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Journal of Forensic and Legal Medicine
Journal Prestige (SJR): 0.622
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  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1752-928X
Published by Elsevier Homepage  [3206 journals]
  • The effect of plastic bag containment of the head on the rate and pattern
           of decomposition
    • Abstract: Publication date: Available online 13 February 2020Source: Journal of Forensic and Legal MedicineAuthor(s): Maxx Weger, Peter Cross, Rachel CunliffeAbstractPlastic bag suffocation has been reported in cases of homicide, suicide, and accidental death, with an increase in numbers of suicide and accidental deaths. Though case reports are abundant, decomposition studies have not been performed. This study utilised 20 Sus scrofa domesticus to quantify the effect of a plastic bag covering the head on the rate and pattern of decomposition. A sample group of ten carcasses had plastic bags placed over the heads, with another ten carcasses acting as a control group, without a head covering. The carcasses were placed in an open field to decompose. Over the course of 52 days, data were collected bi-weekly on the rate and pattern of decomposition.The results show that a plastic bag covering the head of a carcass has an overall decreased effect on the rate of decomposition, compared to the control group. The decomposition pattern of head>trunk>limb in decreasing decomposition rate was not affected by the plastic bag; however, in comparison to the control group, the decomposition of the head and trunk regions differed significantly, while the limbs stayed unaffected. The heads of the sample group showed a decrease in decomposition rate, while the trunks showed an increase. This was deemed due to an increase in insect activity at the trunk and a decrease in activity at the head. An altered PMI calculation is provided.
       
  • Review on post-mortem diagnosis in suspected SUDEP: currently still a
           difficult task for Forensic Pathologists.
    • Abstract: Publication date: Available online 5 February 2020Source: Journal of Forensic and Legal MedicineAuthor(s): Rosario Barranco, Fiorella Caputo, Andrea Molinelli, Francesco VenturaAbstractSudden and unexpected death in epilepsy (SUDEP) represents the predominant cause of premature deaths in young adults with epilepsy and is more common with patients with poorly controlled and generalized convulsive seizures. It is reported that there are 1,16 cases for every 1000 subjects affected with epilepsy.This review takes stock of the current problems and issues in the autopsy of cases of sudden death with epileptic people. For this purpose, all the possible findings of post-mortem examinations reported in the literature were analyzed and summarized, which can currently be considered useful for autopsy diagnoses as well as in the comprehension of the physiopathology of SUDEP. The enormous limitation of forensic pathology studies is the complete lack of a specific SUDEP diagnostic marker. Only in a few cases was it possible to find pathological signs of the brain that would clarify epilepsy-related deaths.Genetic research has tracked down variants of neurocardiac genes of ion channels in a restricted percentage of suspected SUDEP cases. The actual pathogenicity test requires an in-depth statistical analysis in order to prove there is a real excess of variants and evidence that the mutation alters the function.Despite scientific efforts, it is often difficult to distinguish SUDEP from other causes of sudden death. For these reasons, it will be necessary to create an international standard SUDEP death scene investigation and postmortem examination protocols.Further future studies of immunohistochemistry or genetics may help and may facilitate post-mortem diagnosis in cases of presumed SUDEP.
       
  • Visualization and Material-Based Differentiation of Lodged Projectiles by
           Extended CT Scale and the Dual-Energy Index
    • Abstract: Publication date: Available online 5 February 2020Source: Journal of Forensic and Legal MedicineAuthor(s): Dominic Gascho, Niklaus Zoelch, Eva Deininger-Czermak, Carlo Tappero, Alexander Buehlmann, Philipp Wyss, Michael J. Thali, Sarah SchaerliComputed tomography (CT) scans of gunshot wounds and their high sensitivity in detecting osseous lesions has often been reported in the literature. However, studies concerning in situ examinations of lodged projectiles with CT to determine the ammunition used are lacking.Projectile visualizations are hampered in standard CT due to the presence of metal artifacts and the limited range of Hounsfield units (HU). The use of special reconstruction algorithms can overcome these limitations. For instance, using extended CT scale (ECTS) reconstruction supports detailed visualizations of metallic objects. In addition to projectile visualizations, X-ray attenuation measurements (CT numbers) of metallic objects can be used to differentiate materials in CT.This study uses real forensic cases to demonstrate that—depending on the degree of deformation—a detailed visualization of lodged projectiles using ECTS can provide useful information regarding the ammunition used and allows accurate caliber measurements. Independent from the degree of deformation, the in situ classification of bullets, even fragmented bullets, according to their metallic components is feasible by dual-energy index (DEI) calculations. The assessment of a lodged projectile with CT images provides useful information on the case; thus, a close examination of lodged projectiles or bullet fragments should be a part of the overall radiological examination for cases of penetrating gunshot wounds.Graphical abstractImage 1
       
