Friday, June 13, 2025

Partial peace deals may facilitate comprehensive accords, offering roadmap for policymakers, practitioners

By Josh Stowe

University of Notre Dame

image:
Madhav Joshi, research professor and associate director of the Peace Accords Matrix (PAM) at the University of Notre Dame, studies peace agreement design and implementation. PAM is housed within the Kroc Institute for International Peace Studies, part of Notre Dame’s Keough School of Global Affairs.
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Credit: University of Notre Dame

Over the past two decades, conflicts in more than 40 countries, including El Salvador, Northern Ireland, Senegal and The Philippines, have ended in comprehensive peace agreements. But these broader accords don’t happen all at once.

Partial peace agreements — deals signed along the way that address issues ranging from ceasefires to constitutional reforms and human rights — could provide a blueprint for peacebuilding policymakers and practitioners, new research from the University of Notre Dame suggests.

The study, published in the Journal of Peace Research, draws on a newly expanded dataset from the University’s Peace Accords Matrix — a trusted resource for global peace practitioners seeking actionable evidence. Researchers examined 51 provisions from 42 comprehensive peace agreements and 236 partial peace agreements.

“Thanks to this newly expanded dataset, we uncovered findings that can inform the work of negotiators in various global contexts,” said lead author Madhav Joshi, research professor and associate director of the Peace Accords Matrix, which is housed within the Kroc Institute for International Peace Studies, part of Notre Dame’s Keough School of Global Affairs. “These insights are possible because of the impactful research that takes place at the Peace Accords Matrix.”

Partial peace agreements offer multiple strategic advantages, Joshi said. They can help negotiating parties consolidate incremental progress; serve as metrics for stakeholders and the international community; allow parties to test specific measures before fully committing to them; and signal a larger commitment to the peace process.

The new study provided a deeper look into how these agreements work, Joshi said. Researchers found the following:

A greater number of partial agreements is associated with higher implementation of comprehensive agreements.
Generally speaking, it is a better strategy to pursue more partial agreements, even if this lengthens negotiations.
Longer negotiations that do not produce partial agreements are never better than short negotiations.

“These findings suggest that partial peace agreements play an important role in building trust and strengthening relationships between negotiators to help peace processes succeed,” Joshi said.

The study also helped identify additional avenues for future research, Joshi said, which might explore why parties in some processes (but not others) pursue further partial agreements. Further studies could explain why some partial agreements are implemented immediately while others are not, and why only some partial accords reaffirm previous agreements.

“Ultimately, this study is an example of our evidence-to-action approach,” Joshi said. “Our research can guide the work of policymakers and practitioners on the ground who work to end conflicts and save lives. Putting this evidence in their hands is critical to designing effective policies that will yield a tangible impact, helping societies escape the destructive cycles of violence and war.”

The study received funding from the Keough School’s Kroc Institute for International Peace Studies. Joshi co-authored the report with Matthew Hauenstein, assistant research professor at Notre Dame’s Lucy Family Institute for Data & Society and Jason Quinn, research associate professor and a principal researcher for the Peace Accords Matrix data project.

Contact: Tracy DeStazio, associate director of media relations, 574-631-9958 or tdestazi@nd.edu

Journal

Journal of Peace Research

DOI

10.1177/0022343325132259

Method of Research

Data/statistical analysis

Subject of Research

Not applicable

Article Title

Expanding the Peace Accords Matrix Implementation Dataset: Partial peace agreements in the Comprehensive Peace Agreement negotiation and implementation process, 1989–2021

Why caffeine might hold the key to preventing sudden infant death syndrome

Rutgers University

After decades of stalled national progress in reducing the rate of Sudden Unexpected Infant Death (SUID), a category of infant mortality that includes sudden infant death syndrome (SIDS), researchers at Rutgers Health have proposed an unexpected solution: Caffeine might protect babies by preventing dangerous drops in oxygen that may trigger deaths.

The hypothesis, published in the Journal of Perinatology, comes as the number of SUID cases has plateaued nationally at about 3,500 deaths a year for 25 years or one death for every 1000 live births. Despite an initial decline in the 1990s with the introduction of widespread education campaigns promoting back to sleep and other safe infant sleep recommendations by the American Academy of Pediatrics, SIDS, even on its own, remains the leading cause of death in infants between 1 and 12 months old.

"We've been concerned about why the rates haven't changed," said Thomas Hegyi, a neonatologist at Rutgers Robert Wood Johnson Medical School who led the research. "So, we wanted to explore new ways of approaching the challenge.”

