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BACKGROUND Linking different sources of medical data is a promising approach to analyze care trajectories. The aim of the INSHARE (Integrating and Sharing Health Big Data for Research) project was to provide the blueprint for a technological platform that facilitates integration, sharing, and reuse of data from 2 sources: the clinical data warehouse (CDW) of the Rennes academic hospital, called eHOP (entrepôt Hôpital), and a data set extracted from the French national claim data warehouse (Système National des Données de Santé [SNDS]). OBJECTIVE This study aims to demonstrate how the INSHARE platform can support big data analytic tasks in the health field using a pharmacovigilance use case based on statin consumption and statin-drug interactions. METHODS A Spark distributed cluster-computing framework was used for the record linkage procedure and all analyses. A semideterministic record linkage method based on the common variables between the chosen data sources was developed to identify all patients discharged after at least one hospital stay at the Rennes academic hospital between 2015 and 2017. The use-case study focused on a cohort of patients treated with statins prescribed by their general practitioner or during their hospital stay. RESULTS The whole process (record linkage procedure and use-case analyses) required 88 minutes. Of the 161,532 and 164,316 patients from the SNDS and eHOP CDW data sets, respectively, 159,495 patients were successfully linked (98.74% and 97.07% of patients from SNDS and eHOP CDW, respectively). Of the 16,806 patients with at least one statin delivery, 8293 patients started the consumption before and continued during the hospital stay, 6382 patients stopped statin consumption at hospital admission, and 2131 patients initiated statins in hospital. Statin-drug interactions occurred more frequently during hospitalization than in the community (3800/10,424, 36.45% and 3253/14,675, 22.17%, respectively; P CONCLUSIONS This study demonstrates the added value of combining and reusing clinical and claim data to provide large-scale measures of drug-drug interaction prevalence and care pathways outside hospitals. It builds a path to move the current health care system toward a Learning Health System using knowledge generated from research on real-world health data.

Background The risk of cancer is higher in patients with renal diseases and diabetes compared with the general population. The aim of this study was to assess in dialyzed patients, the association between diabetes and the risk to develop a cancer after dialysis start. Methods All patients who started dialysis in the French region of Poitou-Charentes between 2008 and 2015 were included. Their baseline characteristics were extracted from the French Renal Epidemiology and Information Network and were linked to data relative to cancer occurrence from the Poitou-Charentes General Cancer Registry using a procedure developed by the INSHARE platform. The association between diabetes and the risk of cancer was assessed using the Fine & Gray model that takes into account the competing risk of death. Results Among the 1634 patients included, 591 (36.2 %) had diabetes and 91 (5.6 %) patients developed a cancer (n = 24 before or at dialysis start, and n = 67 after dialysis start). The risk to develop a cancer after dialysis initiation was lower in dialyzed patients with diabetes than without diabetes (SHR = 0.54; 95 %CI: 0.32-0.91). Moreover, compared with the general population, the cancer risk was higher in dialyzed patients without diabetes, but not in those with diabetes. Conclusion The risk of developing a cancer in the region of Poitou-Charentes is higher in dialyzed patients without diabetes than with diabetes.

Les bases medico-administratives constituent un enjeu pour le pilotage des etablissements de sante. Des personnels administratifs sont susceptibles d’y avoir acces. Leur exploitation pose des questions relatives a la gouvernance et a la confidentialite. L’objectif de cet article est de faire un point sur les organisations mises en place. Un questionnaire a destination des medecins des Departements d’information medicale (DIM) a ete etabli. Il portait sur 5 themes : description de l’etablissement, positionnement des assistants de gestion, demandeurs d’acces, acces a des donnees agregees, acces a des donnees individuelles. L’analyse a porte sur 171 questionnaires. Les etablissements sont majoritairement publics et de petite taille. Les assistants de gestion sont rattaches hierarchiquement a une Direction dans 55 % des cas. Dans 66 % des etablissements les controleurs de gestion formulent des demandes d’acces aux donnees medicales. Dans 85 % des etablissements, des demandes portent sur des donnees agregees et dans 62 % des etablissements sur des donnees individuelles. Elles sont majoritairement traitees par le DIM et au cas par cas. Cependant dans 29 % des cas aucune procedure de validation des acces n’est mise en place. Un comite d’acces aux donnees n’est consulte que dans 10 etablissements. On releve un acces a des donnees non anonymisees dans 45 etablissements. Les donnees PMSI sont exploitees par des structures administratives sans qu’une politique d’acces et d’exploitation soit toujours etablie. Les missions des differents partenaires devraient etre mieux definies dans le respect de la confidentialite des donnees de sante. Le DIM a un role central dans l’analyse medico-economique de celles-ci.

