Devenu clef de lecture des enjeux internationaux dans le nouveau désordre mondial, le crime organisé transnational concurrence l’État par ses propres moyens de coercition et investit la sphère publique de telle manière que, dans certaines régions du monde, son influence est indispensable pour remporter une élection ou un marché public. Il va même jusqu’à agir au détriment des engagements des États en matière de préservation de l’environnement ou du patrimoine, de politique urbaine ou de non-prolifération des armes de destruction massive. Dans quelle mesure les changements géopolitiques et les mutations juridiques en ex-URSS ont eu des conséquences sur la nature et l’évolution du crime organisé russe postsoviétique ? Anciennement garants des traditions carcérales, la nouvelle génération des Voleurs dans la loi (Vory v zakone) s’est largement développée durant la transition démocratique avant d’investir durablement les États occidentaux, au point qu’Interpol qualifie cette organisation de « grave menace pour le développement économique ». D’une part, seront étudiés la « sous-culture criminelle russophone » bien spécifique, la typologie et la structure des groupes criminels russes, ainsi que le contexte juridique de leur développement en Russie et en Géorgie. D’autre part, sera analysée l’évolution en Europe occidentale de cette criminalité russophone, davantage qualifiable « d’association de type mafieux » par ses liens politiques et ses activités économiques « légalisées ». L’étude des réponses juridiques de différentes législations sur le blanchiment de capitaux établit que la confiscation élargie sur le modèle italien reste le principal instrument de lutte efficace. / From disruptive element to key factor of international stakes in the new world disorder, transnational organized crime competes with the State with its own coercive means and invests in public sector in a way it becomes inevitable in some parts of the world to win an election or obtain a procurement contract, often in spite of international agreements on environmental preservation, protection of holdings or town planning or even non-proliferation of weapons of mass-destruction. To what extent did the geopolitical and legal changes and their consequences in the ex-USSR impact the nature and evolution of post-soviet organized crime? Formerly guardians of the prison criminal traditions, the new generation of Thieves in Law (Vory v zakone) has developed throughout the democratic transition and expanded in Western Europe to such extent Interpol considers it a tremendous threat to economic development, international security and Russian democratic institutions. The first part will study the indigenous Russian-speaking criminal prison “culture” and give an analyzed overview of the structure of current types of Russian criminal groups and the legal context that led to their development in Russia and Georgia throughout the democratic transition. On the second hand, I will study the expansion in Western Europe of Russian-speaking criminality which can be qualified as “association of mafia-type” (cf. Art. 416bis of the Italian Criminal Code) because of its political links and its “legalized” profits. Forfeiture and seizure on the Italian legal model remain the most effective instrument as established from the study of different legislations against money laundering.

La Convention des Nations Unies contre la corruption (CNUCC) a érigé en principe fondamental larestitution internationale des avoirs de la corruption. Bien que partie à la CNUCC, la France n'ajamais restitué de fonds dans le cadre de cette convention contrairement à d'autres États tels que laSuisse. Pourtant, le droit français a été considérablement renforcé au cours des dernières décenniesdans les domaines du recouvrement des avoirs criminels et de la lutte contre la corruptioninternationale. Il est même, en grande partie, conforme à la CNUCC. En outre, la France a toujoursété un État prisé par de nombreux agents publics étrangers dont l'origine licite de la fortune estparfois mise en doute. Le pays demeure également un acteur économique majeur de la scèneinternationale. Dès lors, la question de l'absence de restitution internationale par la France de biensillicites en lien avec la corruption se pose. Ce travail présente les nombreuses évolutions législatives,judiciaires et institutionnelles du droit français, lesquelles ont renforcé le cadre juridique durecouvrement des avoirs et de la lutte contre la corruption internationale. Il suggère, le cas échéant,certaines améliorations. Mais il propose également des réformes importantes afin de rendre effectif lerecouvrement en France des avoirs illicites ainsi que la restitution de biens confisqués aux Étatsvictimes de la corruption. / The United Nations Convention against Corruption (UNCAC) has established the internationalrestitution of corruption-related assets as a fundamental principle. Although France is a State Party ofthe UNCAC, it has never returned any funds in the context of this convention unlike other Statessuch as Switzerland. However, French Law has been substantially strengthened in the areas of assetrecovery and the fight against international corruption over the last few decades. It is even largelycompliant with the UNCAC. Furthermore, France has always been attractive for wealthy foreignpublic officials whose fortune is sometimes questioned. It remains also a major economic player onthe international scale. In this context, the question arises as to why France has not so far returnedany corruption-related assets. This work presents the numerous legislative, judicial or institutionaldevelopments that have recently enhanced the French asset recovery and anti-corruption legalframework. When necessary, it suggests certain improvements. But it also proposes major reforms tomake asset recovery effective in France as well as the return of confiscated funds to the Statesvictims of corruption

