Le système de santé d'aujourd'hui fait appel à de nombreuses technologies de l'information nommées TIS (Technologies de l’Information en Santé). Celles-ci ont donné naissance à de nouvelles formes d’interaction médecin-patient et ont complexifié l'approche thérapeutique dite
« centrée sur le patient ». Les TIS promettent une plus grande efficacité et l’augmentation de la satisfaction des patients par le biais d’une meilleure compréhension de la maladie pour le patient. Or, elles peuvent également devenir des sources de conflit pour le professionnel de la santé, étant donné leur utilisation en dehors des rencontres cliniques ainsi que leur tendance à agir comme des barrières communicationnelles lors des consultations. Cette recherche vise a étudier les critères de design nécessaires à la conception d’un TIS pouvant améliorer la relation médecin-patient et donc, faciliter la communication et améliorer l’alliance thérapeutique. L’étude utilise une approche centrée sur l’utilisateur et vise donc à comprendre les besoins et les attentes des médecins et des patients. En étudiant les nouvelles approches en santé et les TIS, il a été possible de comprendre le contexte et les besoins des utilisateurs en terme de communication. Ces derniers sont primordiaux au processus dit centré sur l’utilisateur. Le faible taux de rétention du discours du médecin devient une barrière communicationnelle importante, tout comme le temps pressurisé. La recherche nous montre que l’ajout d’un outil virtuel de vulgarisation peut, à l’aide de média visuels (tel que des modélisations, des animations 3D et des dessins), grandement aider la relation médecin-patient. / Today’s medical system is using an increasing number of information technologies to help healthcare professionals in their daily practice. Commonly known as HIT (Health Information Technologies), they create new forms of doctor-patient interaction and complexify the therapeutic approach called “patient centered approach”. Their use promises to improve the efficiency of the healthcare system and the overall satisfaction of the patient by improving his understanding of his illness, yet they can also become communication barriers during a consultation and even a source of conflict when used outside a clinical context. This research project aims at studying the design criteria for a Health Information tool that can help improve the doctor-patient relationship. The study uses a user-centered approach and therefore, focuses on understanding the needs and expectations of both doctors and patients. The study of the theoretical and "on the field" therapeutic approach shows that the pressurized time of the consultation, the many communication barriers and the low level of information remembered by patients are problems that can be solved by a HIT. A virtual vulgarization tool that uses multimedia such as 3D animations, 3D models and drawings can considerably help the doctor-patient relationship.

Les centres d’information sur les tératogènes (CIT) fournissent aux professionnels de la santé ainsi qu’au public de l’information sur les risques et bienfaits associés à l’utilisation des médicaments durant la grossesse et l’allaitement. Le Centre IMAGe (Info-Médicaments en Allaitement et Grossesse) du CHU Sainte-Justine (Centre Hospitalier Universitaire Sainte-Justine) au Québec, est un CIT qui offre depuis 1997 un service téléphonique d’information gratuit aux professionnels de la santé. Deux études ont été réalisées à partir des appels reçus au Centre IMAGe. La première étude a été réalisée sur l’ensemble des appels reçus entre janvier 2004 et avril 2007 au sujet de femmes qui prenaient ou envisageaient prendre un médicament durant la grossesse ou l’allaitement. Les objectifs de cette étude visaient à déterminer les classes de médicaments les plus fréquentes ainsi que les indications d’utilisation et les déterminants d’un appel à leur sujet (caractéristiques maternelles associées). Les antidépresseurs, les anti-inflammatoires, les antibiotiques, les benzodiazépines et les antipsychotiques sont les classes de médicaments qui correspondaient aux plus grands nombres d’appels. Cela porte à croire que pour ces classes de médicaments, il existe chez les professionnels de la santé un besoin d’information en ce qui concerne les risques et bienfaits de leur utilisation durant la grossesse et l’allaitement. La dépression représentait une des trois indications les plus prévalentes chez les femmes qui prenaient ou désiraient prendre des antidépresseurs, des benzodiazépines ou des anti-psychotiques durant la grossesse ou l’allaitement. Le tabagisme était associé à l’utilisation des antidépresseurs et des anti-psychotiques durant la grossesse, ainsi qu’à un appel au sujet des anti-inflammatoires durant l’allaitement. La deuxième étude a été réalisée sur l’ensemble des appels reçus entre janvier 2003 et mars 2008. Cette étude visait à déterminer l’impact des avis émis par Santé Canada