Age assessment in unaccompanied minors: assessing uniformity of protocols across Europe.

Age assessment of migrants is crucial, particularly for unaccompanied foreign minors, a population facing legal, social, and humanitarian challenges. Despite existing guidelines, there is no unified protocol in Europe for age assessment.The Forensic Anthropology Society of Europe (FASE) conducted a comprehensive questionnaire to understand age estimation practices in Europe. The questionnaire had sections focusing on the professional background of respondents, annual assessment numbers, requesting parties and reasons, types of examinations conducted (e.g., physical, radiological), followed protocols, age estimation methods, and questions on how age estimates are reported.The questionnaire's findings reveal extensive engagement of the forensic community in age assessment in the living, emphasizing multidisciplinary approaches. However, there seems to be an incomplete appreciation of AGFAD guidelines. Commonalities exist in examination methodologies and imaging tests. However, discrepancies emerged among respondents regarding sexual maturity assessment and reporting assessment results. Given the increasing importance of age assessment, especially for migrant child protection, the study stresses the need for a unified protocol across European countries. This can only be achieved if EU Member States wholeheartedly embrace the fundamental principles outlined in EU Directives and conduct medical age assessments aligned with recognized standards such as the AGFAD guidelines.

Rumor has it: A narrative review on the use of skeletal non-metric traits and variants for personal identification.

The human skeleton displays an immense array of traits and variant features that are elements of inter-individual variability. The general assumption is that they may represent individualizing markers for the personal identification of unidentified decedents, but very few works consider them as such. This review provides an overview on the possible use of non-metric traits and skeletal variants for personal identification. The paper discusses the issues related to unquantified comparisons, then it presents a statistical approach based on frequencies of these features for identifying unknown remains. Narrowing down an initial number of 1000 papers, the core of the review is represented by 10 papers that considered non-metric traits and skeletal variants as individualizing features, according to both qualitative and quantitative assessments. Despite visual examination remains the gold-standard, more sound methods are requested to quantify the strength of a match or a mismatch. This especially applies in the wake of juridical demands, hence also satisfying the desire of prosecutors and judges to rely on a "quantified" risk. To this purpose, non-metric traits and skeletal variants seem to be a suitable tool to provide quantified evidence, when related frequencies are known.

Assessment of Anatomical Uniqueness of Maxillary Sinuses through 3D-3D Superimposition: An Additional Help to Personal Identification.

Paranasal sinuses represent one of the most individualizing structures of the human body and some of them have been already analyzed for possible applications to personal identification, such as the frontal and sphenoid sinuses. This study explores the application of 3D-3D superimposition to maxillary sinuses in personal identification. One hundred head CT-scans of adult subjects (equally divided among males and females) were extracted from a hospital database. Maxillary sinuses were segmented twice from each subject through ITK-SNAP software and the correspondent 3D models were automatically superimposed to obtain 100 matches (when they belonged to the same person) and 100 mismatches (when they were extracted from different individuals), both from the right and left side. Average RMS (root mean square) point-to-point distance was then calculated for all the superimpositions; differences according to sex, side, and group (matches and mismatches) were assessed through three-way ANOVA test (p < 0.017). On average, RMS values were lower in matches (0.26 ± 0.19 mm in males, 0.24 ± 0.18 mm in females) than in mismatches (2.44 ± 0.87 mm in males, 2.20 ± 0.73 mm in females) with a significant difference (p < 0.001). No significant differences were found according to sex or side (p > 0.017). The study verified the potential of maxillary sinuses as reliable anatomical structures for personal identification in the forensic context.

Physical assessment of tortures: Interobserver analysis of medico-legal degrees of consistency based on the Istanbul protocol.

The Istanbul Protocol section on medicolegal evaluation delineates the guidelines for the correct management of the physical examination and the methods of assigning the degrees of consistency. Considering that most cases exhibit highly heterogeneous lesions, the examiner is forced to rely on his own experience, and their evaluation may be very subjective. The purpose of this work is to understand how subjective such an evaluation may be and whether the "experience" factor, interpreted as years dedicated to this profession and the number of cases evaluated, is statistically significant. To this end, a survey containing eleven cases of pre-evaluated asylum seekers was sent to thirty Italian clinical forensic practitioners. The participants were invited to assign a degree of consistency to each case according to the Istanbul Protocol guidelines, besides answering a few questions regarding their professional record. The doctors were divided into groups based on the number of cases evaluated and the experience collected expressed in years, and then interobserver analysis was performed. Results showed that the Fleiss' Kappa coefficient acquired significant values when attention was turned to the sub-samples composed of more experienced participants. Therefore, the introduction of appropriately trained health professionals - "experts in migrations and torture" - could lower the risks of misinterpretation and make the assessment as reproducible as possible.

