The relationship of E. coli and total coliform culture to the quantitative molecular detection of various fecal indicators, sources, and pathogens in private drinking water wells

Water remains a predominant vector for human enteric pathogens not just for developing countries but also developed nations, where numerous infectious disease outbreaks, linked to the contamination of drinking water have been documented. Private drinking water wells are a source of drinking water that is largely unstudied even though a significant percentage of the population in Ontario relies on wells as their primary water source. As there exists little to no systematic surveillance for enteric infections or outbreaks related to well water sources, these individuals may be at higher risk of waterborne infectious diseases. The relationships between various fecal indicators in the water of private drinking water wells, including E. coli, Total Coliforms (TC) and Bacteroides, and enteric pathogens, including Campylobacter jejuni, Salmonella spp., and Shiga toxin producing E. coli, were studied. Convenience private well water samples collected from various regions of interest during the summer of 2014 underwent membrane filtration and culture to determine quantities of E. coli and TC colony forming units. 289 E. coli positive and 230 TC-only waters were successfully analyzed by individual qPCR assays for the aforementioned enteric pathogens. Microbial source tracking methods targeted to specific Bacteroides were used to determine the source of fecal contamination as either human or bovine. The source of fecal contamination varied by geographic region and is thought to be due to such things as differences in septic tank density and underlying geology, among others. Fecal indicators, E. coli and Bacteroides, were significantly correlated. E. coli as measured by qPCR was more strongly correlated to both total and human-specific Bacteroides genetic markers than culturable E. coli. Lastly, 1.9% of samples showed molecular evidence of contamination with enteric pathogens. Although low, this finding is significant given the limited volume of water available for testing, and suggests a potential health risk to consumers. Knowing the extent of contamination, as well as the biologic source, can better inform risk assessment and the development of potential intervention strategies for private well water in specific regions of Ontario.

Indoor air quality in Portuguese schools: levels and sources of pollutants

Indoor air quality (IAQ) parameters in 73 primary classrooms in Porto were examined for the purpose of assessing levels of volatile organic compounds (VOCs), aldehydes, particulate matter, ventilation rates and bioaerosols within and between schools, and potential sources. Levels of VOCs, aldehydes, PM2.5 , PM10 , bacteria and fungi, carbon dioxide (CO2 ), carbon monoxide, temperature and relative humidity were measured indoors and outdoors and a walkthrough survey was performed concurrently. Ventilation rates were derived from CO2 and occupancy data. Concentrations of CO2 exceeding 1000 ppm were often encountered, indicating poor ventilation. Most VOCs had low concentrations (median of individual species <5 μg/m(3) ) and were below the respective WHO guidelines. Concentrations of particulate matter and culturable bacteria were frequently higher than guidelines/reference values. The variability of VOCs, aldehydes, bioaerosol concentrations, and CO2 levels between schools exceeded the variability within schools. These findings indicate that IAQ problems may persist in classrooms where pollutant sources exist and classrooms are poorly ventilated; source control strategies (related to building location, occupant behavior, maintenance/cleaning activities) are deemed to be the most reliable for the prevention of adverse health consequences in children in schools.

Mafic and felsic plutonism in the Elvas region (SW Iberia, Portugal): two distinct Nd isotope sources and geodynamics

