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This article describes and analyzes actors' experiences of distance learning systems in a wide variety of cultural and organizational contexts. In line with the project of this special series of issues, results of research, much of which is longitudinal, allow us to suggest answers to the following questions: Who are the actors of distance learning? How has their experience of learning systems evolved over the last thirty years? What roles have information and communication technologies (ICTs) played in this evolution? How do actors assess the effects of these learning systems on themselves, on the system itself, or on the organization? What are the future perspectives?

In the early 1990s, the number of Europeans studying in the United States for the first time exceeded the number of Americans studying in Europe (Haug 2000, p. 27). This evolution was regarded as a very serious threat in European capitals. Public authorities in large countries requested their intellectuals to explain to them why European universities were becoming less attractive in the eyes of international students and to suggest corrective measures. Their proposals eventually paved the way for the Bologna process, which came as a defensive response from European countries. The Bologna process then became very successful because it enabled signatory countries not only to strengthen the attractiveness of their universities but also to help resolve strictly national problems that they had not addressed effectively. This paper first presents the national and international stakes for the four signatory countries of the Sorbonne declaration in 1998. It then discusses the effects of the Bologna process on the mobility of international students and the institutional reactions it now arouses in the United States. (Contains 1 table and 17 notes.)

Many world-renowned scientists and artists had autism spectrum disorder (ASD). We suggest that the French mathematician and physicist Blaise Pascal (1623-1662) also had ASD. As a boy, he demonstrated his mastery of language, mathematics and science. He showed single-mindedness and obsessive interests in the pursuit of science in his younger years and later he pursued with religion with the same determination. Pascal neglected social interactions; he was cold and aloof and had an obsessive revulsion to any expression of emotional attachment. As shown by his funerary mask and the autopsy report Pascal had craniosynostosis (primary nonsyndromic oxycephaly) with atrophy of the right half of the face. Congenital facial asymmetry due to craniosynostosis has a genetic basis. This suggests that Pascal's facial deformity may betray his propensity to suffer from genetically determined diseases including ASD. Despite the intrinsic limitations of a diagnosis based only on biographical information, we surmise that Pascal had the three key symptoms (obsessive interests, difficulty in social relationship and problems in communicating) that characterize ASD individuals. [ABSTRACT FROM AUTHOR]

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Abstract: The identification of X bodies is an everyday preoccupation in forensic pathology. This retrospective analysis studied all methods of identification and characteristics of unidentified bodies arrived in the Department of Forensic Medicine and Pathology (University Hospital R. Poincaré, Garches, France) during a 6-years period (2003–2009). The aim was to determine the identification methods used during all the forensic investigations, but also to study causes and manner of death in this sample of the population. A total of 9.1% of all autopsies were on X cadavers (217 cases out of 2384). On this total, only 134 of them have been included in our series after exclusion of archaeological and animal samples, but also of unidentified individuals or incomplete data available. Almost 28% of them have been identified with molecular biology (DNA), 23% with odontological examination, 7.5% with fingerprinting and 6.7% with autopsy data. Manner of death was mainly suicide (40.3%) especially by asphyxia following drowning, then accidental death (17.9%) especially consecutive to multiple trauma after traffic accident, acute carbon monoxide intoxication or carbonization in a fire. A total of 11.9% natural deaths were found (50% of them being of cardio-vascular origin) and 11.2% of homicides (with the use of firearm in a third of them). For 18.7% of X cadavers, the mode of death was undetermined. 46.4% of all unidentified bodies in our series were only identified by the police investigations, using physical recognition (direct or with photographs) or personal effects or identity documents in close relationship with the body. Our study highlights the fact that quite half of all unidentified bodies are inhumed with an identity not scientifically proved. Bodies which remained unidentified after all investigations represent 10.2% of X cadavers (if we consider a group of 176 cases composed of our study sample of 134 cases plus 24 subjects identified just before the autopsy and the 18 cases which remained unidentified) and 0.8% of all autopsies performed in the department. [Copyright &y& Elsevier]