  • Genetic analysis of Yunnan sudden unexplained death by whole genome
           sequencing in Southwest of China
    • Abstract: Publication date: Available online 23 January 2020Source: Journal of Forensic and Legal MedicineAuthor(s): Lan-Jiang Li, Yue-Bing Wang, Peng-Fei Qu, Lin Ma, Kai Liu, Lin Yang, Sheng-Jie Nie, Yan-Mei Xi, Peng-Lin Jia, Xue Tang, Zhong-Chun Sun, Wen-li Huang, Yu-Hua Li, Yi Dong, Pu-Ping Lei
       
  • Evaluation of urinary catecholamines to reconstruct the individual death
           process after the catastrophe of Rigopiano (Italy)
    • Abstract: Publication date: Available online 11 January 2020Source: Journal of Forensic and Legal MedicineAuthor(s): C. D'Ovidio, M. Bonelli, E. Rosato, F. Savini, A. Carnevale
       
  • A unique case of traumatic pulmonary food embolism
    • Abstract: Publication date: Available online 8 January 2020Source: Journal of Forensic and Legal MedicineAuthor(s): Fiorella Lanzillotta, Silvia Visonà, Marco Ballardini, Gulnaz T. Javan, Antonio OsculatiAbstractWe report a unique case of post-traumatic pulmonary food embolism, due to a lethal blunt force trauma occurred in a traffic accident.The subject was a 37-year old man, victim of a road traffic accident while he was riding his motorbike. A forensic autopsy, followed by histological examination, was ordered in order to find out the cause of death and to assess the compatibility of the lesions with the dinamic of the accident.Autopsy revealed a blunt force thoraco-abdominal trauma responsible of the death. The most interesting histological evidences concerned lungs. Here, inside arterious and arteriolar pulmonary vessels, we identified crystal-like corpuscles, of various shape and size, sometimes aggregated in small masses and thin vegetal fibers, refracting at polarized light, both PAS-positive and meat fibers shadows.The presence of alimentary material in the pulmonary vessels was explained by a pulmonary food embolism. The occurring of this kind of embolism implies a communication between the viscera lumen and the venous circulation of his wall (through a small wall rupture) in presence of cardiocirculatory activity, and provides, therefore, a strong proof of vitality.
       
  • Skate or die: Unusual circumstances surrounding a natural cause of death
    • Abstract: Publication date: Available online 8 January 2020Source: Journal of Forensic and Legal MedicineAuthor(s): Frederique Thicot, Tony FracassoAbstractIn a forensic pathologist's mind, a suspicious death scene involving inflicted injuries and a weapon always raises three possible hypotheses regarding the manner of death—homicide, suicide, or accident; the latter is slightly less common. We present a case of a 43-year-old homeless man with a history of chronic alcohol abuse who was found dead in a skate park in Geneva. He was inflicted with a stab wound to his abdomen, with a knife found in situ. With the suspicion of homicide, a crime scene investigation team, including a forensic pathologist, was summoned to the scene. However, further examination of the body revealed a deep cut with hesitation marks on the left forearm. This discovery raised the hypothesis of a suicide. Here, we have described the investigations made by the police and forensic department, along with the circumstances and autopsy findings that determined the cause of death as an effect of a natural disease.
       