That approach led Hegyi and Ostfeld to a striking realization: Virtually all known risk factors for SIDS and other sleep-related infant deaths, from stomach sleeping to maternal smoking to bed-sharing to preterm birth, have one thing in common. They are all associated with intermittent hypoxia, brief episodes where oxygen levels drop below 80%.

"I wondered, what can counter intermittent hypoxia?" Hegyi said. "Caffeine."

The connection isn't entirely theoretical. Neonatologists already use caffeine to treat apnea in premature infants, where it works as a respiratory stimulant. The drug has an excellent safety profile in babies, with minimal side effects even at high doses.

What makes caffeine particularly intriguing as a proposed preventive measure is how differently infants process it. While adults metabolize caffeine in about four hours, the half-life in newborns can be as long as 100 hours. Caffeine remains in an infant's system for weeks, not hours.

This unique metabolism might explain a long-standing puzzle: why SIDS peaks between two and four months of age. As infants mature, they begin metabolizing caffeine more quickly. The researchers suggest caffeine consumed during pregnancy or passed through breast milk might provide early protection that wanes as metabolism speeds up.

The theory also could explain why breastfeeding appears to protect against SIDS.

"We hypothesize that the protection afforded by breast milk is, in part, due to caffeine," wrote the researchers, noting caffeine readily passes from mothers to infants through breast milk.

Barbara Ostfeld, a professor at Rutgers Robert Wood Johnson Medical School, the program director of the SIDS Center of New Jersey and co-author of the paper, said if the theory proves true, any efforts to give infants caffeine would complement, not replace, existing risk reduction strategies.

"The idea isn't that caffeine will replace risk-reduction behaviors," Ostfeld said. “A baby dying from accidental suffocation, one component of SUID, is not likely to have benefited from caffeine but would have from such safe sleep practices as the elimination of pillows and other loose bedding from the infant’s sleep environment.”

The researchers plan to test their hypothesis by comparing caffeine levels in infants who died of SIDS with those who died from other causes, such as trauma or disease.

The research represents a fundamental shift in approaching SIDS prevention. While current strategies focus on eliminating environmental risks, this would be the first potential pharmaceutical intervention.

"For over 30 years, we've been educating New Jersey’s parents about adopting safe infant sleep practices. These efforts have contributed to our state rates being the second lowest in the US. Still, for various reasons, these proven recommendations are not universally adopted,” Ostfeld said. "This new hypothesis offers a way not just to address important risk factors but potentially intervene."

Crucially, the researchers said this is hypothesis-generating research meant to inspire further study, not a recommendation for parents to give their babies caffeine. Any intervention would require extensive testing for safety and efficacy.

Still, in a field where progress has stagnated for decades, the possibility of a new approach offers hope.

As Hegyi put it, the goal is "to stimulate new thinking about a problem that has remained unchanged for 25 years."

Journal

Journal of Perinatology

DOI

10.1038/s41372-025-02333-x

Method of Research

Commentary/editorial

Subject of Research

Not applicable

Article Title

Reducing the risk of sudden unexpected infant death: the caffeine hypothesis

Article Publication Date

10-Jun-2025

Study develops optimal cover crop adoption thresholds

North Carolina State University

Researchers have developed a new model that can suggest the optimal conditions for farmers to plant cover crops, or crops grown in between cash-crop seasons, to help ensure long-term cash-crop success. The findings could help improve farm budgets and serve as aids to farmers making decisions about their land.

The model, based on an examination of 35 years of available data on an experimental cotton farm in west Tennessee, accounts for local conditions – including current prices of cash crops and fertilizer as well as the health and fertility of the soil – and then suggests whether an investment in cover crops would be economically beneficial for farmers.

North Carolina State University researchers involved in the study say the model generally favors planting cover crops on fields with relatively healthy soil and on land that has not been tilled. The cost of planting and maintaining cover crops appears to reduce the need for fertilizer treatments, so high fertilizer costs would be one key factor in favor of planting cover crops, the researchers add.

Cover crops have been shown in the academic literature to improve soil conditions by controlling excess water and fixing nitrogen, among other benefits. But only a small percentage of farmers – about 4% nationally – utilize cover crops. Many farmers looking for short-term benefits may consider the costs of planting cover crops overly excessive.

“There is a lot of academic literature looking at short-term effects of cover crops, but our contribution here is in thinking about cover crops as a long-term investment,” said Rod Rejesus, professor and department extension leader of agricultural and resource economics at NC State and a co-author of a paper describing the research. “Agronomists seem to mostly agree that cover crops are a worthwhile investment; many economists say they are not. We find some truth to both sides of the argument in this paper: In certain conditions it might be worth it to plant cover crops; in other conditions it might not be worth it.”