The occurrence of mafic (mainly gabbros and diorites) and felsic (syenites and granites) rocks, in close spatial association, in the Elvas region, at the northern part of the Ossa-Morena Zone, could be interpreted as a single bimodal (alkaline) plutonic complex. However, in spite of scarce isotopic (Sm-Nd) data, the co-magmatic origin of both rock groups (mafic and felsic) has already been questioned [1]. Based on the mineral chemistry of primary clinopyroxenes (Di–Hd, %En: 45.5 – 27.2) and representative whole-rock analyses, gabbros and diorites of the Elvas massif show a transitional character between alkaline and non-alkaline fields and wide compositions: SiO2 (42.47 – 58.00 wt%); TiO2 (0.24 – 1.68 wt%); Y/Nb (4.0 – 10.7); Th (0.1 – 6.8 ppm); Zr (18.6 – 576.9 ppm). The felsic group is composed by highly differentiated rocks which correspond to distinct levels of silica saturation and alkalinity. Peralkaline syenites usually present sodic (riebeckite) and sodic-calcic (aegirine-augite, ferrowinchite) inosilicates and reveal quite variable compositions: SiO2 (57.50 – 72.07 wt%); TiO2 (0.10 – 1.45 wt%); Th (1.7 – 67.0 ppm); Zr (133.0 – 4800.0 ppm). The alkaline granites show hedenbergite as the characteristic inosilicate, presenting relatively common compositions: SiO2 (61.85 – 78.06 wt%); TiO2 (0.21 – 0.58 wt%); Th (11.8 – 38.4 ppm); Zr (317.3 – 1234.6 ppm) [2]. Recent Sm-Nd isotopic results, on a total of 18 whole-rock samples (6 mafites and 12 felsites), allow new and more consistent interpretation concerning the petrogenesis of these plutonic rocks. Assuming an age of 490 Ma [3], the felsic rocks provide (0.6 < Nd490 < 4.3), similar to other contemporary (per)alkaline rocks of this region [4], reflecting magmatic extractions from time-integrated depleted mantle sources followed by variable and incomplete mixing (and/or AFC-type) processes with enriched, probably crustal sources. This alkaline/peralkaline magmatism is thought to represent the main regional record of the rifting event which presumably led to the opening of the Rheic Ocean. On the other hand, the mafic plutonic rocks of the Elvas massif cannot represent the magmatic precursors of these syenites and granites as they show completely distinct Nd isotopic ratios (3.7 < Nd490 < 1.2) indicating important contribution of long-term enriched (crustal) sources. Instead, considering the age and the Nd isotopic signature of other mafic plutonic unit emplaced nearby (the Campo Maior massif: ca. 370 Ma; 6.0 < Nd370 < 5.2) [5], and recalculating the isotopic ratios of the Elvas massif for the same age (4.3 < Nd370 < 1.6), it is plausible to consider that these plutons (Campo Maior and Elvas) can be coeval and representative of the Variscan magmatism in this region. In such hypothesis, the differences between these isotopic values could be explained, on a time-integrated basis, either by magmatic sources for the Elvas massif less enriched in LREE than the sources involved in the Campo Maior massif, or, if both plutonites share similar depleted mantle sources, by magmatic differentiation paths considerably affected by crustal contamination processes, which reached higher degrees in the Campo Maior massif.

Sources of Information about Dietary Fibre: A Cross-Country Survey

Problem statement: Dietary fibre (DF) has been recognized as a major determinant for improvement of health. Hence the means of information through which people become aware of its benefits are crucial. Research questions: Where do you usually find information about dietary fibre? What means of communication do you consider the most appropriate to encourage the consumption of dietary fibre? Purpose of the study: This work aimed at studying the sources of information about dietary fibre, as a means to educate people about aspects related to healthy eating. Factors such as gender, level of education, living environment or country were evaluated as to their effect on the selection of sources and preferences.   Research Methods: Descriptive cross-sectional study by means of a questionnaire, applied to a non-probabilistic sample of 6010 participants from 10 countries in different continents (Europe, Africa and America), answered after informed consent by all participants. For the analysis were used several descriptive statistics tools, crosstabs and chi square test to assess the relations between some of the variables under study. Findings: Mostly the information about DF comes from the internet, but television is recognized as suitable. Differences were found between genders, levels of education, living environments and countries. The internet (preferred source), got highest scores for Hungary, urban areas, university education and female gender. The radio (least scored source) was preferred in Egypt, for men and with lower education (primary school). Conclusions: People get information through the internet due to easy access. However, it is to some extent a risk given the impossibility to control de information made public on the internet. The role of health centres and hospitals as well as schools should definitely be increased, as a responsible way to ensure correct information.

Optimization of flocculation process and continuous filtration for sea water primary treatment filtration to reduce SDI for entree to reverse osmosis system