How Physical and Molecular Anthropology Interplay in the Creation of Biological Profiles of Unidentified Migrants.

The skeletal sex and ancestry of unidentified human crania can be inferred both from physical and from molecular features. This paper depicts and discusses the experiences of physical and molecular anthropologists on a set of commingled crania from the largest Mediterranean shipwreck disaster on 18 April 2015, in order to facilitate identification of human crania. Twenty-one disarticulated crania that were recovered from the above-mentioned shipwreck were analyzed to estimate skeletal sex and ancestry, following a physical and a molecular pipeline. The physical analyses applied morphological and metric methods that provided posterior probabilities for the crania to be classified into a sex or ancestral group. The molecular analyses were performed on petrous bones via a shotgun sequencing approach that allowed us to determine the sex of each individual and to retrieve the complete mitochondrial genome, Y chromosome single nucleotide polymorphisms, up to 597573 SNPs across the human genome from each individual. The morphometric sex analyses showed that most crania belonged to male individuals, although some estimations remained uncertain or undetermined. Inconsistent results were obtained for ancestry estimation as well, since morphological methods classified the crania mostly as European/White, in contrast to the most numerous African forms determined by craniometric analyses. This quite agreed with molecular analyses that identified only African males. Overall, undetermined and contrasting results were obtained between disciplines, preventing the creation of reliable and sound biological profiles that could provide guidance on the sex and ancestral group of the victims. Therefore, the times may not be mature for a merger of physical and molecular anthropology. However, future investigations of this research avenue would pave the way to the possible development of novel tools, methods, and wider reference databases that could address the limitations of both disciplines.

The rights of migrants to the identification of their dead: an attempt at an identification strategy from Italy.

Europe is turning a blind eye on a humanitarian disaster unfolding at its doorsteps, with thousands of migrants dying unidentified in Mediterranean waters. Since 2014, Italy has been struggling in an almost indifferent international scenario to identify its dead migrants. Despite the lack of sufficient resources, of the difficulties in collecting post mortem data from the disseminated bodies, and of the problems of contacting and collecting ante mortem information from relatives, it has been proven, with a series of pilot studies, that not only can these bodies be identified but that relatives are also looking for their loved ones and need death certificates. This article focuses on the administrative limbo and lack of regulations obliging single states to engage in appropriate procedures to maximise identification.

Digital pair-matching of iliac bones: pilot study on a three-dimensional approach with models acquired through stereophotogrammetry.

Three-dimensional (3D) pair-matching has brought about an innovative approach for the analysis of commingled skeletal remains, and it has been tested on bone models acquired through CT and laser scans. Here, 3D models of 40 innominate bones (20 left and 20 right) of 20 documented male individuals from a cemeterial skeletal collection were acquired through a stereophotogrammetric device (VECTRA M3, Canfield Scientific, Inc.). The ventral iliac surface was chosen as the anatomical region of interest (ROI) for the analysis. Each left ROI was mirrored and superimposed on the matching right ROI (contralateral element from the same individual) and mismatching ROIs (contralateral elements from different individuals). The point-to-point distance between models was calculated through the Vectra Analysis Module (VAM) software and the root mean square (RMS) point-to-point distance value was used to evaluate the sorting performance of the method, in terms of sensitivity and specificity rates. Differences in RMS between matches and mismatches were investigated through a Student's t test (p < 0.05). The state of preservation of the remains was assessed following an index of anatomical completeness and differences in RMS distances of true matches according to different anatomical completeness were assessed through the Mann-Whitney test (p < 0.05). RMS point-to-point distances of matches and mismatches were significantly different (p < 0.01), being the matches lower than mismatches. The RMS threshold of 2.9 mm identified all the true pairs; the test was 100% sensitive and 51% specific. The RMS of matches with a better state of preservation are significantly lower than the less preserved matches (p < 0.05). In general, a low RMS distance value may indicate a true match, being it to be further verified. The 3D approach for sorting innominate bones provides a valid screening test that could complete subjective and osteometric methods with numerical evidence of the match. Preliminary data suggest a possible relation between RMS distance values and taphonomic condition, which would benefit from further research.