Poor soil quality and low prices for nitrogen fertilizer products are two factors that tend to make cover-crop adoption sub-optimal, according to the model.

“If you’re starting from a place where the soil is degraded, it takes so long to build up better soil conditions that, from an economic perspective, it’s not worth it to plant cover crops,” said Zachary Brown, associate professor of agricultural and resource economics at NC State and a co-author of the paper. “Like other investments, farmers are interested to know how fast the returns are for cover-crops investments.”

The research also shows that, over time, cover crops can serve as “substitutes” for nitrogen fertilizer, as two of the studied cover crops, crimson clover and hairy vetch, both “fix” nitrogen in the soil.

“The more you use cover crops, the fewer fertilizer inputs are needed,” Brown said. “That effect also increased over time. So, the longer you used cover crops, the more they were able to offset nitrogen fertilizer.”

The paper appears in the European Review of Agricultural Economics. Former NC State Ph.D. student Le Chen, who is now at the University of Tennessee-Knoxville, is the paper’s corresponding author. Christopher N. Boyer and James A. Larson of the University of Tennessee-Knoxville also co-authored the paper.

Support for the work was provided by NASA through Grant 80-NSSC23-M0034; the U.S. Department of Agriculture NRCS Grant No. 2021-1033/NR213A750013G022, USDA NRCS Grant No. 2023-1372/134157-Z5393201, USDA NRCS Grant No. 2023-0801/RI-CS04172023-180-NCSU, and USDA NIFA Hatch Project No. NC02959.

- kulikowski -

Note to editors: The abstract of the paper follows.

“Dynamically optimal cover crop adoption”

Authors: Roderick M. Rejesus and Zachary S. Brown, North Carolina State University; Le Chen, Christopher N. Boyer and James A. Larson, University of Tennessee-Knoxville

Published: May 31, 2025 in European Review of Agricultural Economics

DOI: 10.1093/erae/jbaf018

Abstract: This paper develops a stochastic dynamic programming model to investigate optimal cover crop adoption policies, accounting for cumulative effects on soil fertility, uncertain future fertilizer and output prices, irreversibility of sunk machinery costs and flexibility in the timing of adoption over time. Based on data from a 35-year cotton field experiment in West Tennessee (1984–2018), we first estimate the static and dynamic yield effects of cover crop adoption and then use these estimates to evaluate the decision of a representative cotton farmer to adopt three cover cropping practices – hairy vetch, winter wheat and crimson clover – under conventional till and no-till production systems. Econometric estimates imply significant cumulative effects of cover crops on yields, as well as static and dynamic substitution effects between cover crops and nitrogen fertilizer inputs. With these substitution effects implying increasing marginal profit from soil fertility, our analysis suggests a threshold level of soil fertility level, above which it is optimal to adopt cover crops and below which it is not. Adoption of cover crops is more favored if no-till practices have been implemented. Moreover, in the presence of sunk costs that have not yet been incurred, the optimal strategy is to postpone the adoption of cover crops in both conventional till and no-till fields until crop prices improve, the cost of adoption decreases, or fertilizer prices increase. Our results also indicate that when fertilizer prices are higher, cover crop adoption in no-till systems can lead to substantial fertilizer cost savings, with the amount of those fertilizer cost savings increasing over time as soil health further improves.

Journal

European Review of Agricultural Economics

DOI

10.1093/erae/jbaf018

Method of Research

Meta-analysis

Subject of Research

Not applicable

Article Title

Dynamically optimal cover crop adoption

Calling for renewed Israeli-Palestinian health cooperation

The Hebrew University of Jerusalem

New editorial in the American Journal of Public Health calls for the renewal of Israeli–Palestinian public health cooperation, even amid the current conflict. Drawing on decades of joint successes—including polio eradication, measles control, maternal health advances, and epidemic surveillance—the editorial urges stakeholders to revive collaborative efforts in critical areas like immunization, environmental health, and hospital rehabilitation. Emphasizing that health partnerships have historically bridged divides, the authors argue against academic boycotts and stress that shared public health is both a moral imperative and a strategic necessity for regional stability and peace.

The Hebrew University of Jerusalem proudly announces the publication of an important editorial in the American Journal of Public Health (AJPH), titled “Israel and Gaza: Keeping Room for Hope Based on Past Cooperation in Public Health”, highlighting decades of successful Israeli–Palestinian collaboration in public health and urges a revival of such partnerships amid the ongoing conflict.