Rasmussen’s encephalitis is a rare neurological disease first described in 1958 that is characterized by medico-refractory seizures, focal unilateral cerebral inflammation, and deficits such as hemiparesis. While we still do not have a full understanding of this disease, proposed theories behind its etiology include auto-immune manifestations, immune attack by T cells, and malfunctional alterations in genetic expression. It is classically considered a rare childhood malady with a median age of onset of six years, and cases in adolescents and adults are even rarer, representing up to 10% of all cases to date. In this report, we would like to share a rare case of Rasmussen's encephalitis that occurred in an adolescent. Our 17-year-old male patient presented with signs and symptoms beginning at age 14 and was initially diagnosed with cerebral palsy only to later present with additional symptoms and characteristic EEG and MRI findings that ultimately led to a diagnosis of Rasmussen’s encephalitis. Thus, with this case report, our intent is twofold: to shed light on an atypical presentation of an already rare disease, even rarer in adolescents and adults, and to underscore the importance of keeping a broad differential when it comes to evaluating a patient with seizures.

Physiotherapists, occupational therapists, and speech therapists play a key role in the treatment of children with epilepsy. We performed a survey of therapists’ knowledge of and attitudes towards epilepsy in two regions of Germany, the city of Leipzig and the rural district of Zwickau. Therapists of 29/68 (43%) outpatient practices and 4/9 (44%) hospitals took part. In total, 195 therapists participated: 63 (32%) physiotherapists, 74 (38%) occupational therapists, and 58 (30%) speech therapist. In 65%, epilepsy was subject of vocational training. Of all therapists, 8% claimed they had not treated epilepsy patients so far. During professional life, 43% had witnessed a seizure. Of all therapists, 44% correctly assumed a seizure could result in death. During a seizure, 42% would perform the obsolete measure of placing something solid in the patient’s mouth, and 41% would administer a prescribed rescue medication. More information on epilepsy was requested by 92%. Conclusion: Most therapists treat patients with epilepsy, and almost half have already witnessed a seizure. Often, however, epilepsy is not subject of vocational training. The risk of a fatal outcome of a seizure is underestimated, and many therapists would perform obsolete measures. Knowledge of seizure management should be transmitted to therapists especially during vocational training.:Inhaltsverzeichnis Abkürzungsverzeichnis ............................................................................................... 3 1. Einführung in die Thematik..................................................................................... 4 1.1. Hintergrund ................................................................................................... 4 1.1.1. Epilepsie ................................................................................................. 4 1.1.2. Therapie der Epilepsie ............................................................................ 5 1.1.3. Bedeutung von Physiotherapie, Ergotherapie und Logopädie im Rahmen der Epilepsietherapie................................................................ 6 1.2. Therapeuten und Epilepsie als Schwerpunkt bereits vorhandener Studien . 8 1.3. Zielsetzungen der Studie ............................................................................ 10 1.4. Studiendesign ............................................................................................. 11 2. Originalartikel.......................................................................................................12 3. Zusammenfassung der Arbeit..............................................................................20 4. Literatur................................................................................................................25 5. Anlagen................................................................................................................30 I. Darstellung des eigenen Beitrages, Anteile der Co-Autoren................................ 40 II. Eigenständigkeitserklärung..................................................................................41