A Pilot COVID-19 Surveillance Program at the Zendrini Center in Milan (Italy) for Unaccompanied Foreign Minors.

During the COVID-19 pandemic, not only crowded refugee camps and immigration detention centers, but also receptions were places in which outbreaks occurred. To date there has been no report of the application of a COVID-19 surveillance system in reception centers for unaccompanied foreign minors only, who most of all deserve the utmost attention. Aware of this critical issue, we implemented a pilot COVID-19 surveillance program at the Zendrini center in Milan. It was started in September 2021 and was carried out for 4 months. Nasopharyngeal antigenic swabs were adopted. One day a week, two forensic physicians performed the first antigenic swab to minors who had just entered the center, or a monitoring swab after 15 days to those who were still hosted at the center. Operators were also swabbed for surveillance. A total of 80 subjects were enrolled and divided into 68 (72.5%) unaccompanied foreign minors and 22 (27.5%) operators. A total of 178 antigenic nasopharyngeal swabs were performed and tested negative. Regarding the monitoring activities, it was found that the minimum number of swabs per subject was 1 and the maximum number was 7, with an average value of 2.2 per individual. Having been able to confirm the absence of SARS-CoV-2 within the community represented a way to protect individual and collective health that could not have been pursued otherwise. Only inclusive approaches can allow communities and societies to respond more effectively to this crisis, and reduce the risk of future ones, intended as both upcoming COVID-19 waves and new infectious diseases.

Morphological and Immunopathological Aspects of Lingual Tissues in COVID-19.

COVID-19, a recently emerged disease caused by SARS-CoV-2 infection, can present with different degrees of severity and a large variety of signs and symptoms. The oral manifestations of COVID-19 often involve the tongue, with loss of taste being one of the most common symptoms of the disease. This study aimed to detect SARS-CoV-2 RNA and assess possible morphological and immunopathological alterations in the lingual tissue of patients who died with a history of SARS-CoV-2 infection. Sixteen cadavers from 8 SARS-CoV-2 positive (COVID-19+) and 8 negative (COVID-19-) subjects provided 16 tongues, that were biopsied. Samples underwent molecular analysis through Real-Time RT-PCR for the detection of SARS-CoV-2 RNA. Lingual papillae were harvested and processed for histological analysis and for immunohistochemical evaluation for ACE2, IFN-γ and factor VIII. Real-Time RT-PCR revealed the presence of SARS-CoV-2 RNA in filiform, foliate, and circumvallate papillae in 6 out of 8 COVID-19+ subjects while all COVID-19- samples resulted negative. Histology showed a severe inflammation of COVID-19+ papillae with destruction of the taste buds. ACE2 and IFN-γ resulted downregulated in COVID-19+ and no differences were evidenced for factor VIII between the two groups. The virus was detectable in most COVID-19+ tongues. An inflammatory damage to the lingual papillae, putatively mediated by ACE2 and IFN-γ in tongues from COVID-19+ cadavers, was observed. Further investigations are needed to confirm these findings and deepen the association between taste disorders and inflammation in SARS-CoV-2 infection.

Morphological analysis of lingula shape in a modern Italian cemeterial population: Clinical and forensic considerations.

The lingula is a small bony projection emerging from the medial ridge of the mandibular foramen, subjected to morphological variations. To date, scientific literature has described four different shapes (truncated, triangular, nodular and assimilated) and the relative distributions in different human populations. However, no data are available on Europeans so far. To this purpose, the present study aims to evaluate the distribution of the lingula shapes in the Italian population and to verify its relevance in ancestry estimation. Lingula was analysed in 235 dry mandibles selected among contemporary Italian cemeterial skeletons. Since only well-preserved sides were considered, 453 sides were evaluated according to a classification method, which includes the description of a fifth shape (the bridge shape) and the presence of mixed morphologies. In our sample, the most prevalent shape was the truncated shape (38.6%), followed by the nodular (26.3%), mixed morphologies (15.2%), triangular (10.8%), bridge (5.1%) and assimilated (4.0%) shapes. Within mixed morphologies, the most prevalent were the nodular/truncated (31.9%), nodular/triangular (30.4%), and nodular/assimilated (23.2%). Differently to previous studies, the lingula morphology could not actually offer a concrete and reliable help to ancestry estimation. However, its shape and extension would assume a stronger clinical influence for the execution and success of the alveolar nerve block used in dental and maxillofacial surgery procedures.