  • Histology and Raman spectroscopy of limed human remains from the Rwandan
           Genocide
    • Abstract: Publication date: Available online 7 January 2020Source: Journal of Forensic and Legal MedicineAuthor(s): Eline M.J. Schotsmans, Roland Wessling, W. Alan McClue, Andrew S. Wilson, Howell G.M. Edwards, John DentonAbstractThe Murambi Genocide Memorial Centre is one of the major centres in Rwanda that commemorate the 1994 Rwandan genocide. Seventeen months after the genocide, about 1000 excavated human remains were put on display in Murambi Technical School. Repeated efforts were made to desiccate the human remains with lime for educational reasons. The aim of this study was to assess their state of preservation and understand the extent of degradation of the tissue. Limed soft tissue samples from four individuals were examined with light and electron microscopy, and subjected to histological analysis. Raman spectroscopy at 785 nm and 1064 nm provided information about the impact of environmental conditions on the extent of deterioration to these samples, the presence of organics and the conversion of the associated lime from calcium hydroxide to calcium carbonate. While visual degradation of the bodies in Murambi has been reported, this study confirms deterioration at a microscopic and molecular level. Both histology and Raman spectroscopic analysis revealed that the limed bodies in Murambi were deteriorating at the time the samples were collected. The results of this study will inform future decisions regarding the long-term conservation of those human remains.
       
  • Bruise detection and visibility under alternate light during the first
           three days post-trauma
    • Abstract: Publication date: January 2020Source: Journal of Forensic and Legal Medicine, Volume 69Author(s): Katherine N. Scafide, Shashi Sharma, Natalie E. Tripp, Matthew J. HayatAbstractIntroductionCutaneous bruises are often hard to detect particularly on individuals with a darker complexion. Researchers and federal agencies have recommended the use of alternate light to aide in the assessment of subtle injury. However, studies are limited in their evaluation of wavelength performance during the first few days of bruise healing. The purpose of this pilot study was to examine whether an alternate light source (ALS) improves detection of bruises when compared to normal light typical of clinical practice during the first three days following induction.MethodsA sample of eight healthy adults between 22 and 36 years of age with diverse skin color were recruited for this study. One bruise was induced on each participant by dropping a 4-oz (113g) steel ball through a 5-ft (1.5 m) vertical pipe onto the anterior surface of the forearm. Using the ALS, bruises were assessed under 14 different combinations of ultraviolet and short narrowband visible wavelengths and filters along with overhead fluorescent “examination” lighting. Participants were examined 3 to 4 times per day at approximately 4-h intervals for three consecutive days post induction.ResultsRepeated bruise assessments on 8 subjects resulted in 59 bruise assessments and 885 total observations under the different wavelengths and filters combinations. A bruise was detectable in 46 (78%) of the assessments, with bruise ages ranging from 30 min to 57 h. Twenty (34%) bruises not detectable under normal light were visible with ASL. Multilevel modeling revealed a strong association between time and detection for shorter wavelengths, such as 365 nm (ultraviolet) and 450 nm.ConclusionThe results of our study suggest alternate light is more likely to detect faint bruises than normal lighting during the first three days post injury. However, more research is needed to determine which wavelengths and filter combinations are most effective during that time frame.
       
  • Review of gunshot fatalities in the Northern part of Ghana; a 6 year
           forensic autopsy based study
    • Abstract: Publication date: January 2020Source: Journal of Forensic and Legal Medicine, Volume 69Author(s): P.P.S. Ossei, N. Niako, W.G. Ayibor, E. Asante, K.F. Safo, A.S. Mensah, E. Owusu, K.L. AppiahAbstractStudies on firearm fatalities in some parts of Ghana have been reported. However, the incidence and pattern of firearm fatalities in the Northern sector of Ghana have fled the spotlight. This study aimed at reporting the incidence and pattern of gunshot fatalities autopsied within 2008 and 2013 year. There were 82(91.1%) male and 8(8.9%) female victims of gunshot deaths during the study period with an average of 15 cases annually. Where 60(66.7%) of the victims aged within 21–40; years resembling the pattern observed in several parts of the world. A significant number 28(31.1%) of the victims died of multiple shots or dispersed pellets affecting several parts of the body, followed by a single shot to the chest 18(20.0%), abdomen 17(18.9%), head 14(15.6%). Collectively, entry sites like the neck and upper limb among others accounted for 13(14.4%). Robbery accounted for 44(48.9%) followed by homicides 14(15.6%) cases. Recovered pellets, nature and legal status of firearm involved were also examined, and like in several developing countries, country-made guns played a substantial role in the firearm fatalities with calls to strengthen laws governing gun acquisition and use in the country.
       