The healthcare sector is currently facing a new paradigm, the explosion of "big data". Coupled with advances in computer technology, the field of "big data" appears promising, allowing us to better understand the natural history of diseases, to follow-up new technologies (devices, drugs) implementation and to participate in precision medicine, etc. Data sources are multiple (medical and administrative data, electronic medical records, data from rapidly developing technologies such as DNA sequencing, connected devices, etc.) and heterogeneous while their use requires complex methods for accurate analysis. Moreover, faced with this new paradigm, we must determine who could (or should) have access to which data, how to combine collective interest and protection of personal data and how to finance in the long-term both operating costs and databases interrogation. This article analyses the opportunities and challenges related to the use of open and/or "big data", from the viewpoint of pharmacologists and representatives of the pharmaceutical and medical device industry.

Resume Position du probleme Un registre se definit comme un enregistrement exhaustif de cas. Le registre breton des malformations congenitales s’appuie sur une declaration des cas a la source. Les resumes de sejour hospitaliers du programme de medicalisation des systemes d’information (PMSI) permettent de verifier la completude des declarations. Nous presentons dans cet article un outil informatise de controle d’exhaustivite des cas. Methodes Le controle d’exhaustivite est realise une fois par an selon le meme protocole pour tous les etablissements de la region. La selection des sejours porte sur les enfants nes vivants jusqu’a l’âge de 1 an et sur les sejours des meres pour les enfants mort-nes et les interruptions medicales de grossesse. Les donnees d’identite sont obtenues par croisement avec les bases administratives. Les fichiers sont transmis par messagerie securisee et traites sur un serveur securise. Un algorithme de rapprochement d’identites est implemente. Les cas non rapproches avec un cas du registre donnent lieu a un retour au dossier medical. L’exhaustivite theorique du registre est evaluee par la methode de capture recapture. L’evaluation de l’algorithme de rapprochement d’identites est basee sur le nombre de rapprochements manuels. Resultats En ce qui concerne les annees 2011 et 2012 sur le departement d’Ile-et-Vilaine, le nombre de cas potentiels reperes par le PMSI etait de 470 pour 2011 et de 538 pour 2012 ; 35 nouveaux cas ont ete detectes pour 2011 (32 enfants nes vivants et 3 mort-nes ou IMG) et 33 pour 2012 (enfants nes vivants). Il y avait 85 faux positifs pour 2011 et 137 pour 2012. Le taux d’exhaustivite theorique etait de 91 % chaque annee. Un rapprochement parfait a ete retrouve pour 68 % des cas PMSI, 6 % des cas ont ete rapproches manuellement. Conclusion Les bases de donnees de RSS du PMSI des etablissements contribuent a ameliorer la qualite du registre bien qu’il y ait une declaration des cas a la source. L’outil developpe facilite le travail des enqueteurs. Le croisement entre les cas registre et les cas PMSI pourrait etre facilite par l’utilisation du numero d’inscription au Repertoire national d’identification des personnes physiques.

Resume Objectif Evaluer les performances d’une requete sur des codes de la classification internationale des maladies 10 e revision (CIM10) dans la base de donnees du programme de medicalisation des systemes d’information (PMSI) pour l’identification d’effets indesirables medicamenteux (EIM) graves. Methodes La requete effectuee concernait les sejours de patients sortis d’hospitalisation au Centre hospitalier universitaire de Rennes en 2009. Tous les comptes-rendus d’hospitalisation identifies par des codes CIM10 selectionnes ont ete analyses afin de valider les EIM. Resultats Sur 383 dossiers, 142 cas ont ete retenus (37,1 %). Certains codes CIM10 avaient un rendement particulierement interessant, superieur a 40 % (T88.6, L27.0, J70.4, G62.0 et N14.1) et 79,5 % des EIM ont ete detectes par ces cinq codes. Sur la meme periode, 98 EIM du meme type ont ete declares spontanement aupres du Centre regional de pharmacovigilance. Vingt-deux cas etaient communs. Conclusion L’utilisation du PMSI peut constituer un outil de veille pour la detection de signaux d’EIM graves, en complement de la notification spontanee.

