID-19 Dynamics in Brazil (preprint)

In response to the COVID-19 pandemic, most governments around the world implemented some kind of social distancing policy in an attempt to block the spreading of the virus within a territory. In Brazil, this mitigation strategy was first implemented in March 2020 and mainly monitored by social isolation indicators built from mobile geolocation data. While it is well known that social isolation has been playing a crucial role in epidemic control, the precise connections between mobility data indicators and epidemic dynamic parameters have a complex interdependence. In this work, we investigate this dependence for several Brazilian cities, looking also at socioeconomic and demographic factors that influence it. As expected, the increase in the social isolation indicator was shown to be related to the decrease in the speed of transmission of the disease, but the relation was shown to depend on the urban hierarchy level of the city, the human development index and also the epidemic curve stage. Moreover, a high social isolation at the beginning of the epidemic relates to a strong positive impact on flattening the epidemic curve, while less efficacy of this mitigation strategy was observed when it has been implemented later. Mobility data plays an important role in epidemiological modeling and decision-making, however, we discuss in this work how a direct relationship between social isolation data and COVID-19 data is hard to be established. Understanding this interplay is a key factor to better modeling, for which we hope this study contributes.Funding: PSP was supported by grant # 16/18445-7, São Paulo Research Foundation (FAPESP) and by grant #301778/2017-5, Na tional Council for Scientific and Technological Development (CNPq). The research of CPF is supported by grant #2019/22157- 5, São Paulo Research Foundation (FAPESP) and by grant #302984/2020-8, National Council for Scientific and Technological Development (CNPq). DM was supported by the National Council for Scientific and Technological Development (CNPq) dur ing the development of this paper.Declaration of Interest: The authors declare no competing financial or non-financial interests.

Exploring eating and exercise-related indicators during COVID-19 quarantine: Concerns and routine changes in women with different BMI (preprint)

Purpose. The present study aimed to understand how quarantine associated to COVID-19 was experienced by women from different BMI groups (underweight, normal weight, pre-obesity, and obesity), by exploring the changes introduced in eating and exercise routines and the differences between BMI groups regarding shape concern, weight concern and binge eating behaviours reported during this time.Methods. This study comprised 580 women aged between 18 and 65 years old, who completed self-report measures, during the mandatory confinement in Portugal due to COVID-19. The total sample was divided into four groups, according to their BMI.Results. Results revealed that overall, there were no significant differences between the groups regarding the eating and exercise routine changes introduced during quarantine. However, significant differences between the four groups were found in the reported body and eating-related difficulties (shape concern, weight concern and binge eating behaviours), with the pre-obesity and obesity groups presenting significant higher levels. Conclusions. Our study suggests that, even though the changes introduced to the eating and exercise routine are independent from BMI, the pre-obesity and obesity group represent a major vulnerability group for the development of eating disorders. We hope this study allows professionals to understand the need to develop different guidelines and strategies for the pre-obesity and obesity female population during the deconfinement period. Level of evidence. Level V - Descriptive study.

Several countries in one: a mathematical modeling analysis for COVID-19 in inner Brazil (preprint)

Early 2020 and the world experiences its very first pandemic of globalized era. A novel coronavirus, SARS-Cov-2, is the causative agent of severe pneumonia and rapidly spread through many nations, crashing health systems. In Brazil, the emergence of local epidemics in major metropolitan areas is a concern. In a huge and heterogeneous country, with regional disparities and climate diversity, several factors can modulate the dynamics of COVID-19. What should be the scenario for an inner Brazil and what can we do to control infection transmission in each one of these locations? In this paper, a mathematical model was developed to simulate disease transmission among individuals in several scenarios, differing by the intensity and type of control measures. Mitigation strategies rely on social distancing of all individuals, and detection and isolation of infected ones. The model shows that control effort varies among cities. The social distancing is the most efficient method to control disease transmission but improving detection and isolation of infected individuals can help loosening this mitigation strategy.