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According to a recent review by researchers at Semmelweis University, published in the journal Nutrients, lifestyle and dietary changes may help people living with endometriosis. The study analyzed more than 100 international papers and found that factors such as a healthy diet, regular physical activity, stress management, good sleep and adequate micronutrient intake can help reduce pain and improve quality of life. The Semmelweis University research team reviewed international studies to better understand the role of lifestyle factors in managing endometriosis. Endometriosis is a chronic, estrogen-dependent inflammatory disease affecting around 10% of women of reproductive age. It is characterized by tissue similar to the uterine lining growing outside the uterus. These lesions respond to the menstrual cycle and can cause pain, inflammation and bleeding, often leading to severe menstrual pain, chronic pelvic symptoms, fatigue and infertility. Diagnosis is often delayed, and symptoms can significantly affect quality of life over time. One of the key findings is that regular physical activity – at least 150 minutes per week, according to general recommendations, three times a week – can have several benefits. Exercise can influence hormone balance and the way the body processes pain. Clinical studies show that activities such as yoga, stretching and strengthening exercises, cardio workouts and resistance training, as well as relaxation techniques like progressive muscle relaxation, can help reduce endometriosis-related pain and improve quality of life. “Physical activity and other lifestyle factors do not replace medical treatment, but they can support it,” said Dóra Boroncsok, PhD candidate at Semmelweis University and first author of the study. The researchers also highlight the benefits of a Mediterranean-style diet, which is high in vegetables, fruits, whole grains, fish and olive oil, while limiting red and processed meat. This type of diet has been linked to reduced pain and improvements in some digestive symptoms. By contrast, pro-inflammatory diets, particularly those high in red meat, may increase the risk of the disease. The review also looks at the possible role of several micronutrients and dietary supplements – including vitamins C, D and E, omega-3 fatty acids, magnesium, zinc and certain antioxidant compounds – while noting that further clinical research is needed to confirm their benefits. “A key message is that patients can actively contribute to improving their condition. Everyday choices – from physical activity to diet and stress management – can reduce symptoms. Lifestyle change is not a cure, but it offers a real opportunity for women to take an active role in their own health,” added Dr Gábor Sobel, associate professor at the Department of Obstetrics and Gynecology at Semmelweis University and senior author of the study. The publication also introduces a new dietary approach currently under investigation, known as the fasting-mimicking diet (FMD). This is a short, typically five-day, plant-based, low-calorie program designed to trigger effects similar to fasting without requiring complete food restriction. In clinical studies of other chronic inflammatory and metabolic conditions – such as type 2 diabetes and cardiovascular risk – FMD has been shown to reduce inflammation, support hormonal and metabolic balance, and activate cellular repair processes. Based on its biological effects, FMD appears promising, but it has not yet been studied in gynecological diseases. The Semmelweis University research team has therefore developed a clinical trial protocol, which will be the first study worldwide to investigate FMD in gynecological conditions, including endometriosis. |
Category: Health
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Lifestyle also influences the severity of endometriosis symptoms
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Harnessing AI to Revolutionize Organ Transplants in India
Bhubaneswar, March 31: Emphasizing the transformative potential of artificial intelligence (AI) in healthcare, Subhasish Panda, Additional Secretary to the Prime Minister’s Office, highlighted how AI could significantly enhance organ transplantation in India. Speaking at a workshop-cum-regional Continuing Medical Education (CME) programme on “Organ Transplantation and Artificial Intelligence in Healthcare,” he said AI can integrate large datasets to support smarter, faster, and more informed clinical decisions.
“AI has the ability to revolutionize the organ transplantation ecosystem,” Panda noted. “It can streamline donor-recipient matching using genetic, clinical, and laboratory data, track organ availability in real time, optimize transport logistics for timely delivery, and assist clinicians through predictive analytics and intelligent dashboards.”
India currently ranks third globally in organ transplantation, with approximately 20,000 procedures performed in the past year. However, Panda expressed concern that 82 percent of donations come from living donors, with women representing the majority. He also highlighted that most transplants are conducted in the private sector, which affects affordability, and stressed the need for greater public awareness and increased participation from government healthcare institutions.
The programme was organized by AIIMS-Bhubaneswar, in collaboration with the National Academy of Medical Sciences (NAMS). It brought together more than 300 doctors from Odisha, West Bengal, Bihar, and Jharkhand to discuss innovations in transplantation and the role of AI in improving patient outcomes.