concernant les risques de l’exposition aux antidépresseurs durant la grossesse et celui concernant le retrait du rofécoxib, sur le nombre d’appels reçus à IMAGe. L’analyse des séries temporelles du nombre hebdomadaire d’appels reçus a révélé que l’avis de Santé Canada sur les risques de malformations cardiaques associés à l’utilisation de la paroxétine lors du premier trimestre de la grossesse a généré une augmentation statistiquement significative, soudaine et permanente du nombre d’appels reçus à IMAGe au sujet des antidépresseurs. Ces études permettent de mieux comprendre le besoin d’information des professionnels de la santé sur les risques et bienfaits de l’utilisation des médicaments durant la grossesse et l’allaitement. / Teratogen Information Services (TIS) are giving information on the risks and benefits associated with medication use during pregnancy and lactation, to the health care providers and the public. IMAGe Center at the CHU Sainte-Justine in Quebec is a TIS which providing since 1997 a free telephone information service to the health care providers. Two studies were conducted using the calls received at IMAGe Center. The first study included all the calls received between January 2004, and April 2007, concerning women who used or expected to use medication during pregnancy or lactation. The objectives of this study aimed to identify the most frequent medication classes, the indications of use, and the predictors of a call concerning them (associated maternal characteristics). Antidepressants, anti-inflammatory drugs, antibiotics, benzodiazepines, and anti-psychotics represented the medication classes with the greater amount of calls. These results rise to the possibility that more information about the risks and benefits associated with the use of these medication classes during pregnancy and lactation is needed by the health care providers. Depression was in the top three of the most prevalent indications of use for the antidepressants, benzodiazepines, and anti-psychotics. Smoking was associated with the use of antidepressants and anti-psychotics during pregnancy, and with a call concerning the anti-inflammatory drugs during lactation. The second study included all the calls received between January 2003, and March 2008. This study aimed to identify the impact of the Health Canada (HC) warnings, concerning the risks of antidepressant use during pregnancy, and related to the rofecoxib market withdrawal, on the number of calls received to IMAGe. Time series of the weekly number of calls received demonstrated that the Health Canada warning on the risk of cardiac malformations associated with paroxetine use during the first trimester of pregnancy generated a statistically significant abrupt and permanent increase of the calls received at IMAGe about the antidepressants. These studies ensure to better understand the information need of the health care providers concerning the risks and benefits of medication use during pregnancy and lactation.

Le cancer de l’ovaire (COv) est le cancer gynécologique le plus létal chez la femme et les traitements existants, chirurgie et chimiothérapie, ont peu évolué au cours des dernières décennies. Nous proposons que la compréhension des différents destins cellulaires tels que la sénescence que peuvent choisir les cellules du cancer de l’ovaire en réponse à la chimiothérapie pourrait conduire à de nouvelles opportunités thérapeutiques. La sénescence cellulaire a été largement associée à l’activité de la protéine TP53, qui est mutée dans plus de 90% des cas de cancer de l’ovaire séreux de haut grade (COv-SHG), la forme la plus commune de la maladie. Dans nos travaux, à partir d’échantillons dérivés de patientes, nous montrons que les cultures primaires du cancer de l’ovaire séreux de haut grade exposées au stress ou à des drogues utilisées en chimiothérapie entrent en senescence grâce à l’activité d’un isoforme du gène CDKN2A (p16INK4A). Dans ces cellules, nous avons évalué les caractéristiques fondamentales de la sénescence cellulaire tels que les altérations morphologiques, l’activité béta galactosidase associée à la sénescence, les dommages à l’ADN, l’arrêt du cycle cellulaire et le phénotype sécrétoire associé à la sénescence. En utilisant des micromatrices tissulaires construites à partir d’échantillons humains de COv-SHG pré- et post-chimiothérapie, accompagnées de leurs données cliniques, nous avons quantifié des marqueurs de sénescence incluant une diminution de la prolifération cellulaire quelques semaines après chimiothérapie. De façon intéressante, l’expression de p16INK4A dans les échantillons de COv-SHG prétraitement corrèle avec une survie prolongée des patientes suite au traitement. Ceci suggère ainsi pour la première fois un impact biologique bénéfique pour la présence de cellules cancéreuses qui sont capable d’activer la sénescence, particulièrement pour le traitement du cancer de l’ovaire. Dans le but de complémenter les