Introduction Des structures dediees a l’exploitation des donnees patients pour la recherche dans un entrepot de donnees biomedicales se mettent en place dans les CHU de la region Grand Ouest. Nous presentons le cadre organisationnel retenu. Methodes La gouvernance se decline selon plusieurs axes : aspects reglementaires, responsabilites, deontologie, confidentialite et respect de la vie privee, circuit des demandes, tracabilite, valorisation. Afin de definir les mesures a mettre en œuvre, des principes ont ete edictes pour chaque axe comme l’information et le droit d’opposition du patient, des structures de regulation, la structure tiers de confiance, la responsabilisation des utilisateurs, la transparence, la deidentification, la parcimonie, la tracabilite, la valorisation. Resultats Les mesures preconisees concernent : – la mise en place d’une structure decisionnelle locale qui valide les demandes de traitement, d’une structure operationnelle depositaire de donnees sensibles qu’elle exploite en toute transparence et d’une structure inter-regionale qui fixe les regles de bon usage et se prononce sur les projets federatifs ; – la determination du circuit de l’information du patient et l’enregistrement de son opposition ; – la redaction de la charte d’utilisation ; – la deidentification des donnees textuelles ; – la tracabilite des demandes, des acces aux sous-entrepots et aux documents patients, des exports de donnees, de la source des informations reportees ; – la realisation de tableaux de bord sur les etudes en cours et la publication des resultats globaux des etudes realisees. Discussion/Conclusion Cette gouvernance assure la reutilisation des donnees patients dans le respect de la reglementation, de la deontologie et de la confidentialite. Les structures mises en place contribuent a instaurer la confiance. La deidentification repond a la directive du nouveau reglement europeen sur la protection des donnees concernant la pseudonymisation. Il faudra s’assurer de la conformite au nouveau texte a propos du consentement de la personne et de la reutilisation de ses donnees.

Rare earth element (REE), dissolved organic carbon (DOC) and trace-element (Al, Mn, Fe, Sr, Ba, U and Th) concentrations were measured in fourteen well water samples (

Aspergillus oryzae was found to secrete two distinct β-glucosidases when it was grown in liquid culture on various substrates. The major form had a molecular mass of 130 kDa and was highly inhibited by glucose. The minor form, which was induced most effectively on quercetin (3,3′,4′,5,7-pentahydroxyflavone)-rich medium, represented no more than 18% of total β-glucosidase activity but exhibited a high tolerance to glucose inhibition. This highly glucose-tolerant β-glucosidase (designated HGT-BG) was purified to homogeneity by ammonium sulfate precipitation, gel filtration, and anion-exchange chromatography. HGT-BG is a monomeric protein with an apparent molecular mass of 43 kDa and a pI of 4.2 as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and isoelectric focusing polyacrylamide gel electrophoresis, respectively. Using p -nitrophenyl-β- d -glucoside as the substrate, we found that the enzyme was optimally active at 50°C and pH 5.0 and had a specific activity of 1,066 μmol min −1 mg of protein −1 and a K m of 0.55 mM under these conditions. The enzyme is particularly resistant to inhibition by glucose ( K i , 1.36 M) or glucono-δ-lactone ( K i , 12.5 mM), another powerful β-glucosidase inhibitor present in wine. A comparison of the enzyme activities on various glycosidic substrates indicated that HGT-BG is a broad-specificity type of fungal β-glucosidase. It exhibits exoglucanase activity and hydrolyzes (1→3)- and (1→6)-β-glucosidic linkages most effectively. This enzyme was able to release flavor compounds, such as geraniol, nerol, and linalol, from the corresponding monoterpenyl-β- d -glucosides in a grape must (pH 2.9, 90 g of glucose liter −1 ). Other flavor precursors (benzyl- and 2-phenylethyl-β- d -glucosides) and prunin (4′,5,7-trihydroxyflavanone-7-glucoside), which contribute to the bitterness of citrus juices, are also substrates of the enzyme. Thus, this novel β-glucosidase is of great potential interest in wine and fruit juice processing because it releases aromatic compounds from flavorless glucosidic precursors.