  • The demographics of patients presenting for sexual assault to US emergency
           departments
    • Abstract: Publication date: January 2020Source: Journal of Forensic and Legal Medicine, Volume 69Author(s): Randall T. Loder, Tyler P. RobinsonAbstractBackgroundFew studies address the demographics/epidemiology of patients presenting to emergency departments (ED) for evaluation of sexual assault across an entire nation. It was the purpose of this study to analyze the demographics of sexual assault using a national data base.MethodsThis was a retrospective study of prospectively collected data from National Electronic Injury Surveillance System - All Injury Program for years 2005–2013. Patients presenting for sexual assault were analyzed. Descriptive and logistic regression statistical analyses were performed with SUDAAN 11.0.01™ software. A p 
       
  • Review of the pattern of traumatic limb lesions sustained in cases of
           hanging
    • Abstract: Publication date: January 2020Source: Journal of Forensic and Legal Medicine, Volume 69Author(s): Mark Mc Cabe, Noorusamah Nadia Fyzul, Linda Mulligan, Michael Curtis, Marie CassidyAbstractThis retrospective study sought to identify a regular pattern of limb bruising which occurs in association with suicidal or accidental hanging. Following exclusion of cases suspicious for homicide, 82 consecutive cases of hanging from a 10-year period were retrospectively reviewed to identify the pattern of traumatic limb injury in each case. Relevant information such as location, toxicology, and type of suspension was also noted. 72% of the reviewed cases had traumatic limb lesions, the majority of which occurred on the posterior upper limb and the anterior lower limb. Although the distribution of limb injury in our study mirrored that found in the literature, the incidence is much higher than in previous studies (7.4–20%). This could either be due to differences in confounding factors such as intoxication and location of hanging or differences in the practice of recording of limb trauma in hanging between centres. Neither type of suspension nor location of hanging were significantly associated with an increased incidence of traumatic limb injury. Positive toxicology was found to increase the likelihood of sustaining limb injury (p = .044084). In conclusion, the presence of this well documented pattern of traumatic limb lesions in cases of hanging should not always raise suspicion of foul play.
       
  • Injury patterns of less lethal kinetic impact projectiles used by law
           enforcement officers
    • Abstract: Publication date: January 2020Source: Journal of Forensic and Legal Medicine, Volume 69Author(s): Jennifer A. Beatty, Jason P. Stopyra, John H. Slish, William P. Bozeman
       
  • The “compassionate medicine” in the past and in the present
    • Abstract: Publication date: Available online 20 December 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Rosagemma Ciliberti, Giuseppe Armocida, Marta Licata
       
  • Prohibiting medically assisted procreation to gay couples is not
           illegitimate
    • Abstract: Publication date: Available online 19 December 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Andrea Cioffi, Fernanda CioffiAbstractIn Italy, the law n. 40 of 2004 (Norms in matter of medically assisted procreation), allows to access to the techniques of Medically assisted Procreation (MAP) exclusively to couples formed by two individuals of different sex. On the basis of this law, two couples of homosexual women were prohibited from using MAP techniques. For this reason, the couples have appealed to the competent courts that have raised doubts of constitutional legitimacy. In June 2019, the Italian Constitutional Court stated that it is not illegal to prohibit gay couples from accessing MAP techniques. In October 2019, the judgment No. 221, in which this decision is based, was published. Following the publication of the judgment, a bioethical-legal debate arose on this issue: is this a discrimination, or a simple limit based on medical-legal criteria'
       
  • Istanbul Protocol implementation in Central Asia: Bending the arc of the
           moral universe
    • Abstract: Publication date: Available online 29 November 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Vincent Iacopino, Rohini J. Haar, Michele Heisler, Rusudan BeriashviliAbstractIn countries emerging from authoritarian rule, a major challenge is ending often widespread and systematic torture and ill-treatment practices. Between 2011 and 2019, Physicians for Human Rights (PHR), in collaboration with the Open Society Foundation (OSF), the Open Society Justice Initiative (OSJI) and regional and local partners, worked to establish effective torture investigation and documentation practices in the Central Asian countries of Kyrgyzstan, Tajikistan, and Kazakhstan. Our approach consisted of activities in three sequential phases – (1) assessment, (2) capacity building, and (3) policy reform. In this paper, we briefly describe activities during each phase and identify key lessons learned from these experiences and resulting policy and program reforms as a model for future efforts in other settings.
       