The cause of death of Saint-Louis is not known, but recent findings indicated that he presented scurvy and inflammatory jaw disease, which has been associated with infection by oral commensals. Here, we have the exceptional opportunity to analyze the relics of the viscera of King Saint-Louis. A 4.3 g sample from the viscera relics of King Saint-Louis conserved in Versailles' cathedral was subjected to radiocarbon dating, electronic and optic microscopy, and elementary, palynological, molecular, proteomics and microbiological analyses including specific PCR and v3v4 16 S rRNA gene amplification prior to large-scale sequencing using an Illumina MiSeq instrument. The measured radiocarbon age was Cal 1290 CE-1400, which was compatible with that of the viscera of St Louis viscera, considering the addition of lime, incense and vegetables within the human organs. Elemental and palynological analyses confirmed a medieval embalming process. Proteomics analysis identified mainly human muscle and blood proteins. Specific PCR for plague, amoebiasis, shigellosis and typhoid fever was negative. C. sputigena was identified as the main pathogenic species representing 10.8 % of all microbial sequences. In contrast, C. sputigena was found in only 0.001 % of samples sequenced in our center, and the 23 positive human samples showed a dramatically lower abundance (0.02-2.6 %). In the literature, human infections with C. sputigena included odontitis, dental abscess, sinusitis, thoracic infections and bacteremia, particularly in immunocompromised patients with oral and dental diseases consistent with recent analysis of King Saint-Louis' jaw. C. sputigena, a commensal of the mouth that is potentially pathogenic and responsible for fatal bacteremia, may have been the cause of the king's death., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

On April 7, 1498, Charles VIII, King of France, attended a game of palm in the ditches of the Château d'Amboise. The 27-year-old King suddenly collapsed and became comatose. He laid down, almost on his own, on a straw mat that was hastily arranged, and he died 9 hours later. His contemporaries perceived his death as a perfect reminder of fatality: a king could die alone in a miserable gallery. All who looked into this curious death had dwelled on the frontal blow to head that the king had sustained right before his demise and had not considered alternative scenarios. The present study, still with limited available evidence, aimed to reexamine the historical account of his death in light of modern medical knowledge. It is virtually impossible that a minor bump with low kinetic energy could kill a 27-year-old man. Many historical accounts of Charles VIII's life and death, including Italian ambassadors' letters, led us to reconsider the commonly held version and to propose an alternative hypothesis. We have concluded that Charles VIII had experienced an acute consciousness disorder with language impairment that could have been related to an epileptic condition secondary to neurosyphilis. We have discussed whether a more accurate diagnosis for the cause of death could be obtained by a pathological analysis of the King's remains., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objectives: The increasing numbers of migrants and refugees to Europe include persons seeking asylum, many of whom will have experienced physical violence and torture. Here we describe the personal histories and clinical evidence of violence and torture among attendees at a public health specialist service in France., Methods: Physicians in a multidisciplinary team conducted examinations to corroborate refugees' skin lesions and other signs of injury with self-reported histories of physical violence and torture to provide evidence for asylum applications., Results: The 240 asylum seekers assessed between October 2016 and September 2018 were mostly male (89% (213/240)) with median age 29 years (IQR 26-34 years) and originating from north and west Africa. Consultations took place on average 15 months after arrival in France. In most cases (58%) the reason for seeking asylum was political persecution. Almost all attendees (94%) presented with scars. The most common mechanisms of injury were beatings (84%), burns (32%) and cuts/stab wounds (15%). Sexual violence was reported for 37% of women (10/27) and 4% of men (9/213). Police tended to use multiple methods for inflicting injuries, whereas the army and non-state actors mostly inflicted beatings. Sexual violation was most commonly reported for violence inflicted by family members or partners. Corroboration of lesions with patients' histories of physical violence and torture was affirmative in 93% (224/240) of cases., Conclusion: For this ethnically diverse group, a specialist service which can provide clinical corroboration of self-reported histories of physical violence and torture to support asylum applications is an essential minimum., (Copyright © 2020 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