thérapies actuelles avec des approches de manipulation pharmacologique de la sénescence, nos résultats suggèrent qu’il serait important de déterminer l’impact positif ou négatif de la sénescence induite par la thérapie sur la progression de la maladie et la survie, pour chaque type de cancer de façon indépendante. / Human ovarian cancer (OvCa) is the deadliest gynecologic malignancy and existing surgical/chemotherapeutic treatment options have been relatively static for decades. We propose that understanding OvCa cell fate decisions taken in response to chemotherapy could guide new therapeutic opportunities. Damage-induced cellular senescence is often associated with TP53 activity, which is heavily mutated in high grade serous (HGS) OvCa (>90%), the most common form of this disease. Here, using patient derived tissues, we show that primary HGS-OvCa cultures predominantly trigger CDKN2A- associated (p16INK4A isoform) senescence following exposure to stress or chemotherapy. Key senescence hallmarks including altered morphology, senescence-associated-Betagalactosidase, DNA damage, cell cycle arrest and the senescence-associated secretory phenotype were evaluated and detected in damaged cells. Using tissue microarrays built from pre- and post-treatment human HGS-OvC tissue samples with accompanying clinical data, we quantified post-treatment hallmarks of senescence including reduced cell proliferation weeks after chemotherapy. Importantly, p16INK4A expression in pretreatment HGS-OvC samples correlated with increased patients survival, suggesting for the first time that senescence-competence in human cancer cells may have a beneficial impact on treatment outcomes for patients. In order to guide the potential improvement of existing human therapies via pharmacological senescence manipulation, our results suggests that it is important to determine for many types of human cancer whether treatment-induced senescence positively or negatively impacts disease progression and patient survival.

<p>This report is a technical verification and validation of Traffic Information Service Broadcast (TIS-B) using the data link VDL Mode 4. </p><p>The main objective of the report is to examine the usefulness of TIS-B considering the results from tests performed in the Stockholm Terminal Area and for the Advanced Surface Movement Guidance and Control System (A-SMGCS) at Arlanda airport. The results are compared with the requirements that have been set by the standardisation organisations ICAO, RTCA, Eurocontrol and Eurocae. TIS-B is however such a new concept, so most of the operational requirements have not yet been defined.</p><p>The process for performing the evaluation of TIS-B involves three stages: </p><p>· Study the requirements on TIS-B, ADS-B, radar and A-SMGCS. </p><p>· Verify TIS-B by performing tests at Arlanda airport. </p><p>· Validate the test results through analysis. </p><p>A theoretical study of slot allocation optimisation is performed to decide how the slot allocation is to be implemented. </p><p>The report includes a Functional Hazard Analysis (FHA). The FHA is done to see if the applications for TIS-B are ready for implementation or if more hazard preventing actions has to be taken, before any operational actions can be performed. </p><p>The report also involves a theoretical introduction to Air Traffic Management (ATM), Surveillance techniques and TIS-B. </p><p>All parts included in the report results in conclusions and recommendations regarding the TIS-B service.</p>

This report is a technical verification and validation of Traffic Information Service Broadcast (TIS-B) using the data link VDL Mode 4. The main objective of the report is to examine the usefulness of TIS-B considering the results from tests performed in the Stockholm Terminal Area and for the Advanced Surface Movement Guidance and Control System (A-SMGCS) at Arlanda airport. The results are compared with the requirements that have been set by the standardisation organisations ICAO, RTCA, Eurocontrol and Eurocae. TIS-B is however such a new concept, so most of the operational requirements have not yet been defined. The process for performing the evaluation of TIS-B involves three stages: · Study the requirements on TIS-B, ADS-B, radar and A-SMGCS. · Verify TIS-B by performing tests at Arlanda airport. · Validate the test results through analysis. A theoretical study of slot allocation optimisation is performed to decide how the slot allocation is to be implemented. The report includes a Functional Hazard Analysis (FHA). The FHA is done to see if the applications for TIS-B are ready for implementation or if more hazard preventing actions has to be taken, before any operational actions can be performed. The report also involves a theoretical introduction to Air Traffic Management (ATM), Surveillance techniques and TIS-B. All parts included in the report results in conclusions and recommendations regarding the TIS-B service.