Today , Providing drinking water and process water is one of the major problems in most countries ; the surface water often need to be treated to achieve necessary quality, and in this way, technological and also financial difficulties cause great restrictions in operating the treatment units. Although water supply by simple and cheap systems has been one of the important objectives in most scientific and research centers in the world, still a great percent of population in developing countries, especially in rural areas, don't benefit well quality water. One of the big and available sources for providing acceptable water is sea water. There are two ways to treat sea water first evaporation and second reverse osmosis system. Nowadays R.O system has been used for desalination because of low budget price and easily to operate and maintenance. The sea water should be pretreated before R.O plants, because there is some difficulties in raw sea water that can decrease yield point of membranes in R.O system. The subject of this research may be useful in this way, and we hope to be able to achieve complete success in design and construction of useful pretreatment systems for R.O plant. One of the most important units in the sea water pretreatment plant is filtration, the conventional method for filtration is pressurized sand filters, and the subject of this research is about new filtration which is called continuous back wash sand filtration (CBWSF). The CBWSF designed and tested in this research may be used more economically with less difficulty. It consists two main parts first shell body and second central part comprising of airlift pump, raw water feeding pipe, air supply hose, backwash chamber and sand washer as well as inlet and outlet connections. The CBWSF is a continuously operating filter, i.e. the filter does not have to be taken out of operation for backwashing or cleaning. Inlet water is fed through the sand bed while the sand bed is moving downwards. The water gets filtered while the sand becomes dirty. Simultaneously, the dirty sand is cleaned in the sand washer and the suspended solids are discharged in backwash water. We analyze the behavior of CBWSF in pretreatment of sea water instead of pressurized sand filter. There is one important factor which is not suitable for R.O membranes, it is bio-fouling. This factor is defined by Silt Density Index (SDI).measured by SDI. In this research has been focused on decreasing of SDI and NTU. Based on this goal, the prototype of pretreatment had been designed and manufactured to test. The system design was done mainly by using the design fundamentals of CBWSF. The automatic backwash sand filter can be used in small and also big water supply schemes. In big water treatment plants, the units of filters perform the filtration and backwash stages separately, and in small treatment plants, the unit is usually compacted to achieve less energy consumption. The analysis of the system showed that it may be used feasibly for water treating, especially for limited population. The construction is rapid, simple and economic, and its performance is high enough because no mobile mechanical part is used in it, so it may be proposed as an effective method to improve the water quality and consequently the hygiene level in the remote places of the country.

Farm visits: interdisciplinary outdoor learning for primary school pupils and Scotland’s Curriculum for Excellence

There is concern around children’s lack of knowledge and understanding of food sources and production, and more broadly around their apparent disconnection from nature. Spending time in the outdoors has been shown to yield a range of benefits, although the mechanisms underpinning these are not well understood. Studies have suggested, however, that there has been a decline in time spent outdoors by children. The introduction of the ‘Curriculum for Excellence’ guidelines in Scotland was heralded as an opportunity to address this decline. Although the guidelines advocate the use of outdoor environments, little research has been conducted, and little guidance is available, on how teachers can and do use outdoor learning in relation to the guidelines, particularly beyond ‘adventure’ activities. Farms are utilised as an educational resource around the world. This research explored the use of educational farm visits, as an example of outdoor learning, in the context of Curriculum for Excellence. A qualitatively driven, mixed methods study, comprising survey and case study methodologies, was undertaken. A questionnaire for teachers informed subsequent interviews with teachers and farmers, and ‘group discussions’ with primary school pupils. The study found that teachers can link farm visits and associated topics with the Curriculum for Excellence guidelines in a range of ways, covering all curriculum areas. There was a tendency however for farm visits to be associated with food and farming topics at Primary 2-3 (age 6-7), rather than used more widely. Issues to consider in the planning and conduct of farm visits were identified, and barriers and motivations for teachers, and for farmers volunteering to host visits, were explored. As well as practical examples of the use of farm visiting, this research offers a perspective on some of the theoretical literature which seeks to explain the benefits of spending time outdoors. Furthermore, five main recommendations for farm visiting in the context of Curriculum for Excellence are given. These relate to the type of visit appropriate to different age groups, opportunities for teachers to become more familiar with what farms visits can offer, and raising awareness of the organisations and networks which can support volunteer farmers to host visits.

Sources of Information about Dietary Fibre: A Cross-Country Survey

Dietary fibre (DF) has been recognized as a major determinant for improvement of health. Hence the means of information through which people become aware of its benefits are crucial. This work aimed at studying the sources of information about DF, as a means to educate people about aspects related to healthy eating. Factors such as gender, level of education, living environment or country were evaluated as to their effect on the selection of sources and preferences. For this, a descriptive cross-sectional study by means of a questionnaire, applied to a non-probabilistic sample of 6010 participants from 10 countries in different continents (Europe, Africa and America), answered after informed consent by all participants. For the analysis were used several descriptive statistics tools, crosstabs and chi square test to assess the relations between some of the variables under study. The results showed that mostly the information about DF comes from the internet, but the participants recognize that television might be a most suitable way to disseminate information about DF. The results also indicated differences between genders, levels of education, living environments and countries. The internet, the preferred source of information, got highest scores for Hungary, for urban areas, for university level of education and for female gender. The radio, the least scored source of information, was preferred in Egypt, for men and with lower education (primary school). As a conclusion, people get information through the internet due to easy access. However, it is to some extent a risk given the impossibility to control de information made public on the internet. The role of health centers and hospitals as well as schools should definitely be increased, as a responsible way to ensure correct information.