3D-3D facial registration method applied to personal identification: Does it work with limited portions of faces? An experiment in ideal conditions.

Personal identification of faces represents a challenging issue, especially for what concerns the quantification of the comparison. The 3D-3D superimposition approach proved to distinguish between matches and mismatches. However, the potential of this procedure applied to cases where only parts of faces are visible still has to be verified. This study aimed at verifying the applicability of a 3D-3D procedure to faces divided into three thirds. 3D models of fifty male subjects acquired through stereophotogrammetry were used. The 3D facial models were divided into upper, middle, and lower thirds and registered onto other models belonging to the same and different individuals according to the least point-to-point distance. In total, 50 matches and 50 mismatches were analyzed. RMS value (root mean square) of point-to-point distance between the two facial surfaces was calculated through VAM® software. Statistically significant differences between matches and mismatches in each facial third were assessed through Mann-Whitney test (p < 0.05). On average, RMS value in matches was 0.32 ± 0.12 mm in upper third, 0.36 ± 0.15 mm in middle third, and 0.40 ± 0.20 mm in lower third, respectively; in mismatches, RMS value was 1.40 ± 0.32 mm in upper third, 1.96 ± 0.58 mm in middle third, and 2.39 ± 0.90 mm in lower third, respectively. Differences in RMS values between matches and mismatches were significantly different for all facial thirds, without superimpositions (p < 0.01). This study shows that the existing 3D-3D superimposition methods may be useful also when only a limited portion of face is visible in ideal conditions. Their application to forensic cases of identification still needs to be verified.

3D-3D Superimposition of Pubic Bones: Expanding the Anthropological Toolkit for the Pair-Matching of Commingled Skeletal Remains.

Virtual anthropology (VA) has recently produced an additional tool for the analysis of commingled remains and is based on the distance analysis between three-dimensional (3D) models of bones. To date, the pair-matching of the innominate bone through a 3D approach remains partially unexplored. Here, 44 abdominal CT scans (22 males and 22 females) were selected from a hospital database, and the pubic bones were segmented through ITK-SNAP software. The models were hollowed with Viewbox4 to minimize the amount of trabecular bone. The left pubic bones were mirrored and superimposed on the right ones, according to the smallest point-to-point difference between the two surfaces through VAM software. RMS distances between models were calculated through VAM, producing RMS values for 20 matches and 420 mismatches for each sex group. Differences in RMS distance values between matches and mismatches were investigated through Mann−Whitney tests (p < 0.05); the repeatability of the procedure was assessed through absolute and relative technical error measurement (TEM and rTEM). RMS distance values of matches and mismatches were significantly different (p < 0.01) in both groups. The method yielded optimal results with high sensitivity (100.0%) and specificity (99.8% in males, 98.8% in females) rates according to the chosen threshold. This project contributes to the research field of VA with a valuable adjunct that may bolster and strengthen the results of the current visual and osteometric methods through a multidisciplinary approach.

Rediscovering the value of images in supporting personal identification of missing migrants.

The crisis concerning the identification of dead migrants is forcing forensic scientists to deal with the unavailability of classical antemortem (AM) data such as radiological information and DNA. However many times there is abundant AM photographic data of which the availability and quality is underestimated. Independently of when facial image comparison can be used as a valid identification method, description of the unexpected quality and quantity of images in the scenario of unidentified migrant decedents is given in this observational study. It focuses on the overall characteristics of the AM images available for a group of 74 missing migrants related to the disaster of October 3rd, 2013. 394 images were collected: an average of 6 for each missing person. 18% are original pictures, 47.5% scans of original images, 9.9% scans of printed images while 9.4% downloaded from social networks such as Facebook. 42.7% of images resulted in focus. Among all the images, about the 10% has been used in the personal identification process to ascertain the identity of 22 persons, because of the visibility of identifying details (facial, dental and body features). The importance of such a finding should not be diminished by its simplicity. Today, those involved in collecting AM information from relatives of dead migrants are underestimating the possible presence of images, even in sub-Saharan populations, where, contrary to belief and data, technology, though simple, is available and images may turn out to be abundant and useful (and at times the only resort) for identification.