Genetic engineering of wine yeast strains requires the identification of gene promoters specifically activated under wine processing conditions. In this study, transcriptional activation of specific genes was followed during the time course of wine fermentation by quantifying mRNA levels in a haploid wine strain ofSaccharomyces cerevisiaegrown on synthetic or natural winery musts. Northern analyses were performed using radioactive probes from 19 genes previously described as being expressed under laboratory growth conditions or on molasses in S. cerevisiae during the stationary phase and/or under nitrogen starvation. Nine genes, including members of the HSP family, showed a transition-phase induction profile. For three of them, mRNA transcripts could be detected until the end of the fermentation. Expression of one of these genes, HSP30, was further studied using a HSP30::lacZ fusion on both multicopy and monocopy expression vectors. The production of ‚-galactosidase by recombinant cells was measured during cell growth and fermentation on synthetic and natural winery musts. We showed that the HSP30 promoter can induce high gene expression during late stationary phase and remains active until the end of the wine fermentation process. Similar expression profiles were obtained onfive natural winery musts. ?1997 by John Wiley & Sons, Ltd.

To evaluate the performance of a query on international classification of diseases 10(th) version (ICD10) codes in the database of the programme for the medicalisation of information systems (programme de médicalisation des systèmes d'information, PMSI) to identify serious adverse drug reactions (ADR).The query concerned hospital stays of patients discharged from the French University Hospital of Rennes in 2009. All the hospitalization summaries including a selected ICD10 code were analysed to validate ADR.Out of 383 cases, 142 cases were validated (37.1%). Performance of some ICD10 codes was particularly interesting, above 40% (T88.6, L27.0, J70.4, G62.0 and N14.1) and 79.5% of the ADR were detected by these five codes. During the study period, 98 ADR of the same type were spontaneously reported by physicians, 22 of which were common with the ICD10 query.The use of PMSI can be a tool for signal detection of serious ADR, in addition to spontaneous reporting.

Background Clinical practice guidelines give recommendations about what to do in various medical situations, including therapeutical recommendations for drug prescription. An effective way to computerize these recommendations is to design critiquing decision support systems, i.e. systems that criticize the physician's prescription when it does not conform to the guidelines. These systems are commonly based on a list of "if conditions then criticism" rules. However, writing these rules from the guidelines is not a trivial task. The objective of this article is to propose methods that (1) simplify the implementation of guidelines' therapeutical recommendations in critiquing systems by automatically translating structured therapeutical recommendations into a list of "if conditions then criticize" rules, and (2) can generate an appropriate textual label to explain to the physician why his/her prescription is not recommended. Methods We worked on the therapeutic recommendations in five clinical practice guidelines concerning chronic diseases related to the management of cardiovascular risk. We evaluated the system using a test base of more than 2000 cases. Results Algorithms for automatically translating therapeutical recommendations into "if conditions then criticize" rules are presented. Eight generic recommendations are also proposed; they are guideline-independent, and can be used as default behaviour for handling various situations that are usually implicit in the guidelines, such as decreasing the dose of a poorly tolerated drug. Finally, we provide models and methods for generating a human-readable textual critique. The system was successfully evaluated on the test base. Conclusion We show that it is possible to criticize physicians' prescriptions starting from a structured clinical guideline, and to provide clear explanations. We are now planning a randomized clinical trial to evaluate the impact of the system on practices.

Sclerotinia sclerotiorum secretes β-galactosidase, giving very low activity when cultivated in a medium with glucose as the carbon source. This production is greatly enhanced during growth on different pectin related polysaccharides. An extracellular β-galactosidase was purified 26-fold by ammonium sulfate precipitation, gel filtration and ion exchange chromatography. This enzyme has a Km of 0.15 mg/ml, a Mr of 120 000 and a pI of 6.0. Enzyme activity was optimal at pH 4.0 and 50°C.

Cultures of Sclerotinia sclerotiorum grown on different pectin-related polysaccharides (citrus pectin, apple pectin, sodium polygalacturonate), carboxymethylcellulose (CMC) or glucose as the only carbon source were examined daily for polygalacturonase and pectinase activities. Electrophoretic forms of polygalacturonase and pectin methylesterase activities were revealed using analytical IEF and sodium polygalacturonate and citrus pectin as substrates in overlay gels. A sequence in the production of pectic enzymes and isoenzyme synthesis was found in pectic-polymer cultures corresponding to the induction of several isoenzymes. Enzyme activities in glucose media were associated with three polygalacturonase and two pectinmethylesterase isoforms which were produced constitutively. Sodium-dodecyl-sulphate polyacrylamide-gel electrophoresis followed by immunoblotting with polyclonal antibodies against an exo-polymethylgalacturonase and an exo-polygalacturonase revealed that these exo-enzymes were secreted from the beginning of cultivation in the different culture media showing characteristics of constitutive enzymes.