Sensible use of primary energy in organic greenhouse production.

This document addresses the direct and indirect use of energy in European organic greenhouse horticulture (OGH) with the aim of reviewing available means for making it more environmental friendly and identifying knowledge gaps that should be addressed to attain this aim. The first observation is that there is no common regulation for energy use in OGH, which is not unexpected, since the need for climatisation is not uniformly distributed in the EU (and outside). Accordingly, the EU directive on organic agriculture does not set limitations on the use of energy, but rather promotes the responsible use of energy and of natural resources. The restrictions and rules of most private standards are slightly more stringent. Some standards have specific restrictions on the amount and sources of energy and/or on the seasonal use of energy for heating. Some standards also address processes that may affect (in)direct energy use, such as cultivation methods, mulching, lighting and growing media or substrates. However, most private standards have no or little restrictions or regulations on energy use. Accordingly, it should not surprise that very little quantitative information is available about energy use in OGH. In the present document we have filled the gaps with data with estimates drawn on energy use in conventional greenhouses. With respect to ongoing research, whereas many of the present research results about energy use and saving in conventional greenhouses are relevant (and also applied) in OGH, little research is devoted to address the energy use that is peculiar to OGH, particularly energy use for humidity control. In short, there are still a lot of knowledge gaps to improve quality and to lower energy use in organic greenhouses. The purpose of this document is a summary of present relevant knowledge about energy use and energy saving and of the perspective for improvement. In particular, the goal is to make an overview on the methods and technologies which can be used to reduce the energy use in OGH. We start from the assumption that methods and technologies that are used for reducing direct and indirect energy in conventional greenhouses can also be applied in organic greenhouses. Research on reducing energy use in conventional greenhouses is also more widely available because the area of conventional greenhouse horticulture is much larger than the area of OGH. When implementing these methods and techniques we should take into account the specific characteristics of organic agriculture like soil-based cultivation, use of organic fertilizers and the limited use of crop protection products. This document is organised as follows: first we report the results of a survey about energy use and relevant standards in the countries participating to the COST action (chapter 1); then we review the energy use for climatisation: heating (chapter 2) and humidity (chapter 3). In chapter 4 we review the available design and management means that would either reduce energy use and/or increase energy use efficiency by increasing productivity of OGH. In chapter 5 we present a short summary of existing information on indirect energy use, that is the energy required to manufacture production means (greenhouse structure and cover, fertilisers, equipment etc.) and for crop protection, particularly steaming, and briefly discuss possible savings. Finally (chapter 6) we review briefly the potential for application of renewable energy sources in OGH.

Barn owl feathers as biomonitors of mercury: sources of variation

Given their central role in mercury (Hg) excretion and suitability as reservoirs, bird feathers are useful Hg biomonitors. Nevertheless, the interpretation of Hg concentrations is still questioned as a result of a poor knowledge of feather physiology and mechanisms affecting Hg deposition. Given the constraints of feather availability to ecotoxicological studies, we tested the effect of intraindividual differences in Hg concentrations according to feather type (body vs. flight feathers), position in the wing and size (mass and length) in order to understand how these factors could affect Hg estimates. We measured Hg concentration of 154 feathers from 28 un-moulted barn owls (Tyto alba), collected dead on roadsides. Median Hg concentration was 0.45 (0.076–4.5) mg kg-1 in body feathers, 0.44 (0.040–4.9) mg kg-1 in primary and 0.60 (0.042–4.7) mg kg-1 in secondary feathers, and we found a poor effect of feather type on intra-individual Hg levels. We also found a negative effect of wing feather mass on Hg concentration but not of feather length and of its position in the wing. We hypothesize that differences in feather growth rate may be the main driver of between-feather differences in Hg concentrations, which can have implications in the interpretation of Hg concentrations in feathers. Finally, we recommend that, whenever possible, several feathers from the same individual should be analysed. The five innermost primaries have lowest mean deviations to both betweenfeather and intra-individual mean Hg concentration and thus should be selected under restrictive sampling scenarios.