Co-authored by Prof. Theodore H. Tulchinsky (Hebrew University), Prof. Aron M. Troen (Hebrew University), Dr. Dorit Nitzan (Ben Gurion University), Dr. Ron Lobel (Barzilai University Medical Center), and Prof. Gordon DeFriese (University of North Carolina), the editorial documents how public health professionals on both sides worked together from the late 1960s to the mid-1990s to dramatically improve immunization coverage, control infectious diseases, reduce infant mortality, and strengthen epidemic surveillance.

“Even in the face of conflict, public health has long served as a bridge between communities,” said the researchers. “This shared legacy is not only a testament to what was possible but a call to action for what must be renewed.”

Key Historical Achievements Highlighted
• Polio Eradication Through Vaccine Innovation: In response to a polio outbreak in Gaza in the late 1970s, Palestinian and Israeli health workers collaborated on a groundbreaking immunization strategy combining the Sabin oral and Salk inactivated vaccines. This approach, supported by the World Health Organization, resulted in the near-total elimination of polio in the region for over two decades and later became an international model for eradication efforts.

• Cross-Border Control of Rift Valley Fever: During the 1977–78 outbreak of this potentially deadly mosquito-borne disease in Egypt, Israeli and Palestinian veterinarians and public health authorities coordinated mass animal immunizations—over 1.5 million livestock—and shared disease surveillance protocols, successfully preventing the virus’s spread into Gaza and Israel.

• Mother and Child Health System Expansion: In the 1970s, Gaza had only three mother–child health clinics. By 1994, through a combined effort that drew on Israeli health models and Israeli-Palestinian initiatives, that number had grown to 29. This expansion, paired with health personnel training exchanges, halved infant mortality rates and introduced modern maternal care services across the territory.

•   Measles Immunization Leadership: Gaza was among the first in the region to adopt a two-dose measles immunization schedule, combining early infant protection with later MMR (measles, mumps, rubella) boosters. This approach, which exceeded 90% vaccine coverage, sharply reduced child mortality and transmission, and was only adopted by Israel years later.

•   Regional Disease Surveillance Infrastructure: The establishment of the Middle East Consortium on Infectious Disease Surveillance (MECIDS) in 2003 created a formal mechanism for epidemic preparedness and response. Israeli, Palestinian, and Jordanian laboratories collaborated through joint training, shared protocols, and coordinated response mechanisms for crises such as avian influenza and COVID-19.

•   Joint Nutrition and Environmental Health Initiatives: Bilateral research efforts led to successful public health interventions such as the Palestinian Authority’s mandatory salt iodization program and flour fortification to combat harmful micronutrient deficiencies. These efforts were informed by Israeli, Palestinian and international research and extended globally through international and NGO partnerships to remote areas.

These shared successes—grounded in evidence, mutual respect, and practical necessity—serve as powerful precedents for what is still possible today.
Relevance Amid Ongoing Crisis

In the context of the ongoing 2023–2025 Israeli–Hamas war, the editorial highlights the resilience of health cooperation. A 2024 polio vaccination campaign—coordinated by Palestinian, Israeli, and international agencies—successfully reached approximately 560,000 children, despite active conflict and collapsed infrastructure.

The authors argue that continued collaboration at all times in water safety, agriculture and water, environmental health, sanitation, immunization, and hospital rehabilitation is not just beneficial but essential for both sides.
A Rebuttal to Academic Boycotts

The editorial’s message also serves as a strong rebuttal to current calls to isolate Israeli academia and science. Such boycotts ignore the tangible, life-saving benefits produced through decades of Israeli–Palestinian scientific cooperation. Efforts to cut academic ties directly contradict the editorial’s evidence that scientific engagement fosters mutual understanding, improves public health, and builds pathways to peace.

The authors conclude with a powerful reminder: shared public health is a shared responsibility. Rebuilding Gaza’s devastated health infrastructure will require cross-border partnerships, knowledge-sharing, and training. Regional stability depends on it.

Journal

American Journal of Public Health

DOI

10.2105/AJPH.2025.308190l

Method of Research

Commentary/editorial

Subject of Research

People

Article Title

Israel and Gaza: Keeping Room for Hope Based on Past Cooperation in Public Health

Article Publication Date

11-Jun-2025

Rutgers health researchers challenge FDA warning on common epilepsy drug

A study offers evidence supporting the cardiac safety of a popular antiseizure medication

Rutgers University

Rutgers Health researchers found that lamotrigine, a widely prescribed antiseizure medication, to be safe in older adults with epilepsy, contrary to a safety warning by the Food and Drug Administration (FDA).

According to the Centers for Disease Control and Prevention, about 2.9 million adults throughout the United States are living with the neurological disorder.

