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The New York City Office of Chief Medical Examiner (NYC OCME) investigates approximately 9 000–10 000 deaths every year, each of which necessitates a formal identification. Although standard identification protocols resolve the majority of these cases, there are still a substantial number of long-term unidentified persons cases that require a targeted investigation. This process involves not only the comprehensive review of all available postmortem data (e.g. scene findings, personal effects, autopsy findings, toxicology results, forensic anthropology reports, dental findings, fingerprints, forensic biology), but also the collection of antemortem data through focused informant interviews, analyzing casefiles and/or archival records, reviewing public missing person postings (e.g. National Missing and Unidentified Persons System (NamUs)), and collaborating with law enforcement and other agencies. This holistic approach to identification investigations is systematic yet flexible, allowing for the needs of each unidentified person and/or missing person case to be thoroughly assessed and efficiently addressed. These efforts have proven successful at NYC OCME, resulting in over 80 long-term unidentified persons identifications confirmed in the last 7 years, dating as far back as 1969. This paper provides a detailed breakdown of the NYC OCME framework for long-term unidentified persons investigations, citing multiple case studies to underscore how investigators utilize multiple lines of evidence to generate potential leads. Although each jurisdiction faces a unique set of demands and limitations, sharing these investigative strategies and perspectives may benefit practitioners contending with long-term unidentified persons cases and their inherent complexities. Key points The NYC OCME oversees a large caseload of unidentified persons yet achieves a high rate of case resolution by applying a systematic and holistic investigation that involves a comprehensive review of postmortem data and the collection of antemortem data specific to a forensic identification. Analyzing multiple lines of postmortem biological and contextual evidence allows practitioners to hypothesize possible socioeconomic, cultural, and religious social identities that can be used to generate identification leads and inform comparisons to missing persons. Gathering as much detailed, accurate, and comprehensive antemortem data for a missing person is equally important when performing an identification comparison to a long-term unidentified persons (UP) and can better inform archival morgue records searches. [ABSTRACT FROM AUTHOR]

This case study details a rare finding of hyoid body agenesis. Anthropological consultation on structures of the neck is frequently utilized at the New York City Office of Chief Medical Examiner. This practice allows for anthropology findings to supplement and support the autopsy reports produced by the medical examiners, often detailing the presence of trauma and/or anatomical variants. In this case, while no trauma to the neck was suspected, anthropological consultation revealed a unique hyoid morphology that has not yet been documented in the forensic literature. Moreover, this morphology seems to support a single developmental origin for the hyoid body, which has been theorized in recent embryological research. Analysis of this hyoid body agenesis may contribute meaningful data to discussions regarding hyoid bone developmental origins and provide a useful example for other forensic cases involving similar morphology. This case exemplifies the benefit of pathological and anthropological collaboration in distinguishing between trauma, pathology, and anatomical variants when assessing structures of the neck. [ABSTRACT FROM AUTHOR]

Objective  The aim of this study is to evaluate formal bereavement debriefing sessions after infant death on neonatal intensive care unit (NICU) staff. Study Design  Prospective mixed methods study. Pre- and postbereavement debriefing intervention surveys were sent to clinical staff. Evaluation surveys were distributed to participants after each debriefing session. Notes on themes were taken during each session. Results  More staff attended sessions (p  < 0.0001) and attended more sessions (p  < 0.0001) during the postdebriefing intervention epoch compared with the predebriefing epoch. Stress levels associated with the death of a patient whose family the care provider have developed a close relationship with decreased (p  = 0.0123). An increased number of debriefing session participants was associated with infant age at the time of death (p  = 0.03). Themes were (1) family and provider relationships, (2) evaluation of the death, (3) team cohesion, (4) caring for one another, and (5) emotional impact. Conclusion  Bereavement debriefings for NICU staff reduced the stress of caring for dying infants and contributed to staff well-being. Key Points Providing end-of-life care in NICU is challenging. Debriefings assist staff in coping with grief. Staff well-being impacts patient care. [ABSTRACT FROM AUTHOR]

ABSTRACT Interpretations of burial sites from past populations have previously relied on archaeological artifacts, body position, and gross morphological skeletal analysis to reconstruct funerary practices. Recently, microscopic analysis of biotic and abiotic inclusions in bone have resulted in broad assumptions about the antemortem treatment of human remains, including whether the bioerosion is of endogenous and/or exogenous origin. To contextualize the diagenesis present in bone, researchers have developed indices to quantify histotaphonomic features including overall destruction (OHI, GHI), birefringence (BI), cracking (CI), and color changes due to burning (HI). Quantification of the histotaphonomy of bone also allows researchers to determine if the bone is preserved well enough for the application of histological methods, such as age‐at‐death estimation, which can contribute to the osteobiography of the skeletal remains. However, burned bone found at cremation sites may complicate these analyses if thermal alterations obscure histological structures. Though many studies have experimentally tested the impact of burning on bone, most have used excised bones, which presents a very specific example of the effect of burning on excarnated remains. The aim of this research is to test the histotaphonomic effects of thermal alteration on six fleshed human bodies using the indices listed above. One preburn sample of bone from the femur, sixth rib, and metatarsal was collected prior to burning, and the antimere was removed after the experiment, if recoverable (N = 33). These results show that the presence of body tissue and the amount of time the body is burned likely have the greatest impact on bone histological preservation. None of the remains showed evidence of biotic bioerosion, which was expected from previous research that suggests putrefaction in the early postmortem period contributes to microfocal destruction that can be observed soon after death. [ABSTRACT FROM AUTHOR]