Taphonomic study on drowned victims in a non-sequestered aquatic environment in the Mediterranean Sea.

Human decomposition in sea water poses several challenges to forensic practitioners tasked with the analysis of drowned bodies. Postmortem changes in the marine environment have not been extensively investigated and the current literature is mainly based on bodies retrieved from shallow waters or on limited samples. On 18 April 2015, a fishing boat carrying allegedly 1,000 migrants sank in the Mediterranean Sea. In a fifteen-month time span, humanitarian missions were carried out to recover the bodies from the sea. The present study investigates postmortem changes on the drowned victims in a non-sequestered environment in the Mediterranean Sea. A retrospective study was performed by two observers on the autopsy photographic records in the series of bodies recovered from the open sea. For 184 bodies, the postmortem changes were evaluated according to facial, body, limb, and total aquatic decomposition score (FADS, BADS, LADS, TADS, respectively). Furthermore, a modification to the current scoring system that divides upper and lower limbs was suggested. The interobserver agreement was assessed using Krippendorff's alpha coefficient. Possible relations between the decomposition scores and PMSI were investigated with Pearson correlation analysis. According to the sequence of the recovery missions, increasing FADS, BADS, LADS, and TADS were observed. The modified scoring system showed a strong agreement between observers, allowing a more accurate description of the actual extent of decomposition. The scores showed a significant relation with the PMSI (p < 0.01). Prolonged submersion in the open marine environment was confirmed to show increasing decomposition rates, from moderate decay to full disarticulation. This study provides a descriptive unicum of the postmortem changes in the open sea, which may contribute to strengthen the discipline and aid description of bodies recovered in similar circumstances, especially if a body needs to be associated to a disaster or period with respect to another, thus facilitating families or authorities in the search for specific victims.

Analysis of interrater reliability in age assessment of minors: how does expertise influence the evaluation?

Nowadays, the clinical forensic medical management of migration flows comprises the age assessment of unaccompanied minors. The process of age estimation is a fundamental pillar for legally ensuring the minors' rights and their protection needs. The procedure is complex and involves different phases and actors, from medical doctors to law enforcement officers. The present study aimed to investigate the performance of Greulich and Pyle, Demirjian, and Mincer methods when performed by raters both trained and without training. Also, the interrater reliability within groups of raters from different areas of expertise was evaluated. A total of 36 participants were enrolled for this study, divided in two groups according to their level of experience with age estimation methods. Each rater was asked to allocate stages and standards for age assessment, evaluating ten orthopantomograms and ten hand-wrist roentgenograms. The interrater reliability expressed through the Fleiss Kappa coefficient and the agreement with the reference standard were calculated. The results showed that none of the categories analyzed could reach a good interrater reliability (ĸ > 0.8) for both methods. The study results highlighted variation and disagreement in the interpretation of the sample among raters and in the subsequent stages and standards allocation. In conclusion, the results of this study highlight that expertise does influence the reliability of the most utilized methods of age estimation of living individuals and stress the importance of proper training and practice, which could greatly increase the accuracy of age assessments.

Exploring the potential of cranial non-metric traits as a tool for personal identification: the never-ending dilemma.

Forensic anthropologists tasked with identification of skeletal remains often have to set up new strategies to overcome the limitations of conventional individualizing markers. A sound acquaintance with non-metric traits is essential for a reliable distinction between normal variations and pathological or traumatic conditions, yet the role of cranial variants in the identification process is still somehow ill-defined. One hundred crania (50 males and 50 females) of known sex and age were selected from the Collezione Antropologica LABANOF (a documented contemporary skeletal collection) and non-metric traits were scored as present or absent and by side. The frequencies of 13 traits were used to calculate the compound probabilities to find an individual with an exact combination of cranial features in the worldwide population. The probabilities of the majority of the individuals (53%) are within the 1 out of 10 million-1 out of 1 million interval. However, a fair number of subjects (25%) of the sample have the probabilities falling into the 1 out of 1 billion-1 out of 100 million interval, while the probabilities of a small portion of the sample (10%) are less than 1 out of 1 billion. This pilot study illustrates that some combinations of cranial variants are quite rare and may represent potential evidence to discern presumptive identifications, when an appropriate set of traits is selected and antemortem data are available for comparison. However, further research on larger and various samples is needed to confirm or discard the use of combinations of cranial non-metric traits as individualizing markers.