Aims: Grenache noir and Syrah are the predominant grape varieties in the French Rhone valley vineyard. This study aimed at identifying the odorants generated from glycoconjugates extracted from wines made with Grenache noir and Syrah.Methods and results: Synthetic model wines enriched with glycoconjugates, treated or not with enzymes, were stored at 45 °C for 3 weeks, or at 13 °C for 18 months. Aromas generated were extracted and analyzed by GC-Olfactometry (only samples from accelerated aging) and were further quantitatively determined by GC-MS. Analysis of the extracts allowed to identify 49 odorants, including 27 that could be aglycons, or related compounds, of glycoconjugates from the grapes. In addition, the active compounds were quantified in similar experiments led in conditions of natural aging for 18 months.Conclusion: The two varieties, Grenache noir and Syrah, were distinguishable by 14 odorant zones. Multivariate analyses (PCA) performed with the amounts of aroma compounds formed during both model and natural aging confirmed the effect of the glycosidase treatment on the acceleration of the aroma compounds formation and on the increase of the varietal differences of the wines.Significance and impact of study: GC-Olfactometry coupled with GCMS were good techniques to indentify and apreciate the odorants generated from glycoconjugates in the wines of Syrah and Grenache Noir, but in the context of a blend of odors, these techniques showed their limits and did not permit to determine the real impact of a molecule in the global aroma of the wine perceived by the taster. Other methods as additive techniques should be used to complete this study.

The range of polysaccharide-degrading enzymes and glycosidases formed by the phytopathogenic fungus Sclerotinia sclerotiorum was monitored following growth on 16 carbohydrate substrates. Endo- and exoenzymes capable of degrading cellulosic, hemicellulosic, and pectinolytic polysaccharides were secreted. Pectinolytic activities were produced constitutively on all of the substrates tested. Cellulolytic enzymes were not induced in simple sugar (i.e., glucose or xylose) media. Polysaccharide growth substrates and cellulase inducers increased all of the enzyme activities tested. Gel filtration analysis revealed the appearance of new molecular forms of pectinase, β-xylosidase, and cellobiosidase during induction on pectin and carboxymethyl cellulose media.

Computer-interpretable guidelines (CIGs) are more likely to affect the clinician's behavior when they deliver patient-specific and just-in-time clinical advice. CIGs must take into account the data stored in the patient's electronic medical records (EMR). For chronic diseases, the outcome of past and ongoing treatments (therapeutic history) is used in the clinical guidelines. We propose a model for the conceptualization of therapeutic history, facilitating data sharing between EMRs and CIGs and the representation of therapeutic history and recommended treatments in clinical guidelines.Based on medical literature review and an existing treatment model, a core structure is first defined taking into account drug and non-drug treatment components and treatment type (e.g. bitherapy). These elements together with additional concepts obtained by analyzing a sample guideline relating to diabetes, are then organized into an object-oriented model, using UML formalism.We show how this model can be used to store the patient's therapeutic history in the EMR, together with other attributes such as treatment efficacy and tolerance. We also explain how this model can efficiently code guidelines therapeutic rules.We evaluated this model, using additional guidelines hypercholesterolemia and asthma. We found it capable for representing guideline recommendations in several domains of chronic diseases.