Introduction: By threatening our lives, death becomes a medical as well as an institutional issue. To remedy the quest of sense, Man develops a culture amongst which the symbols will be the basis of rites. Recent studies have shown a high rate of burnout syndromes and suicide within the medical community. With a qualitative approach, we aimed to answer the following question: do doctor possess symbolic means of personal defence in front of the dissolvent action of death?, Methods: We built up a questionnaire from key points raised by anthropology and sociology of death. It was addressed to residents of Saint Louis Hospital (Paris, France) during winter 2016-2017., Results: Twenty comprehensive answers were obtained. Young physicians were between 25 and 33 years old (55% haematologists, 35% oncologists, others general practitioners & internal medicine physicians). We show that, to remedy the quest of sense in presence of death, young physicians reckon having repetitive gestures with corpses, thus elaborating the beginning of a personal rite. We also demonstrate the role of empathy and palliative medicine in diminishing the pain of seeing agony and death. Finally, we weave a tie between the lack of collective catharsis at hospital and the high rate of suicide and depressions within the medical community., Conclusion: In the West, we are out of effective symbolism due to the shift of rituals on less metaphysical symbols. This shift of symbolism also affects hospital which failed to develop or protect means to transcend death in a collective scale.

Introduction: Recent paleopathological cases have shown the usefulness of interdisciplinary odontological studies in the investigation of historical figures., Observation: A macroscopic examination of the mandible of Saint-Louis (13th c. AD), conserved in the cathedral of Notre-Dame (Paris, France) was carried out, and compared with biographical data about the life and death of the King, and contemporaneous cases of infectious/inflammatory diseases. We found post-mortem tooth loss associated with moderate signs of infectious and inflammatory diseases, which precise diagnoses are discussed facing historical chronicles and sources: main diagnosis is scurvy, potentially associated with bacterial infection., Discussion: Our results support the identification of the relics, and improve the knowledge about the saint's circumstances of death related to metabolic deficiencies and infections., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Networks for the exchange and/or sharing of genetic data are developing in many countries. We focus here on the situations in the US and France. We highlight some recent and remarkable differences between these two countries concerning the mode of access to, and the storage and use of genetic data, particularly as concerns two-sided markets and dynamic consent or dynamic electronic informed consent (e-IC). This brief overview suggests that, even though the organization and function of these two-sided markets remain open to criticism, dynamic e-IC should be more widely used, especially in France, if only to determine its real effectiveness.

In the digital age, a genetics cohort has become much more than a simple means of determining the cause of a disease. Two-sided markets, of which 23andMe, Ancestry DNA and MyHeritage are the best known, have showed this perfectly over the last few years: a cohort has become a means of producing massive amounts of data for medical, scientific and commercial exploitation, and for genetic use in particular. French law does not currently allow these foreign private companies to develop on French national territory and also forbids the creation of similar entities in France. However, at least in theory, this same law does not preclude the creation of new types of cohorts in France inspired by the success of two-sided markets but retaining features specific to the French healthcare management system. We propose an optimal solution for France, for genomic studies associated with multi-subject questionnaires, still purely theoretical for the moment: the development, with no need for any change in the law, of France's own version of "Genetics v.2.0": "e-CohortE.", (© 2019 The Authors. Clinical Genetics published by John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

In France, genetic data are not covered by property laws. They are considered to be equivalent to a part of the human body, to be protected rather than as something of economic value. However, in this highly competitive world, France must find solutions to increase the scientific and economic values of its genetic data. One possibility would be to define genetic data as raw information with no value for use. The choice of such a value of use (clinical, scientific, economic, etc.), following various key analysis and treatment processes will thus transform genetic data into useful information. In this case, and under certain conditions, intellectual property law could consider this information to be an original creation with an economic value, whilst maintaining current levels of protection for genetic data. France thus faces a choice between changing its laws concerning the protection of genetic data, bringing them into line with the North American approach, according to which data are a form of capital that everyone has the right to increase or sell, and making the distinction between genetic data and information clearer., (© 2018 médecine/sciences – Inserm.)

Over the last three decades, various biotech companies, mostly in North America, have become experts in the production, processing and analysis of large volumes of genetic data. They have surpassed the performance of traditional academic platforms, by appropriating a new economic model: the two-sided market. Thus, by applying web 2.0 ideas, these biotech companies have made it possible for millions of users to produce and "share" data including genetic data, with each other and with third parties through a digital network rich in information and "free" services. However, in reality, data have become a means of payment for access to these networks and the use of these services. In the era of the digital economy, data sharing has become synonymous with commercial exchange and genetic data synonymous with capital., (© 2018 médecine/sciences – Inserm.)