Environmental assessment of industrial chemical and primary sector processes from a life cycle perspective

During the PhD program in chemistry at the University of Bologna, the environmental sustainability of some industrial processes was studied through the application of the LCA methodology. The efforts were focused on the study of processes under development, in order to assess their environmental impacts to guide their transfer on an industrial scale. Processes that could meet the principles of Green Chemistry have been selected and their environmental benefits have been evaluated through a holistic approach. The use of renewable sources was assessed through the study of terephthalic acid production from biomass (which showed that only the use of waste can provide an environmental benefit) and a new process for biogas upgrading (whose potential is to act as a carbon capture technology). Furthermore, the basis for the development of a new methodology for the prediction of the environmental impact of ionic liquids has been laid. It has already shown good qualities in identifying impact trends, but further research on it is needed to obtain a more reliable and usable model. In the context of sustainable development that will not only be sector-specific, the environmental performance of some processes linked to the primary production sector has also been evaluated. The impacts of some organic farming practices in the wine production were analysed, the use of the Cereal Unit parameter was proposed as a functional unit for the comparison of different crop rotations, and the carbon footprint of school canteen meals was calculated. The results of the analyses confirm that sustainability in the industrial production sector should be assessed from a life cycle perspective, in order to consider all the flows involved during the different phases. In particular, it is necessary that environmental assessments adopt a cradle-to-gate approach, to avoid shifting the environmental burden from one phase to another.

Primary Relapse Site Pattern In Women With Triple-negative Breast Cancer.

Despite the remarkable improvements in breast cancer (BC) characterization, accurate prediction of BC clinical behavior is often still difficult to achieve. Some studies have investigated the association between the molecular subtype, namely the basal-like BC and the pattern of relapse, however only few investigated the association between relapse pattern and immunohistochemical defined triple-negative breast cancers (TNBCs). The aim of this study was to evaluate the pattern of relapse in patients with TNBC, namely the primary distant relapse site. One-hundred twenty nine (129) invasive breast carcinomas with follow-up information were classified according to the molecular subtype using immunohistochemistry for ER, PgR and Her2. The association between TNBC and distant relapse primary site was analyzed by logistic regression. Using multivariate logistic regression analysis patients with TNBC displayed only 0.09 (95% CI: 0.00-0.74; p=0.02) the odds of the non-TNBC patients of developing bone primary relapse. Regarding visceral and lymph-node relapse, no differences between in this cohort were found. Though classically regarded as aggressive tumors, TNBCs rarely development primary relapse in bone when compared to non-TNBC, a clinical relevant fact when investigating a metastasis of an occult or non-sampled primary BC.

Iis--integrated Interactome System: A Web-based Platform For The Annotation, Analysis And Visualization Of Protein-metabolite-gene-drug Interactions By Integrating A Variety Of Data Sources And Tools.

High-throughput screening of physical, genetic and chemical-genetic interactions brings important perspectives in the Systems Biology field, as the analysis of these interactions provides new insights into protein/gene function, cellular metabolic variations and the validation of therapeutic targets and drug design. However, such analysis depends on a pipeline connecting different tools that can automatically integrate data from diverse sources and result in a more comprehensive dataset that can be properly interpreted. We describe here the Integrated Interactome System (IIS), an integrative platform with a web-based interface for the annotation, analysis and visualization of the interaction profiles of proteins/genes, metabolites and drugs of interest. IIS works in four connected modules: (i) Submission module, which receives raw data derived from Sanger sequencing (e.g. two-hybrid system); (ii) Search module, which enables the user to search for the processed reads to be assembled into contigs/singlets, or for lists of proteins/genes, metabolites and drugs of interest, and add them to the project; (iii) Annotation module, which assigns annotations from several databases for the contigs/singlets or lists of proteins/genes, generating tables with automatic annotation that can be manually curated; and (iv) Interactome module, which maps the contigs/singlets or the uploaded lists to entries in our integrated database, building networks that gather novel identified interactions, protein and metabolite expression/concentration levels, subcellular localization and computed topological metrics, GO biological processes and KEGG pathways enrichment. This module generates a XGMML file that can be imported into Cytoscape or be visualized directly on the web. We have developed IIS by the integration of diverse databases following the need of appropriate tools for a systematic analysis of physical, genetic and chemical-genetic interactions. IIS was validated with yeast two-hybrid, proteomics and metabolomics datasets, but it is also extendable to other datasets. IIS is freely available online at: http://www.lge.ibi.unicamp.br/lnbio/IIS/.