BACKGROUND: Major Depressive Disorder (MDD) is a common mental health illness, characterized by persistent feelings of sadness, diminished interests, guilt, low-self esteem, and disturbances in sleep and appetite. A significant percentage of patients with MDD are treatment resistant. Electroconvulsive Therapy (ECT) is a biological procedure utilized for treatment resistant illnesses. Diagnosis and clinical conditions primarily dictate when ECT is the appropriate treatment modality for an individual. Circumstances requiring rapid clinical response, risks affiliated with alternative treatments, resistance to pharmacotherapy, and medical history are all factors that designate ECT as the treatment of choice. METHODS: The objective of this systematic review was to examine how different anesthetics or combinations of agents affect ECT’s therapeutic efficacy in depressed, adult patients. Electroencephalography (EEG) and motor seizure durations and Hamilton Depression Rating Scale (HDRS) scores were used as primary measures of clinical outcomes. Two rounds of literature searches were conducted in the PubMed, Web of Science, and Google Scholar databases to identify randomized controlled trials and crossover trials that examined the effects of different intravenous sedatives and hypnotic agents on ECT. Two reviewers independently evaluated the internal validity and quality of studies, extracted data, and analyzed statistics. Utilizing all relevant data, standardized mean differences (SMD) with 95% confidence intervals (CIs), and heterogeneity measures were calculated. Ten studies with 373 participants were included. RESULTS: Thiopental only anesthesia was associated with longer EEG seizure duration when compared to propofol only treatment. The pooled effect size from studies with propofol anesthesia also suggests that this agent is associated with shorter seizure durations. If assessed individually with thiopental, the combination of ketamine and thiopental is correlated with increased motor as well as EEG seizure durations. When pooled; however, studies with patient groups assigned to anesthesia consisting of ketamine and another primary agent do not show significant differences either in EEG or motor seizure durations. Additionally, no difference exists in HDRS score reductions between propofol and methohexital. Of note; however, ketamine combined with either propofol or thiopental had significantly greater decreases in HDRS scores. CONCLUSION: Choice of anesthetic should be determined based on anticipated clinical outcome, adverse effect profile, reemergence, and patient preference. If long seizures are preferred, thiopental may be a reasonable option. However, if significantly larger decreases in depression score are preferred, then the combinations of ketamine and propofol or ketamine and thiopental appear to be the therapies of choice. Small sample sizes and insufficient clinical data limit the interpretations of these variables that determine therapeutic efficacy. Larger randomized control trials and crossover trials would provide greater insight into the optimal use of intravenous anesthetic agents with minimal adverse effects.

Magnesium deficiency in rats is known to precipitate audiogenic seizures. An unknown mineral factor in a diet mixture was found to substantially reduce the seizure occurence in magnesium deficient vii animals. This was corrected when the same mineral mixture was remade. Subsequently the faulty mineral mixture was discarded. This research .. as aimed at determining the mineral factor responsible for the observed changes in seizure occurence, and also aimed at investigating the relationships of serum calcium, magnesium and phosphorus concentrations to seizure susceptibility. Treatments to change the serum concentrations of these minerals included dietary manipulation, subcutaneous injection of calcitonin, of 1 ,25-dihydroxycholecalciferol, of calcium and of phosphorus. Animals fed magnesium deficient, low phosphorus diet and magnesium deficient animals fasted over-night were found to have significantly lower audiogenic seizure susceptibility than all other magnesium deficient animals regardless of treatment. Reduced audiogenic seizure susceptibility was not produced by any of the injections. The reduction in seizure with the magnesium deficient, low phosphorus diet indicates that phosphorus is an important factor in the mechanism of audiogenic seizuring in magnesium deficient rats.

The effects of dietary calcium and phosphorus levels on audiogenic seizure susceptibility and brain neurotransmitter were investigated in magnesium deficient rats. For 17 days, male weanling rats were fed magnesium deficient diets which also contained deficient (-), adequate (=}, and excess (+) amounts of calcium and/or phosphorus. Reduction of seizure incidence was seen in low calcium and/or low phosphorus diets. High calcium, and high calcium in combination with high phosphorus increased the severity of seizures. High calcium and low phosphorus, and high phosphorus and low calcium diets prevented seizuring. Most magnesium deficient diets resulted in elevation of serum phosphorus, calcium, and sodium concentrations. Within diet treatments, animals that seized had higher serum mineral concentrations than animals that failed to seize. Magnesium deficiency increased serotonin in cerebral cortex, cerebellum, and medulla oblongata and pons, and 5-hydroxyindoleacetic acid concentrations in cerebral cortex. There were no significant diet effects in brain neurotransmitter concentrations in the midbrain. Calcium seemed to play an important role in increasing both audiogenic seizure susceptibility and brain neurotransmitters. However, brain neurotransmitter levels were not related to seizure susceptibility. Calcium increased serum potassium and sodium concentrations and it increased brain serotonin concentration overall. Increasing dietary phosphorus levels increased serum phosphorus decreased serum calcium concentrations, but did not affect brain neurotransmitters.