  • Biochemical findings in sudden unexpected death in epilepsy: Hospital
           based case-control study
    • Abstract: Publication date: Available online 9 November 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Shyam Kishore, Sudhir Kumar Gupta, Sudheer Kumar Arava, Asit Ranjan Mridha, Ashok Kumar Jaiswal, Asit Kumar Sikary, Deepak Ramkumar Bharti, Chittaranjan BeheraAbstractPurposeA review study on the biochemistry of epilepsy showed that in epileptic patients, serum glucose and cholesterol concentrations are low, sodium is unaffected, potassium increases, glucose is high and mild hypocalcemia. We have conducted a biochemical study on sudden unexpected death in epilepsy (SUDEP) cases in an attempt to establish the characteristic biochemical values to diagnose these deaths.MethodsThis was a hospital based case-control study done at the center of one year. Twenty SUDEP cases and 20 age- and sex-matched controls were included in the study. Femoral blood, cerebrospinal fluid, vitreous humor, and pericardial fluid were biochemically analyzed for sodium, potassium, calcium, glucose, N-acetyl- cysteine activated creatine kinase (CK-NAC) and isoenzyme CK-MB.ResultSerum sodium, CK-MB and CK-NAC level was found significantly increased and potassium level was found decreased in SUDEP cases in comparison to non-epileptic deaths. Likewise, in CSF, sodium and CK-NAC was found increased and potassium level was found decreased in SUDEP cases. In vitreous humor, sodium and CK-MB level was found increased and potassium level was found decreased in SUDEP cases in comparison to non-epileptic deaths. In pericardial fluid, sodium, CK-NAC and CK-MB level was found increased and potassium level was found decreased in SUDEP cases in comparison to non-epileptic deaths.ConclusionIt concludes that high sodium level and low potassium level could be associated with SUDEP. However, this is a small size study, a larger study is needed to verify the findings. Furthermore, it is difficult to conclude whether these findings are exclusive to SUDEP.
       
  • Indicatory external findings in two cases of fatal cervical spine injury
    • Abstract: Publication date: Available online 31 October 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Clara-Sophie Schwarz, Katrin Uebbing, Tanja Germerott, Astrid KrauskopfAbstractA fatality of an 83-year-old female experiencing acute circulatory failure as a result of a type II odontoid fracture is compared with the case of an 86-year-old female who died from delayed cardiopulmonary complications due to a lower cervical spine injury. Falls on the forehead from minor height can cause odontoid fractures especially in elderly patients, hyperextension of the neck on the other hand can lead to lower cervical spine injury with prevertebral hematoma. The latter can lead to extensive hematoma of the neck, but might be difficult to diagnose by computed tomography in the living patient. Especially in cases of elderly patients showing bruises on the forehead or extensive neck hematoma, the possibility of cervical spine fracture should be taken into account and postmortem examinations should be arranged commensurately.
       
  • Death certification in England must evolve (Considering current
           technology)
    • Abstract: Publication date: Available online 24 October 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Pablo MILLARES MARTINABSTRACTThe death certificate form used in England and Wales is analysed, compared to other available forms in top ranking economies, to determine its fitness for purpose. There are several restrictions linked to its use and also many limitations. Areas where it can evolve and where improvement can be achieved are suggested.
       