Les centres d’information sur les tératogènes (CIT) fournissent aux professionnels de la santé ainsi qu’au public de l’information sur les risques et bienfaits associés à l’utilisation des médicaments durant la grossesse et l’allaitement. Le Centre IMAGe (Info-Médicaments en Allaitement et Grossesse) du CHU Sainte-Justine (Centre Hospitalier Universitaire Sainte-Justine) au Québec, est un CIT qui offre depuis 1997 un service téléphonique d’information gratuit aux professionnels de la santé. Deux études ont été réalisées à partir des appels reçus au Centre IMAGe. La première étude a été réalisée sur l’ensemble des appels reçus entre janvier 2004 et avril 2007 au sujet de femmes qui prenaient ou envisageaient prendre un médicament durant la grossesse ou l’allaitement. Les objectifs de cette étude visaient à déterminer les classes de médicaments les plus fréquentes ainsi que les indications d’utilisation et les déterminants d’un appel à leur sujet (caractéristiques maternelles associées). Les antidépresseurs, les anti-inflammatoires, les antibiotiques, les benzodiazépines et les antipsychotiques sont les classes de médicaments qui correspondaient aux plus grands nombres d’appels. Cela porte à croire que pour ces classes de médicaments, il existe chez les professionnels de la santé un besoin d’information en ce qui concerne les risques et bienfaits de leur utilisation durant la grossesse et l’allaitement. La dépression représentait une des trois indications les plus prévalentes chez les femmes qui prenaient ou désiraient prendre des antidépresseurs, des benzodiazépines ou des anti-psychotiques durant la grossesse ou l’allaitement. Le tabagisme était associé à l’utilisation des antidépresseurs et des anti-psychotiques durant la grossesse, ainsi qu’à un appel au sujet des anti-inflammatoires durant l’allaitement. La deuxième étude a été réalisée sur l’ensemble des appels reçus entre janvier 2003 et mars 2008. Cette étude visait à déterminer l’impact des avis émis par Santé Canada concernant les risques de l’exposition aux antidépresseurs durant la grossesse et celui concernant le retrait du rofécoxib, sur le nombre d’appels reçus à IMAGe. L’analyse des séries temporelles du nombre hebdomadaire d’appels reçus a révélé que l’avis de Santé Canada sur les risques de malformations cardiaques associés à l’utilisation de la paroxétine lors du premier trimestre de la grossesse a généré une augmentation statistiquement significative, soudaine et permanente du nombre d’appels reçus à IMAGe au sujet des antidépresseurs. Ces études permettent de mieux comprendre le besoin d’information des professionnels de la santé sur les risques et bienfaits de l’utilisation des médicaments durant la grossesse et l’allaitement. / Teratogen Information Services (TIS) are giving information on the risks and benefits associated with medication use during pregnancy and lactation, to the health care providers and the public. IMAGe Center at the CHU Sainte-Justine in Quebec is a TIS which providing since 1997 a free telephone information service to the health care providers. Two studies were conducted using the calls received at IMAGe Center. The first study included all the calls received between January 2004, and April 2007, concerning women who used or expected to use medication during pregnancy or lactation. The objectives of this study aimed to identify the most frequent medication classes, the indications of use, and the predictors of a call concerning them (associated maternal characteristics). Antidepressants, anti-inflammatory drugs, antibiotics, benzodiazepines, and anti-psychotics represented the medication classes with the greater amount of calls. These results rise to the possibility that more information about the risks and benefits associated with the use of these medication classes during pregnancy and lactation is needed by the health care providers. Depression was in the top three of the most prevalent indications of use for the antidepressants, benzodiazepines, and anti-psychotics. Smoking was associated with the use of antidepressants and anti-psychotics during pregnancy, and with a call concerning the anti-inflammatory drugs during lactation. The second study included all the calls received between January 2003, and March 2008. This study aimed to identify the impact of the Health Canada (HC) warnings, concerning the risks of antidepressant use during pregnancy, and related to the rofecoxib market withdrawal, on the number of calls received to IMAGe. Time series of the weekly number of calls received demonstrated that the Health Canada warning on the risk of cardiac malformations associated with paroxetine use during the first trimester of pregnancy generated a statistically significant abrupt and permanent increase of the calls received at IMAGe about the antidepressants. These studies ensure to better understand the information need of the health care providers concerning the risks and benefits of medication use during pregnancy and lactation.