Osteogenesis imperfecta (OI), also known as Lobstein's syndrome or Vrolik's syndrome, comprises a heterogeneous group of rare genetic connective tissue disorders. It is characterized by increased bone fragility, low bone mass, and susceptibility to bone fractures of variable severity. Originally named "osteomalacia congenita," the condition was first medically described in a family by Ekman in 1778. Here, we report a 17th century medical account from France, which predates Eckman's doctoral dissertation by about a century. Medical analysis of this anatomical presentation indicates a precise diagnosis of Type I OI. Clin. Anat. 30:128-129, 2017. © 2016 Wiley Periodicals, Inc., (© 2016 Wiley Periodicals, Inc.)

The authors explore two heart rhythm troubles described on the occasion of the medical exami- nation of the Italian astronomer Galileo Galilei and the French politician Talleyrand. According to modern scientific knowledge, the pathological context of respectively the 17th and 19th c., and the personal medical history of the patients, some retrospective original and objective diagnoses are proposed.

In the 18th and 19th centuries, the Dupuytren Museum was indispensable for the knowledge of pathological anatomy for physicians and surgeons. Nowadays, it is more a museum than a learning unit, but it provides an opportunity to understand through numerous scientific studies the origin of diseases, injuries mechanism and the functional consequences of which could suffer some patients. This study illustrates the interest of the study on pieces in pathological anatomy's museums, this time across selected skulls which belonged to hearing loss people. bizarre.

A pyrographically decorated gourd, dated to the French Revolution period, has been alleged to contain a handkerchief dipped into the blood of the French king Louis XVI (1754-1793) after his beheading but recent analyses of living males from two Bourbon branches cast doubts on its authenticity. We sequenced the complete genome of the DNA contained in the gourd at low coverage (~2.5×) with coding sequences enriched at a higher ~7.3× coverage. We found that the ancestry of the gourd's genome does not seem compatible with Louis XVI's known ancestry. From a functional perspective, we did not find an excess of alleles contributing to height despite being described as the tallest person in Court. In addition, the eye colour prediction supported brown eyes, while Louis XVI had blue eyes. This is the first draft genome generated from a person who lived in a recent historical period; however, our results suggest that this sample may not correspond to the alleged king.

Facing modern developments of medicine and biomedical researches, religious communities are a strong source of ethics principles and orientations. Human dignity does not disappear after life, in a context of biomedical research on cadavers. Moral, political, social and scientific aspects of research on human cadavers (mainly autopsies) have been widely discussed in biomedical publications, whereas the religious ones (which could be predominant for some) have rarely been analyzed and presented. This article will present the results of a survey carried out a French Benedictine Abbey (relative to death, cadaver's status and biomedical research) and subsequent Christian background according to canonic texts and practical cases from anthropological, historical, archeological and biomedical origin.

Intentional cranial deformations (ICD) have been observed worldwide but are especially prevalent in preColombian cultures. The purpose of this study was to assess the consequences of ICD on three cranial cavities (intracranial cavity, orbits, and maxillary sinuses) and on cranial vault thickness, in order to screen for morphological changes due to the external constraints exerted by the deformation device. We acquired CT-scans for 39 deformed and 19 control skulls. We studied the thickness of the skull vault using qualitative and quantitative methods. We computed the volumes of the orbits, of the maxillary sinuses, and of the intracranial cavity using haptic-aided semi-automatic segmentation. We finally defined 3D distances and angles within orbits and maxillary sinuses based on 27 anatomical landmarks and measured these features on the 58 skulls. Our results show specific bone thickness patterns in some types of ICD, with localized thinning in regions subjected to increased pressure and thickening in other regions. Our findings confirm that volumes of the cranial cavities are not affected by ICDs but that the shapes of the orbits and of the maxillary sinuses are modified in circumferential deformations. We conclude that ICDs can modify the shape of the cranial cavities and the thickness of their walls but conserve their volumes. These results provide new insights into the morphological effects associated with ICDs and call for similar investigations in subjects with deformational plagiocephalies and craniosynostoses., (Copyright © 2013 Wiley Periodicals, Inc.)