  • Isolation and culture of human adipose-derived mesenchymal stromal/stem
           cells harvested from postmortem adipose tissues
    • Abstract: Publication date: Available online 16 October 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Takashi Saito, Takako Sato, Koichi SuzukiMany cell types maintain their function short-term after death. Stem cells isolated from postmortem tissues have been successfully applied in transplantation studies. However, stem cell viability and stemness are reported to decline with increased time after death. Although postmortem stem cells may be useful for regenerative therapy and forensic diagnostics, their characteristic remain to be better understood. Adipose-derived mesenchymal stromal/stem cells (ASCs) have the capacity to differentiate through several cell lineages and are able to survive in an ischemic environment for a prolonged time. This study aimed to confirm whether human postmortem ASCs can be collected and culture-expanded from cadavers. Axilla subcutaneous adipose tissues were harvested during forensic autopsy and enzymatically digested to obtain a heterogeneous cell mixture, including the ASCs population. The mixture was seeded onto collagen-coated cell culture dishes and spindle-shaped adhesive and proliferative ASCs were confirmed. Senescent cells were also present, visualized as large and flattened cells. When maintained in a cool environment, ASCs were able to survive in the postmortem tissues for up to 7 days after death. We conclude that postmortem ASCs can be readily isolated and culture-expanded from adipose tissues.Graphical abstractImage 1
       
  • Forensic evidence in atrocity trials: A risky sampling strategy'
    • Abstract: Publication date: Available online 8 August 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Caroline FournetAbstractIn the light of the recent judgments issued by the International Criminal Court (ICC), including two acquittals and one very recent condemnation of the accused on all charges, analyzing and assessing evidentiary practice before the Court is all the more pressing. This article focuses on one particular type of evidence used by the Prosecution, namely, forensic evidence, to critically review how it has been used so far at the ICC and consider whether the prosecutorial strategy of focusing on a certain sample of crimes is finally paying off.
       
  • Estimation of stature from radiographically determined lower limb bone
           length in modern Chinese
    • Abstract: Publication date: Available online 22 February 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Kui Zhang, Meng-jun Zhan, Jing-hui Cui, Ying-zhen Luo, Li-rong Qiu, Li-ping Deng, Zhen-lin Li, Xiao-gang Chen, Zhen-hua DengAbstractTo develop population - specific stature prediction equations from measurements of the lower limb bone in a contemporary Chinese. 303 individuals of Han group in Western China, including 201 females and 102 males were collected. The study sample was randomly divided into two subgroups. A calibration sample, which consisted of 171 females and 87 males, was used to develop the regression formula. A validation sample comprising the remaining 30 female and 15 male individuals was then used to test the predictive accuracy of the established formula. The regression equations were developed from intact bones and fragments of the femur, tibia and fibula, the maximum lengths of femur, tibia, and fibula were highly correlated with the stature. The maximum length of femur provide the most accurate result with the prediction accuracy of 3.84 cm for unknown sex, 4.00 cm in the male group, 3.45 cm in the female group, 3.61 cm in the group with age no more than 45, 3.45 cm in the group with age above 45. Moreover, the multiple regression equations were developed, and they portray a more accurate stature in instances in which the femur, tibia and fibula are available. This paper provides indications that the femur, tibia and fibula are important bones for stature estimation and they could be effectively used in forensic cases.
       
  • Three groups of suspects in police reported rape cases: First-time
           suspects, recidivists and unidentified suspects. A comparative study
    • Abstract: Publication date: Available online 15 February 2019Source: Journal of Forensic and Legal MedicineAuthor(s): Bjarte Frode Vik, Kirsten Rasmussen, Berit Schei, Cecilie Therese HagemannAbstractBackgroundPrevious studies show that reported suspects in adult rape cases often have a criminal record, and that many are rape recidivists. Annual numbers of police reported rapes have dramatically increased but the proportion of rapes being prosecuted and numbers of convictions are low. To increase knowledge about the suspects in cases of police reported rapes; whether they have committed the crime before or not may inform preventive measures.AimsTo compare suspect, victim, and assault related characteristics among different groups of police-reported rape suspects (first-time suspects, recidivist suspects and unidentified suspects).MethodsRetrospective, descriptive study of suspects in cases of rape or attempted rape reported by women ≥16 years of age in the Sør-Trøndelag police district, Norway, from 2003 to 2010.ResultsAmong the 356 suspects included, 207 (58%) were first-time suspects, 75 (21%) were recidivists and 74 (21%) were unidentified. Being a first-time suspect was significantly associated with victim being
       
 
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