Panda’s remarks underscored the importance of combining technology, awareness, and policy support to make organ transplantation more efficient, accessible, and equitable across India.
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Odisha Governor Urges Stronger Awareness and Early Detection to Fight Cancer
On Monday, Odisha Governor Hari Babu Kambhampati urged everyone to come together to fight the rising number of cancer cases in the state. Speaking at the “Cancer-Free Odisha” Awareness Conclave and the Mahanayak–2026 Awards, he said cancer is not just a medical problem—it affects families and communities across Odisha.
The Governor pointed out that lifestyle changes, tobacco use, environmental factors, and late diagnosis are contributing to the steady rise in cancer cases. He stressed that prevention is better than cure. By spreading awareness about healthy diets, physical activity, and avoiding tobacco, many cancer cases could be prevented.
He also emphasized the importance of early detection. Strong primary healthcare and wider screening, especially in rural areas, can help identify cancer early, improve survival rates, and reduce the emotional and financial burden on families.
Governor Kambhampati called for collaboration between the government, private sector, and civil society to ensure cancer care reaches every corner of the state. He also congratulated the Mahanayak–2026 awardees for their contributions and encouraged continued efforts to create a cancer-aware Odisha.
The event was attended by dignitaries including Korei MLA Akash Dasnayak and former Balasore MP Rabindra Kumar Jena, while the welcome address was delivered by Asim Odisha Foundation Trust Chairperson Asima Das.
The conclave made it clear that tackling cancer in Odisha will require awareness, early detection, and the support of the entire community.
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India Pharma 2026 Highlights Move from Volume to Innovation Led Growth
New Delhi: The upcoming India Pharma 2026 is set to spotlight India’s transition from volume-driven production to an innovation-led growth model in the pharmaceutical sector.
Industry leaders and policymakers are expected to use the platform to highlight the need for stronger research and development, advanced manufacturing, and greater global competitiveness. The focus is shifting from producing large quantities of generic medicines to developing high-value drugs, novel therapies, and cutting-edge technologies.
Experts believe this transition is crucial for India to strengthen its position in the global pharmaceutical landscape. While the country has long been known as a major supplier of affordable medicines, the next phase of growth will depend on investments in innovation, quality, and intellectual property.
The event will also provide an opportunity to discuss regulatory reforms, collaborations between industry and academia, and strategies to boost exports. Participants are likely to explore how emerging technologies and digital solutions can further enhance efficiency and innovation in the sector.
With growing global demand for advanced healthcare solutions, India Pharma 2026 is expected to serve as a key platform to shape the future direction of India’s pharmaceutical industry.
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CCRAS Partners with AI Platform to Expand Ayurveda Research Across Languages
New Delhi: The Central Council for Research in Ayurvedic Sciences (CCRAS) has joined hands with Anuvadini AI to make Ayurveda research more accessible to people across India by translating it into 13 languages.
The initiative aims to bridge language barriers that often limit access to traditional knowledge, especially in a country as linguistically diverse as India. By leveraging artificial intelligence, the collaboration will enable wider dissemination of research findings, educational materials, and scientific literature related to Ayurveda.
Officials said the move is expected to benefit students, researchers, and practitioners by allowing them to access authentic information in their native languages. It will also help bring traditional Indian medical knowledge closer to local communities, encouraging greater awareness and understanding.
The partnership reflects a growing effort to combine technology with traditional systems of medicine, making them more inclusive and easier to engage with. By expanding the reach of Ayurveda research, CCRAS hopes to promote its relevance not just within India but also on a global stage.
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From Oiling to Molecular Repair: K Formula Brings Peptides to Haircare
Mar 30: For decades, the Indian haircare industry has operated on a singular myth: that real repair requires overnight oiling or hours in a salon chair. K formula, a homegrown science-led beauty brand, is dismantling that narrative with India’s first peptide-powered molecular haircare range, delivering visible hair repair in just minutes.
Launched in October 2025, the brand has quickly emerged at the forefront of the growing skinification of haircare movement – a shift where consumers demand skincare-grade ingredients and molecular science for their hair, not just cosmetic shine.
At the heart of the brand is Trichopeptics™ technology, a proprietary peptide system developed over two years in laboratories specifically for Indian hair types, climate conditions, and water quality.