Improving 3D-3D facial registration methods: potential role of three-dimensional models in personal identification of the living.

Personal identification of the living from video surveillance systems usually involves 2D images. However, the potentiality of three-dimensional facial models in gaining personal identification through 3D-3D comparison still needs to be verified. This study aims at testing the reliability of a protocol for 3D-3D registration of facial models, potentially useful for personal identification. Fifty male subjects aged between 18 and 45 years were randomly chosen from a database of 3D facial models acquired through stereophotogrammetry. For each subject, two acquisitions were available; the 3D models of faces were then registered onto other models belonging to the same and different individuals according to the least point-to-point distance on the entire facial surface, for a total of 50 matches and 50 mismatches. RMS value (root mean square) of point-to-point distance between the two models was then calculated through the VAM® software. Intra- and inter-observer errors were assessed through calculation of relative technical error of measurement (rTEM). Possible statistically significant differences between matches and mismatches were assessed through Mann-Whitney test (p < 0.05). Both for intra- and inter-observer repeatability rTEM was between 2.2 and 5.2%. Average RMS point-to-point distance was 0.50 ± 0.28 mm in matches, 2.62 ± 0.56 mm in mismatches (p < 0.01). An RMS threshold of 1.50 mm could distinguish matches and mismatches in 100% of cases. This study provides an improvement to existing 3D-3D superimposition methods and confirms the great advantages which may derive to personal identification of the living from 3D facial analysis.

Does the choice of the reference model affect the results of 3D-3D superimposition procedure? A comparison of different protocols for personal identification.

In literature, 3D-3D superimposition has been widely recognized as a valid method for personal identification. However, very little information is available about possible variability due to differences in protocols of registration of 3D models and calculation of RMS (root mean square) point-to-point distance. Frontal sinuses from 50 CT scans were segmented twice through the ITK-SNAP software and grouped in two samples (1 and 2). Maximum breadth, height and volume were measured. 3D models belonging to the same subject were then superimposed one on each other in 50 matches. In addition, superimposition of 50 random mismatches was performed. For each superimposition, the procedure was repeated four times choosing different reference models both for registration and calculation of RMS. Differences in RMS value among protocols of registration and RMS calculation were assessed through paired Student's t-test (p < 0.05). Possible correlations between differences in RMS among groups and differences in frontal sinus size between the superimposed models were analysed through calculation of Pearson's correlation coefficient (p < 0.05). Results showed that RMS calculation did not yield significant differences according to which 3D model is used as reference; on the other hand, RMS values from registration procedure significantly differ according to which model is chosen as reference, but only in the mismatch group (p < 0.001). Differences in RMS value according to RMS calculation are dependent upon all the three measurements, whereas differences according to registration protocols were significantly related only with the breadth of frontal sinuses but only in mismatches (p < 0.001). In no case, superimpositions of RMS values were found between matches and mismatches. This article for the first time proves that the protocol of registration and calculation of RMS significantly influences the results of 3D-3D superimposition only in case of mismatches.

Twenty-five years of unidentified bodies: an account from Milano, Italy.

The identification of decedents has always been a central issue in forensic pathology, for ethical, criminal, and administrative reasons, but today, it needs more attention due to issues related not only to migration but also to the weakening of family ties. This article presents a descriptive study discussing the Italian regulatory situation developed in the last decade to face the many identification issues, with all its improvements and flaws. Hence, data gathered in 25 years of at the Institute of Legal Medicine of Milan and the epidemiology of unidentified decedents are illustrated. Briefly, from 1995 to 2019, the number of unidentified human remains with no identity or requesting verification of identity amounts to 726, i.e., 3% circa of all autopsies performed at the Institute, with an average of 29 individuals per year. In total, 528 (72.7%) individuals were successfully identified, 100 (13.8%) remained without an identity, and 98 (13.5%) individuals remained with suspected yet unconfirmed identities. Percentages for each identification technique are displayed, with insight into the role of forensic anthropology and odontology compared to genetics, and into the misuse of non-scientific methods allowed by Public Prosecutors. All the data is compared, as much as possible, with the very few recent studies concerning the problem worldwide. Finally, the article aims to show the Italian experience in dealing with unidentified bodies, in order to provide food for thought for other countries toward a discussion regarding a global issue which is sometimes taken for granted and underestimated.