京都大学 / 0048 / 新制・論文博士 / 博士(医学) / 乙第13120号 / 論医博第2133号 / 新制||医||1023(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 高橋 淳, 教授 村井 俊哉, 教授 林 康紀 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第21680号 / 医博第4486号 / 新制||医||1036(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 伊佐 正, 教授 村井 俊哉, 教授 松原 和夫 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Scalp electroencephalograms (EEGs) are used in a broad range of health care institutions to monitor and record electrical activity in the brain. EEGs are essential in diagnosis of clinical conditions such as epilepsy, seizure, coma, encephalopathy, and brain death. Manual scanning and interpretation of EEGs is time-consuming since these recordings may last hours or days. It is also an expensive process as it requires highly trained experts. Therefore, high performance automated analysis of EEGs can reduce time to diagnosis and enhance real-time applications by identifying sections of the signal that need further review.Automatic analysis of clinical EEGs is a very difficult machine learning problem due to the low fidelity of a scalp EEG signal. Commercially available automated seizure detection systems suffer from unacceptably high false alarm rates. Many signal processing methods have been developed over the years including time-frequency processing, wavelet analysis and autoregressive spectral analysis. Though there has been significant progress in machine learning technology in recent years, use of automated technology in clinical settings is limited, mainly due to unacceptably high false alarm rates. Further, state of the art machine learning algorithms that employ high dimensional models have not previously been utilized in EEG analysis because there has been a lack of large databases that accurately characterize clinical operating conditions. Deep learning approaches can be viewed as a broad family of neural network algorithms that use many layers of nonlinear processing units to learn a mapping between inputs and outputs. Deep learning-based systems have generated significant improvements in performance for sequence recognitions tasks for temporal signals such as speech and for image analysis applications that can exploit spatial correlations, and for which large amounts of training data exists. The primary goal of our proposed research is to develop deep learning-based architectures that capture spatial and temporal correlations in an EEG signal. We apply these architectures to the problem of automated seizure detection for adult EEGs. The main contribution of this work is the development of a high-performance automated EEG analysis system based on principles of machine learning and big data that approaches levels of performance required for clinical acceptance of the technology. In this work, we explore a combination of deep learning-based architectures. First, we present a hybrid architecture that integrates hidden Markov models (HMMs) for sequential decoding of EEG events with a deep learning-based postprocessing that incorporates temporal and spatial context. This system automatically processes EEG records and classifies three patterns of clinical interest in brain activity that might be useful in diagnosing brain disorders: spike and/or sharp waves, generalized periodic epileptiform discharges and periodic lateralized epileptiform discharges. It also classifies three patterns used to model the background EEG activity: eye movement, artifacts, and background. Our approach delivers a sensitivity above 90% while maintaining a specificity above 95%. Next, we replace the HMM component of the system with a deep learning architecture that exploits spatial and temporal context. We study how effectively these architectures can model context. We introduce several architectures including a novel hybrid system that integrates convolutional neural networks with recurrent neural networks to model both spatial relationships (e.g., cross-channel dependencies) and temporal dynamics (e.g., spikes). We also propose a topology-preserving architecture for spatio-temporal sequence recognition that uses raw data directly rather than low-level features. We show this model learns representations directly from raw EEGs data and does not need to use predefined features. In this study, we use the Temple University EEG (TUEG) Corpus, supplemented with data from Duke University and Emory University, to evaluate the performance of these hybrid deep structures. We demonstrate that performance of a system trained only on Temple University Seizure Corpus (TUSZ) data transfers to a blind evaluation set consisting of the Duke University Seizure Corpus (DUSZ) and the Emory University Seizure Corpus (EUSZ). This type of generalization is very important since complex high-dimensional deep learning systems tend to overtrain. We also investigate the robustness of this system to mismatched conditions (e.g., train on TUSZ, evaluate on EUSZ). We train a model on one of three available datasets and evaluate the trained model on the other two datasets. These datasets are recorded from different hospitals, using a variety of devices and electrodes, under different circumstances and annotated by different neurologists and experts. Therefore, these experiments help us to evaluate the impact of the dataset on our training process and validate our manual annotation process. Further, we introduce methods to improve generalization and robustness. We analyze performance to gain additional insight into what aspects of the signal are being modeled adequately and where the models fail. The best results for automatic seizure detection achieved in this study are 45.59% with 12.24 FA per 24 hours on TUSZ, 45.91% with 11.86 FAs on DUSZ, and 62.56% with 11.26 FAs on EUSZ. We demonstrate that the performance of the deep recurrent convolutional structure presented in this study is statistically comparable to the human performance on the same dataset. / Electrical and Computer Engineering