The result is a new promise for consumers: “New Hair in 5 Minutes.”
The Science Behind the 5-Minute Transformation
While the claim may sound bold, the technology is rooted in advanced molecular repair. Traditional conditioners typically coat the hair with silicones that create temporary smoothness. K Formula’s peptide complexes work differently. Powered by Trichopeptics™, the formulas penetrate the polypeptide chain level of the hair fiber, the deepest structural layer where keratin bonds exist.
Damage caused by heat styling, bleach, pollution, UV exposure, and India’s prevalent hard water breaks these chains. K Formula’s peptides reconnect and repair these bonds, reversing visible damage within minutes rather than hours. The result is instant transformation with long-term structural repair.
Riding the Skinification Wave
The global beauty industry is witnessing the skinification of haircare – where hair products borrow the same molecular science, active ingredients, and precision formulations traditionally seen in skincare.
K Formula is among the first Indian brands to bring this movement to the country through peptide-powered molecular repair, transforming haircare from cosmetic maintenance into science-led structural treatment. Instead of temporary smoothness, the focus shifts to repairing the biology of the strand itself.
The Viral ‘5-Minute Hair Challenge’
K Formula’s rapid rise has been fueled not by heavy advertising, but by transparent proof-driven content. The brand’s #5MinuteHairChallenge went viral on Instagram, where users filmed single-take transformations using a live stopwatch to demonstrate visible results. From college students to professional stylists, real users documented the peptide routine in real time, creating a wave of authentic peer validation.
Within weeks, the challenge generated:
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900,000+ organic reach
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5,000+ peer-to-peer shares
The viral momentum proved that in a skeptical beauty market, visible proof travels faster than polished advertising.
Market Traction & Professional Validation
Beyond social media momentum, K Formula has rapidly built credibility across both consumer and professional ecosystems.
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50+ Salon Partnerships across India
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Developed with and endorsed by celebrity hairstylist Sahib Mongia
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Rapidly scaling across its official website, and leading commerce platforms including Amazon, Flipkart, Myntra, and quick-commerce platform Blinkit
Early batches of the peptide-powered routine sold out quickly following viral demand.
A Vision for Science-Led Indian Beauty
Founded by Anoushka Adya, K Formula was created to bridge the gap between global biotech innovation and the real needs of Indian hair.
“Indian consumers deserve haircare built for our climate, water quality, and genetics – not just adapted global formulas. We wanted to build a brand where the results are so immediate that consumers themselves become the marketing engine. When you see molecular repair happen in five minutes on a live timer, you don’t need a sales pitch.” says Anoushka Adya, Founder, K Formula.
As India’s beauty industry moves toward ingredient literacy and scientific formulations, K Formula is positioning itself at the forefront of peptide-powered molecular haircare, proving that the future of hair repair lies not in surface treatments – but in the biology of the strand itself.
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Screen time among children and adolescents has increased over three decades – especially after COVID-19 pandemic
First systematic review to track long-term trends across pre- and post-pandemic periods finds dramatic rise in screen use among children and adolescents. Screen time among children and adolescents has increased significantly over the past three decades, with clear rise occurring after the onset of the COVID-19 pandemic, according to a new systematic review conducted at the University of Turku, Finland.
The review analysed 60 peer-reviewed studies published between 1991 and 2022 and is the first to comprehensively examine long-term trends in screen time use among individuals aged 0–19 years across both pre-pandemic and pandemic periods.
Postdoctoral Researcher Yuko Mori from the Research Centre for Child Psychiatry at the University of Turku, Finland, the shared lead author, tells that the nature of screen use has changed dramatically, shifting from traditional television to more interactive and personalised digital devices, such as mobile phones and video games. Earlier studies focused mainly on TV viewing, but from the mid-2010s onward, research began to include newer devices, such as smartphones and tablets.
“Interestingly, even during the pandemic, television viewing continued to decline,” says Mori.
School closures during the pandemic intensified screen dependence
Before the COVID-19 pandemic, research showed a mixed picture, as most studies indicated an increasing trend while others showed mixed results. The majority of studies conducted after the pandemic showed a dramatic increase in both total and leisure screen time among children and adolescents.
Across age groups, older children and adolescents generally reported higher screen time than younger children.