During the urbanization process, vehicles quantity increase with expansion in population. Under this situation, bus transportation system also suffers from bus delay. Bus delay could be caused by a series of factors, for instance, overload passengers, traffic jam, traffic accident and other unpredictable situations. Therefore, choosing crucial elements to efficiently evaluate bus delay is a complex problem in bus delay researches and operation management. The thesis propose an approach to evaluate and explain bus delay by two elements: traffic congestion and passengers’ waiting time. Those two elements would represent the action of external and internal factors on bus operation. This approach could be adaptive to explain the reasons for bus delays, thus to help the optimization of bus lines and give useful information for decision making of transportation company. To achieve the research aim, a GIS-T database was created by combining the GIS database and TIS database. Spatial data as well as attribute data are combined in the database to represent the crucial information for bus delay. Based on GIS-T the database, the impact of traffic congestion and passengers’ waiting time was calculated using the bus line simulation. By implementing the above steps, the main cause of bus delay was studied. A case study application of this method is narrated; focusing on optimize the bus system of Guiyang city, South China. Different methods are used to find out the problem of system and the reason for delay. Moreover, optimization suggestion is proposed according to result. Compared with other methods, the two-factor method has the advantage of locating the reason of delay for each station. The time performance is not superior to other methods. By comparing the situation of adjacent station, the proportion of traffic congestion and overload passenger in bus delay was determined. The two-factor method is applicable for other transit system in different cities which has similar structure as Guiyang. However, for cities with other structure, a feasibility should be made to select an appropriate model.

This diploma thesis deals with a design modification of detection part of the laboratory instrument for measuring the topography of rough surfaces – laser goniometric scatterometer (SM II). Design modification is based on replacement of so far used detector instead for the detector of higher quality with better measurement parameters. The first part of the diploma thesis contains theoretical basics, which are necessary to understand the relationship between scalar diffraction theory and scattering measurements of monochromatic light. The emphasis is on the importance of choosing appropriate detection coordinates, which are affecting the aberrations of detected diffracted light. The practical part is dedicated to improving the sensitivity of the detection part of the scatterometer SM II that is used in The laboratory of coherence optics at IFE FME BUT. This part justifies the choice of the detector which predetermines both the use of optical elements and the overall design of the detection part as the goniometer.

Hormone-dependent cancers (HDCs), such as those of the prostate, ovary, breast and endometrium, share characteristics that indicate similar underlying mechanisms of carcinogenesis. Through steroid hormone signalling on "down-stream" target genes, the growth, development and progression of HDCs are regulated. One such family of target genes, highly expressed in HDCs and regulated by steroid hormones, are the tissue kallikreins (KLKs). The KLKs are a multigene family of serine proteases involved in physiological processes such as blood pressure regulation, inflammation, and tumour development and progression via the hydrolysis of specific substrates. Although the KLK gene family is clearly implicated in tumourigenesis, the precise roles played by these genes are largely unknown. Additionally, except for the androgen-responsive genes, KLK2 and KLK3, the mechanisms underlying their hormonal regulation in HDCs are yet to be identified. The initial focus of this thesis was to examine the regulation of the kallikreins, KLK1 and KLK4, by estradiol and progesterone in endometrial and breast cancer cell lines. From these studies, progesterone clearly regulated KLK4 expression in T47D cells and therefore, the focus of the remaining studies was to further examine this regulation at the transcriptional level. An overview of the results obtained is detailed below. Human K1 and hK4 protein levels were increased by 10 nmol/L estradiol benzoate, progesterone, or a combination of the two, over 48 hours in the endometrial cancer cell line, KLE. However, these same treatments resulted in no change in KLK1 gene or hK1 protein levels in the endometrial cancer cell lines, HEC1A or HEC1B (only hK1 analysed). Progesterone treatment (0-100 nmol/L) over 24 hours resulted in a clear increase in KLK4 mRNA at the 10 nmol/L dose in the breast cancer cell line, T47D. Additionally, treatment of T47D cells with 10 nmol/L progesterone over 0-48 hr, resulted in the rapid expression of the hK4 protein at 2 hr which was sustained for 24 hr. Further analysis of this latter progesterone regulation with the antiprogesterone, RU486, over 