The transport of glucose and fructose into yeast cells is a critical step in the utilization of sugars during wine fermentation. Hexose uptake can be carried out by various Hxt carriers, each possessing distinct regulatory and transport-kinetic properties capable of influencing yeast fermentation capacity. We investigated the expression pattern of the hexose transporters Hxt1 to 7 at the promoter and protein levels in Saccharomyces cerevisiae during wine fermentation. The Hxt1p carrier was expressed only at the beginning of fermentation, and had no role during stationary phase. The Hxt3p carrier was the only one to be expressed throughout fermentation, displaying maximal expression at growth arrest and slowly decreasing in abundance over the course of the stationary phase. The high-affinity carriers Hxt6p and Hxt7p displayed similar expression profiles, with expression induced at entry into stationary phase and persisting throughout the phase. The expression of these two carriers occurred despite the presence of high amounts of hexoses, and the proteins were stably expressed when the cells were starved for nitrogen. The Hxt2p transporter was only transiently expressed during lag phase, which suggests a role for the protein in growth initiation. Characterization of glucose transport kinetics indicated the presence of a shift in the low-affinity component that is consistent with a predominant expression of Hxt1p during growth phase and of Hxt3p during stationary phase. In addition, a high-affinity uptake component consistent with functional expression of Hxt6p/Hxt7p was identified during stationary phase.

High-precision oxygen isotope analyses were carried out on dissolved phosphate extracted from discharge waters from three wastewater treatment plants (WTP) located in western France, as well as on the different phosphate-based fertilizers applied by farmers in the same region. Measured delta(18)O values of phosphate from chemical fertilizers range from 19.6 to 23.1 per thousand, while those of phosphate from WTP discharge waters are more tightly grouped between 17.7 and 18.1 per thousand. The variability in delta(18)O values of phosphate fertilizers is attributed to oxygen isotope variations of the phosphorite deposits from which France's fertilizers are manufactured. The significance of the delta(18)O values of phosphate from WTP discharge waters is less straightforward. At present, it is not clear whether these values are primary isotopic compositions corresponding, e.g., to the oxygen isotope composition of phosphate builders included in detergents (delta(18)O(P)=17.9 per thousand), or represent secondary values reflecting biological recycling of the phosphate in equilibrium with ambient WTP water The restricted difference in isotopic composition obtained between phosphate from fertilizers and phosphate from WTP discharge waters (2 per thousand), as well as the fairly large internal isotopic variability observed in both end-members (/=1.5 per thousand), cast doubt about the possibility that the oxygen isotope composition could serve as a tracer for the source of anthropogenic phosphates in waters.

We investigated the role of hexose transporters in a Saccharomyces cerevisiae strain derived from an industrial wine strain by carrying out a functional analysis of HXT genes 1–7 under enological conditions. A strain in which the sugar carrier genes HXT1–HXT7 were deleted was constructed and the HXT genes were expressed individually or in combination to evaluate their role under wine alcoholic fermentation conditions. No growth or fermentation was observed in winemaking conditions for the hxt1-7Δ strain. The low-affinity carriers Hxt1 and Hxt3 were the only carriers giving complete fermentation of sugars when expressed alone, indicating that these carriers play a predominant role in wine fermentation. However, these two carriers have different functions. The Hxt3 transporter is thought to play a major role, as it was the only carrier that gave an almost normal fermentation profile when produced alone. The hxt1 carrier was much less effective during the stationary phase and its role is thought to be restricted to the beginning of fermentation. The high-affinity carriers Hxt2, Hxt6 and/or Hxt7 were also required for normal fermentation. These high-affinity transporters have different functions: hxt2 is involved in growth initiation, whereas Hxt6 and/or Hxt7 are required at the end of alcoholic fermentation. This work shows that the successful alcoholic fermentation of wine involves at least four or five hexose carriers, playing different roles at various stages in the fermentation cycle. Copyright © 2002 John Wiley & Sons, Ltd.

Dissolved concentrations were determined for Fe, Mn, Al, Cu, Zn, La, U, Th, Cd and As in a wetland and its recipient stream to reveal the effect of seasonal changes in environmental conditions on the cycling and transfer of trace elements at the transition between terrestrial and aquatic ecosystems. These preliminary results from the wetland show marked seasonal changes in dissolved concentration for all elements except Zn and Cu. Concentrations are found to be low until about mid-February and then increase abruptly. The onset of trace element release appears to coincide with a marked decline in redox potential and increase of organic carbon content. Because this decline is itself correlated with a pronounced increase in temperature and dissolved Fe, Mn and organic carbon content, we suggest that the microorganisms which use soil iron and manganese oxy-hydroxides as electron acceptors catalyzed the change in redox conditions and induced an increase of DOC. Temporal changes were also observed in the recipient stream which showed marked positive concentration peaks during stormflow events (except Zn). The seasonal processes occurring in the wetland appear to play a major role in determining the amount of trace elements which are transferred from the wetland to the river.