“This likely reflects developmental factors,” says shared lead author Sanju Silwal, Postdoctoral Researcher at the University of Turku. “Adolescence is a life stage where peer relationships, online social interaction, and romantic relationships become increasingly central.”
The increase in screen time was observed across socioeconomic groups, but it was more pronounced among children from higher socioeconomic backgrounds. The authors suggest this may reflect greater access to personal digital devices.
Guidance needed for healthy screen use
The sustained rise in screen exposure raises concerns regarding potential impacts on physical health, mental well-being, sleep, and development. Beyond time spent on digital devices, digital environments may expose young people to cyberbullying, inappropriate content, and unrealistic body ideals.
Several countries have introduced regulatory measures in response to growing concerns about youth digital media use. The authors emphasise that effective responses must be grounded in high-quality evidence.
Most research has focused on the duration of screen use rather than the quality, context, or content of digital activities. The authors call for future research to adopt a more nuanced and multidimensional approach, examining not only how much time children spend on screens but also what they are doing online and how it affects their well-being.
“Technology offers tremendous opportunities, but it also presents risks,” Silwal notes. “To ensure that children benefit from digital environments, we need continuous research, evidence-based policies, and coordinated efforts from families, schools, communities, and governments.”
This systematic review was funded by the INVEST Flagship programme of the Research Council of Finland and the European Research Council under the European Union’s Horizon 2020 research and innovation programme.
The review titled “Long-term trends in screen time use among children and adolescents: A systematic review including pre- and post-COVID periods” was published in the journal Clinical Child Psychology and Psychiatry on March 2026: https://doi.org/10.1177/
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The Blind Spot Undermining Hospital Margins
By Shawn Sefton, MBA, RN
A circulator flips through a picklist that doesn’t match the back table. A surgeon asks for a device, and the nurse hesitates, “Is it even here?” A supply tech finds an expired implant just as the case is closing. The nurse tries to document the implant, but the scanner isn’t working and she can’t find it in the item master. Hours later, a revenue integrity analyst sits with unexplained and missed charges.
None of these moments make headlines. But together, they add up to stress in procedural rooms, missed revenue, unbudgeted waste, and hours of manual data entry. Hospitals can track a FedEx package from Memphis to Miami in real time. But the orthopedic plate placed in a patient yesterday? Sometimes it disappears into the system like it never existed.

Photo by RDNE Stock project:
The status quo can’t keep up
OR and procedural room documentation systems are failing to keep pace with the realities of modern surgery. The problem isn’t that hospitals don’t try to record implants and supplies, it’s that even newer system designs struggle to capture every supply and implant, resulting in missing and unreliable data.
Manual documentation, whether electronic or on paper, depends on perfect input often during the most complex moments of a procedure. In reality, barcode scanners can fail and reconciliation happens hours, sometimes days, after the fact. As a result, up to 50% of the supplies and implants used in ORs go undocumented.
Meanwhile, reconciliation teams are left deciphering handwritten item numbers, trying to match unlabeled implants to the correct records, and often chasing down clinical team members long after a case ends just to ensure proper billing and records.
The result is incomplete, unreliable data that breaks the billing chain. Missed scans and documentation errors often mean items never make it onto the claim, directly translating into missed charges and lost revenue.
The impact?
Not only do missed charges create an administrative burden but hospitals can lose up to 30% of billable revenue tied to supplies and implants, a margin loss that would be unimaginable in any other industry.
What’s more, failing to accurately capture these items can introduce significant quality, regulatory, and patient safety risks, exactly the kinds of problems health systems try very hard to avoid.
What perioperative leaders are saying
With OBBBA requirements tightening margins, hospitals are under pressure to minimize waste, understand costs and protect profitability more than ever before. Because the OR drives up to 70% of hospital revenue, it’s no surprise that Becker’s first Perioperative Summit kept circling back to the topic of revenue.
Workforce relief is non-negotiable for hospitals that want to scale. When nurses and techs can anticipate surgeon needs, the OR hums. Delays vanish, substitutions shrink, cases flow and surgeons trust their team. Staff stress levels lower. As another leader put it, “Getting nurses away from the supply screen and back to anticipating the surgeon’s needs is the biggest win.”