A mummified head was identified in 2010 as belonging to Henri IV, King of France. A putative blood sample from the King Louis XVI preserved into a pyrographically decorated gourd was analyzed in 2011. Both kings are in a direct male-line descent, separated by seven generations. We have retrieved the hypervariable region 1 of the mitochondrial DNA as well as a partial Y-chromosome profile from Henri IV. Five STR loci match the alleles found in Louis XVI, while another locus shows an allele that is just one mutation step apart. Taking into consideration that the partial Y-chromosome profile is extremely rare in modern human databases, we concluded that both males could be paternally related. The likelihood ratio of the two samples belonging to males separated by seven generations (as opposed to unrelated males) was estimated as 246.3, with a 95% confidence interval between 44.2 and 9729. Historically speaking, this forensic DNA data would confirm the identity of the previous Louis XVI sample, and give another positive argument for the authenticity of the head of Henri IV., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Disturbances in some endocrine hormones have been implicated in the pathophysiology of depression and psychosis. We consider here further the hypothesis that there may be a correlation between suicide risk and the weight of the thyroid gland. The thyroid weight and other relevant information (sex, BMI) were collected retrospectively from 576 autopsies including 299 cases of completed suicide, analyzed in the west area of Paris between 1994 and 2010. Multiple regression model, adjusted on sex and BMI, confirmed that only for subjects more than 60 years of age, deceased by suicide, had a significant decrease in their weight of thyroid compared to those who deceased for another cause (decrease of around 3g, p=0.03, for age class 60 and over). Our hypothesis is that there could exist an anatomical correlate (thyroid weight) among people who have committed suicide, especially old individuals. Various hypotheses regarding the hypothalamus-pituitary-thyroid axis dysfunction and the physiopathology of major depression are proposed and discussed. Further studies will be necessary in order to confirm that such a tendency exists on other populations., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Archaeological remains can provide concrete cases, making it possible to develop, refine or validate medico-legal techniques. In the case of the so-called 'Joan of Arc's relics' (a group of bone and archaeological remains known as the 'Bottle of Chinon'), 14 specialists analysed the samples such as a cadaver X of carbonised aspect: forensic anthropologist, medical examiners, pathologists, geneticists, radiologist, biochemists, palynologists, zoologist and archaeologist. Materials, methods and results of this study are presented here. This study aims to offer an exploitable methodology for the modern medico-legal cases of small quantities of human bones of carbonised aspect., (2009 Elsevier Ireland Ltd. All rights reserved.)

This article describes the potential interest in physical and forensic anthropology of the microscopic analysis of residues of putrefaction fluid, a calcified deposit frequently found associated with bone rests. Its sampling and analysis seem straightforward and relatively reproducible. Samples came from archeological material (Monterenzio Vecchia, an Etruscan necropolis from the north of Italy dated between the fifth and third century B.C.; body rests of Agnès Sorel, royal mistress died in 1450 A.D.; skull and grave of French King Louis the XI and Charlotte of Savoy dated from 1483 A.D.). All samples were studied by direct optical microscope and scanning electron microscopy. Many cytological, histological, and elemental analysis were possible, producing precious data for the identification of these remains and, in some cases, the cause of death.

Bouchet and Charlier regret the low level of the history of medicine in French faculties of medicine and try to classify them according to their efforts in this field.

According to her last will Agnès Sorel has been buried in the Collegiate Church Saint-Ours de Loches. The transfer from Logis Royal gave the opportunity to authenticate her ashes and to clarify the year of her birth, the cause of her death or ... the colour of her hair.

The development of paleopathology and the use of techniques inspired by forensic medicine authorise new observations about embalming methodology. We will discuss in this article five different examples taken from personal recent analysis dealing with aristocratic bodies from French Middle Ages to modern times. Botanical, mineralogical and toxicological studies were performed in order to better understand anatomic discoveries and technical facts.