Lamotrigine, sold under the brand name Lamictal, represents about 10% of all antiseizure medication use. In 2020, the FDA placed a safety warning label on lamotrigine based on reports the drug could increase the risk of heart conditions. As such, patients with epilepsy who may be good candidates for the drug but had a history of heart issues may be precluded from being prescribed this effective treatment modality.

The FDA safety warning, however, came with the caveat that it was based on limited evidence. That prompted Rutgers Health researchers to further analyze the health risks associated with the drug in epilepsy patients.

“The FDA’s safety warning of lamotrigine may have limited the use of this effective drug in patients with epilepsy,” said Chintan Dave, a senior author of the study, a core member of Rutgers Institute for Health, Health Care Policy and Aging Research (IFH), and an assistant professor of pharmacy and epidemiology at the Ernest Mario School of Pharmacy. “It’s important for the public to know that our research found that lamotrigine is safe in older adults with epilepsy, including those with underlying heart disease.”

Their study, published online on June 11 in Neurology, the medical journal of the American Academy of Neurology, examined data from more than 158,000 adults with epilepsy to compare outcomes of two common antiseizure drugs in use, making it the largest study to date analyzing the effects of lamotrigine on cardiac risks in epilepsy patients.

Researchers found no increased risk for heart rhythm problems or sudden cardiac arrest among older adults taking lamotrigine compared to those using the other commonly prescribed antiseizure drug, levetiracetam. Study findings were consistent across a range of subgroups, including age, gender, race and those with histories of heart conditions.

“Our results do not support the FDA safety warning about the use of lamotrigine in patients with heart issues,” said Gloria Ho, a visiting scholar at the Center for Pharmacoepidemiology and Treatment Science (PETS) at IFH and a corresponding author of the study.

Study coauthors include Tobias Gerhard of PETS, IFH and the Ernest Mario School of Pharmacy; Daniel Horton of PETS, IFH and Rutgers Robert Wood Johnson Medical School; and Parin Patel of Ascension St. Vincent Heart Center in Indiana.

Journal

Neurology

DOI

10.1212/WNL.0000000000213643

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

Risk of Ventricular Arrhythmia and Sudden Cardiac Arrest Among Older Patients Using Lamotrigine for Epilepsy

Article Publication Date

11-Jun-2025

Doctors raise concern over rise in recreational ketamine use

More individuals are seeking treatment for ketamine addiction; Greater awareness, research, and treatments are needed

BMJ Group

The rise in non-prescribed ketamine use across the UK in recent years is a cause for concern, say doctors in The BMJ today.

Irene Guerrini at South London & Maudsley NHS Foundation Trust and colleagues warn that its low cost has made it popular among young people, and the number of people starting treatment for ketamine addiction in 2023-2024 reached 3609, more than eight times higher than in 2014-2015.

They say public awareness of the risks and long term harms associated with ketamine remains insufficient, and they call for better diagnostic criteria, a national registry, and screening tools to support earlier identification, guide treatment, and help evaluate emerging therapies.

Ketamine is routinely used as a general anaesthetic and lower doses are prescribed for chronic pain, treatment resistant depression and suicidality, they explain. Intranasal esketamine is also licensed for the treatment of depression.

But ketamine is also increasingly used recreationally at doses much higher than those prescribed for depression, which can cause serious health problems, such as irreversible damage to the bladder and kidneys and psychiatric conditions, they warn.

And as ketamine use increases, more individuals are seeking treatment for addiction. The number of people starting treatment for ketamine addiction in 2023-24 was 3609, more than eight times higher than the 426 reported in 2014-15.

However, the authors point out that ketamine use disorders remain inadequately defined in psychiatric guidelines, and there is a lack of evidence around potential drugs for treatment and prevention.

Individuals who use ketamine also report that health services often lack an understanding of ketamine addiction and offer minimal treatment options specific to the drug, meaning treatment is often partially effective.

Balancing ketamine’s medical value with rising non-prescribed use presents a complex challenge, write the authors.

“The Home Office is considering reclassifying ketamine as class A, but opinions remain divided. A proportionate response should go beyond legislation to include clear governance of therapeutic use, investment in treatment and prevention, and balanced public messaging.”

[Ends]

Journal

The BMJ

DOI

10.1136/bmj.r1167

Method of Research

Commentary/editorial

Subject of Research

People

Article Title

Non-prescribed ketamine use is rising in the UK

Article Publication Date

11-Jun-2025

COI Statement

The BMJ has judged that there are no disqualifying financial ties to commercial companies. The authors declare no other interests. Further details of The BMJ policy on financial interests are here: https://www.bmj.com/sites/default/files/attachments/resources/2016/03/16-current-bmjeducation-coi-form.pdf