While resolving missed OR and procedural room charges is critical, leaders also underscored the importance of integration. Technology must fit into daily workflows and EHRs if it’s going to stick in such a fast-paced environment. As one panelist emphasized, “If it doesn’t integrate and work for our people, it won’t scale.”
Many OR leaders are taking action but ultimately still missing far too many products due to systems that fail them, with one leader at Becker’s Perioperative conference saying, “The number of items that go unscanned every case is disturbing.”
However, one healthcare system decided to find a solution and the results are compelling.
How one hospital turned admin chaos into profit
Owensboro Health set out to audit and resolve this very problem. Their perioperative teams were grappling with manual, error-prone documentation in the OR. Nurses entered supply and implant data by hand, items slipped through the cracks, inventory data lagged, and billing teams spent hours chasing missed charges.
Determined to improve workflow and margins, Owensboro Health rolled out an AI-enabled automated supply and implant capture program across its ORs. The impact was significant:
- Delighted clinical, revenue integrity, and supply chain teams
- 48% reduction in monthly expired product costs
- 90%+ reduction in ERP inventory depletion errors
- 12% increase in monthly billable revenue
The volume of cases didn’t change. What changed was product and implant visibility. For staff, that meant fewer end-of-shift reconciliations and less administrative burden. For leaders, it meant millions in recovered revenue.
What should leaders do?
Many hospitals aim to close the OR documentation gap by adding extra staff processes and duplicative tracking systems. This looks like control but creates silos, extra work, and ultimately flawed data.
While plenty of AI tools overpromise, some were built to solve administrative problems like this. It is important to assess solutions carefully. Here are key ways to evaluate AI tools for perioperative documentation:
- Prioritize real-time integration—Does the solution capture data as cases unfold, or does it rely on manual reconciliation after the fact?
- Check workflow alignment—Can it fit seamlessly into existing OR workflows without adding screens and clicks for nurses and techs?
- Look for measurable impact—Can it demonstrate clear metrics, like improved item capture rates, reduced reconciliation time, case costing, expiry management or recovered revenue?
- Evaluate interoperability—Does it connect cleanly with your EHR, ERP, and billing systems, or does it create another silo?
- Test with frontline staff—Does it make the job easier for nurses, techs, and supply teams, or just shift work elsewhere?
Closing the loop
Every day, critical details in the OR slip through the cracks of manual systems. A recalled implant from last week’s surgery. A missed charge for a high-cost disposable. Small moments, easily overlooked, that quietly add up. They create blind spots that chip away at hospital margins, wear down staff, and skew reports that leaders rely on to make decisions. But this no longer has to be the norm. AI technology now gives hospitals the ability to see and capture what’s been missed. Hospitals that act can protect their margins, ease the load on their teams, and bring clarity back to the center of care. The gap is clear. The tools exist. It’s time to close the blind spots.
Shawn Sefton, MBA, RN, is Clinical Advisor at AssistIQ.
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Scalable platform sheds light on how cancer spreads
Study links support cells to improved cancer cluster survival in bloodstream
HOUSTON, TX (March 27, 2026) – Metastasis, the spread of cancer from a primary tumor to other parts of the body, is difficult to study in the lab, in part because researchers lack reliable ways to recreate the conditions cancer cells encounter as they travel through the bloodstream.
Rice University bioengineers report a new platform designed to streamline one of the major challenges for metastasis research: Called the Advanced Tumor Landscape Analysis System, or ATLAS, the platform makes it easier to generate large quantities of cancer cell clusters that accurately model those involved in metastasis. Using the platform, the Rice team gained new insights into the mechanisms that enable cancer clusters to survive in the bloodstream during the metastatic process.

Developed in the lab of Michael King, Rice’s E.D. Butcher Professor of Bioengineering, ATLAS builds on earlier work using superhydrophobic surfaces, i.e. materials that strongly repel water. When droplets containing cells are placed on these surfaces, they bead up rather than spread out, encouraging cells to stick to each other and produce three-dimensional clusters.
“Metastasis is still poorly understood because adequate laboratory techniques to recreate this complex process are lacking,” said King, a Cancer Prevention and Research Institute of Texas Scholar who also serves as special adviser to the provost on life science collaborations with the Texas Medical Center.
The King lab has been working for years on new high-throughput approaches of creating clusters of cancer cells, both on their own and alongside stromal cells, which are noncancerous but are frequently found in the tumor microenvironment. To study what happens during the metastatic process, the researchers expose these models to conditions that closely resemble those in the body ⎯ either via animal models or laboratory blood flow experiments.