Homozygous Inactivating Mutation In Nanos3 In Two Sisters With Primary Ovarian Insufficiency.

Despite the increasing understanding of female reproduction, the molecular diagnosis of primary ovarian insufficiency (POI) is seldom obtained. The RNA-binding protein NANOS3 poses as an interesting candidate gene for POI since members of the Nanos family have an evolutionarily conserved function in germ cell development and maintenance by repressing apoptosis. We performed mutational analysis of NANOS3 in a cohort of 85 Brazilian women with familial or isolated POI, presenting with primary or secondary amenorrhea, and in ethnically-matched control women. A homozygous p.Glu120Lys mutation in NANOS3 was identified in two sisters with primary amenorrhea. The substituted amino acid is located within the second C2HC motif in the conserved zinc finger domain of NANOS3 and in silico molecular modelling suggests destabilization of protein-RNA interaction. In vitro analyses of apoptosis through flow cytometry and confocal microscopy show that NANOS3 capacity to prevent apoptosis was impaired by this mutation. The identification of an inactivating missense mutation in NANOS3 suggests a mechanism for POI involving increased primordial germ cells (PGCs) apoptosis during embryonic cell migration and highlights the importance of NANOS proteins in human ovarian biology.

Determination Of Flavanones In Orange Juices Obtained From Different Sources By Hplc/dad.

Flavanones (hesperidin, naringenin, naringin, and poncirin) in industrial, hand-squeezed orange juices and from fresh-in-squeeze machines orange juices were determined by HPLC/DAD analysis using a previously described liquid-liquid extraction method. Method validation including the accuracy was performed by using recovery tests. Samples (36) collected from different Brazilian locations and brands were analyzed. Concentrations were determined using an external standard curve. The limits of detection (LOD) and the limits of quantification (LOQ) calculated were 0.0037, 1.87, 0.0147, and 0.0066 mg 100 g(-1) and 0.0089, 7.84, 0.0302, and 0.0200 mg 100 g(-1) for naringin, hesperidin, poncirin, and naringenin, respectively. The results demonstrated that hesperidin was present at the highest concentration levels, especially in the industrial orange juices. Its average content and concentration range were 69.85 and 18.80-139.00 mg 100 g(-1). The other flavanones showed the lowest concentration levels. The average contents and concentration ranges found were 0.019, 0.01-0.30, and 0.12 and 0.1-0.17, 0.13, and 0.01-0.36 mg 100 g(-1), respectively. The results were also evaluated using the principal component analysis (PCA) multivariate analysis technique which showed that poncirin, naringenin, and naringin were the principal elements that contributed to the variability in the sample concentrations.

Infratentorial Gray Matter Atrophy And Excess In Primary Craniocervical Dystonia.

Primary craniocervical dystonia (CCD) is generally attributed to functional abnormalities in the cortico-striato-pallido-thalamocortical loops, but cerebellar pathways have also been implicated in neuroimaging studies. Hence, our purpose was to perform a volumetric evaluation of the infratentorial structures in CCD. We compared 35 DYT1/DYT6 negative patients with CCD and 35 healthy controls. Cerebellar volume was evaluated using manual volumetry (DISPLAY software) and infratentorial volume by voxel based morphometry of gray matter (GM) segments derived from T1 weighted 3 T MRI using the SUIT tool (SPM8/Dartel). We used t-tests to compare infratentorial volumes between groups. Cerebellar volume was (1.14 ± 0.17) × 10(2) cm(3) for controls and (1.13 ± 0.14) × 10(2) cm(3) for patients; p = 0.74. VBM demonstrated GM increase in the left I-IV cerebellar lobules and GM decrease in the left lobules VI and Crus I and in the right lobules VI, Crus I and VIIIb. In a secondary analysis, VBM demonstrated GM increase also in the brainstem, mostly in the pons. While gray matter increase is observed in the anterior lobe of the cerebellum and in the brainstem, the atrophy is concentrated in the posterior lobe of the cerebellum, demonstrating a differential pattern of infratentorial involvement in CCD. This study shows subtle structural abnormalities of the cerebellum and brainstem in primary CCD.