24 hours, resulted in an observable decrease in hK4 levels at 1 µmol/L RU486. Although the estrogen and progesterone regulation of the hK1 protein was not further analysed, the data obtained for hK4 regulation in T47D cell lines, supported the premise that this gene was progesterone-responsive. The rapid expression of hK4 protein by progesterone at two hours suggests that KLK4 transcription is directly coupled to progesterone regulation, perhaps through progesterone receptor (PR) binding to progesterone-responsive regions within the KLK4 promoter or far "up-stream" regions. Thus, the following further studies were performed. To test this hypothesis, the transcription initiation site (TIS) and 5' flanking regions of the KLK4 gene in T47D cells were interrogated. Primer extension and 5' RACE identified the TIS 78 bp 5' of the putative ATG site for translation as identified by Korkmaz et al. (2001). This KLK4 gene transcript consists of only four exons, and thus excludes the pre/pro signal peptide. Although a TATA-box is not present within -25 to -30 bp 5' of the identified TIS, a number of consensus binding motifs for Sp1 and estrogen receptor half-sites were identified. It is possible that the Sp1 sites are involved in the basal levels of transcription for this gene. Additionally, a putative progesterone response element (PRE) was identified in the far "up-stream" regions of the KLK4 gene. Basal levels of transcription were observed within the KLK4 proximal promoter region when coupled to a luciferase reporter gene and transfected into T47D cell lines. Additionally, the KLK4 proximal promoter region did not induce the luciferase reporter gene expression when progesterone was added to the system, however, estradiol was inhibitory for luciferase gene expression. This suggests that the proximal promoter region of the KLK4 gene could contain functional EREs but not PREs. In keeping with this hypothesis, some ER half-sites were identified, but PR sites were not obvious within this region. The identified PRE in the far "up-stream" region of the KLK4 gene assembled the progesterone receptor in vitro, and in vivo, as assessed by electromobility shift assays and chromatin immunoprecipitation assays (EMSAs and ChIPs), respectively. The binding of the PR to the KLK4 PRE was successfully competed out by a PR antibody and not by an androgen receptor antibody, and thus confirms the specificity of the KLK4 PRE-PR complex. Additionally, the PR was recruited and assembled onto and off the progesterone-responsive KLK4 region in a cyclic fashion. Thus, these data strongly suggest that the PR represents one of the core components of a transcription complex for the KLK4 gene, and presumably also contributes to the expression of this gene. Moreover, these data suggest a functional coordination between the PR and the KLK4 progesterone-responsive region in T47D cells, and thus, provide a model system to further study these events in vivo.

Today humankind is facing numerous sustainability challenges that require us to question CO2 intensive practices like those present in the transport and energy sector. To meet those challenges, many countries have adopted ambitious climate targets. Achieving such targets requires an understanding of the wider socio-technical context of transitions. The aim of this licentiate thesis is therefore to analyse such socio-technical transitions towards low-emission futures enabled by the electrification of passenger cars and high voltage grid development. A combination of different transitions theories (for ex. Multi-level perspective and Technological innovation systems) and institutional theory has been used. To reach the aim paper I analyses the climate impacts of electric vehicles (EVs) and policy measures to achieve a breakthrough scenario for EVs. The results show that a mixture of short and long term policies are needed that take into account the technology development stage and behavioural aspects of EV adopters. Paper II addresses the need to include the high voltage transmission grid and its planning procedures as a central part of debates on transitions. Therefore the opportunities, challenges and reasons for conflict in the established regime are studied. The results show that in order to achieve a sustainable grid development regime, it is necessary to spend time on achieving legitimacy and social sustainability. The third paper uses semi-structured expert interviews and focuses on innovation dynamics for EV adoption. By focusing on dynamics instead of single policy measures, it is possible to grasp interactions within a niche, but also in between a niche, regime and landscape. The results show that strong initial technology legitimacy was needed to start substantial innovation dynamics. This could be further strengthened with a strong and broad coalition of actors. Both those factors led, if present, to an improved variety and match of policy instruments. As such this thesis has shown that transitions are not just about technology or policy instruments as such but about the dynamics and processes needed to enable them. This can be relevant in other transitions that otherwise may underestimate the importance of these components. / <p>QC 20170512</p> / Norstrat