Compared to earlier methods, ATLAS takes less time to deploy and costs less to produce. It uses 3D-printed microwell arrays that are treated to create the same kind of water-repelling effect seen in nature, such as on a lotus leaf.
“The way this is achieved, both in nature and in the laboratory, is to create a surface that is rough on a nanoscale level, and then to coat the nanoscale bumps with a nonwetting substance such as Teflon or wax,” said Alexandria Carter, a doctoral student in the King lab who is the first author on the study. “Here, we achieved this for the first time through 3D printing, which means the method is scalable and easily adoptable by other labs.”
Going beyond method development into actual testing, the researchers used ATLAS to create clusters of prostate cancer cells, including ones containing a type of stromal cell called cancer-associated fibroblasts, or CAFs. Testing revealed that cancer clusters are more likely to survive when traveling in groups, especially when CAFs are present. These support cells actively help cancer cells withstand the stresses of circulation and continue to grow.
“One of the most exciting elements of our paper is that it does not just report on a new experimental method for other researchers to use, but it also reports new fundamental biological results,” Carter said. “Perhaps in the future the next generation of prostate cancer drugs will target these CAF ‘escorts’ as a way to prevent metastasis.”
Carter recently completed the Rice Innovation Fellows program and is working on establishing a startup company called Bionostic to commercialize ATLAS. Run by Rice’s Liu Idea Lab for Innovation and Entrepreneurship (Lilie), the program trains doctoral students and postdoctoral researchers to translate their research into breakthrough solutions for real-world problems.
Kyle Judah, Lilie executive director, said “a pre-requisite for bringing research beyond the bench is to be deeply passionate about the problem space, and Carter is the perfect example of an exceptionally driven and committed engineer willing this idea into reality.”
Models that are both realistic and practical make possible research that would otherwise take longer and be costlier to undertake.
“ATLAS makes it easier to study one of the most dangerous aspects of cancer,” King said.
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Zuellig Pharma Reinforces Commitment to Japan through Its New Misato Depot, Advancing Clinical Logistics and Sourcing Excellence
MISATO, JAPAN – 26 March 2026 – Zuellig Pharma today announced the successful relocation of its new clinical depot to Misato, strengthening its ability to deliver global quality standards with local operational agility and further strengthening its clinical supply capability across Asia Pacific. Japan remains one of the region’s preferred locations for clinical research, underpinned by its strong focus on medical advancement, rigorous ethical standards and commitment to healthcare.
Medical innovation across the region continues to accelerate, with China, India, Australia, Japan, South Korea, Taiwan and Singapore emerging as key pillars of Asia Pacific’s clinical trial ecosystem over the past five years[1]. Against this backdrop, the move in Japan reinforces Zuellig Pharma’s commitment to supporting sponsors and clients with reliable, compliant and seamless access to Japan – advancing its broader mission to make healthcare more accessible.
The new depot will bring together Zuellig Pharma’s established knowledge assets, operational excellence, and clinical logistics and sourcing expertise. Backed by a highly experienced and expert-led local team, the depot delivers precision project management tailored to Japan’s intricate regulatory and logistical requirements, while enabling smoother coordination for multi-market studies as the clinical landscape continues to evolve.
“As sponsors and clients increasingly run multi-market studies, they need clinical supply partners that can deliver consistency across borders while navigating local complexity,” said John Graham, Chief Executive Officer, Zuellig Pharma. “This relocated depot will strengthen access to Japan within our regional network, helping us execute with greater reliability, compliance, and speed across the region.”
The Misato clinical depot will also provide a streamlined, turnkey solution for global sponsors seeking rapid and compliant market entry into Japan. Sponsors will benefit from the same rigorous operational excellence, regulatory adherence, and service consistency delivered by Zuellig Pharma’s strategic network of clinical depots, without the overhead of building or managing costly standalone facilities. This milestone supports Zuellig Pharma’s ongoing efforts to accelerate clinical development and improve patient access to innovative therapies across Asia Pacific.
With this strategic move, Zuellig Pharma further strengthens its position as a trusted partner for global clinical development, combining scale, expertise, and agility whilst delivering high-quality, compliant clinical logistics and sourcing solutions across Asia Pacific.