Parallel Health World News Logo
update

Parallel Health World

cropper
update
  • Home
  • Categories
    • EcoHealth Trends
    • Healing Naturally
    • Age-Defying Diets
    • Supplement Savvy
    • Mind-Body Synergy
    • Finance and Health
    • Biolimitless
    • Tech Hacks
    • Health & Medicine
    • Political
    • BioBuzz
    • Holistic Rehabilitation Techniques
    • Practitioner Insights
    • AI In Healthcare
  • Featured Business Profiles
December 29.2025
1 Minute Read

Is Orphan Diseases Research the Breakthrough We Urgently Need?

Did you know? More than 300 million people worldwide are affected by one of over 7,000 rare and orphan diseases—outnumbering the global prevalence of HIV and many cancers combined

A Startling Reality: The Prevalence and Impact of Orphan Diseases

While orphan diseases are individually rare, collectively they represent a significant and often overlooked global health burden. By definition, an orphan disease—sometimes known as a rare disease—affects fewer than 200,000 people in the United States, but worldwide prevalence rates confirm millions live daily with these conditions. Many of these diseases are chronic, progressive, and life-threatening, leading to complex medical challenges for patients, families, and the healthcare system. Unlike high-profile illnesses, orphan diseases rarely receive the attention or funding necessary for robust research and treatment.

Compelling group of diverse patients with orphan diseases in hospital waiting room
  • There are over 7,000 distinct orphan diseases identified globally (NIH – rarediseases.info.nih.gov).
  • 72% of orphan diseases are genetic, with symptoms often appearing in childhood.
  • Only 5% of orphan diseases have a specific treatment approved by regulatory agencies such as the FDA or EMA.
  • Patients may wait 5-7 years on average for a correct diagnosis due to limited healthcare provider awareness.
“Addressing orphan diseases isn’t just about treating rare disorders—it's about redefining what is possible in medicine and dramatically improving lives on a global scale.”

What You'll Learn About Orphan Diseases

  • Understanding definitions: orphan diseases, rare diseases, and orphan drugs
  • Key challenges in orphan diseases research and treatment
  • Why orphan diseases should be a priority in medical science

Defining Orphan Diseases: Rare Disease or Something More?

Rare Diseases vs. Orphan Diseases: The Overlap and Distinctions

The terms rare diseases and orphan diseases are often used interchangeably but have important distinctions, especially across international borders. In most regions, a rare disease refers strictly to prevalence—typically a disease or condition that affects fewer than 1 in 2,000 individuals. The phrase orphan disease, however, not only considers rarity but also reflects conditions that have been “orphaned” by the pharmaceutical industry. This “orphaning” arises due to lack of commercial incentives for orphan drug development, which means these diseases frequently lack both research focus and effective therapies.
In countries like the United States, legislation such as the Orphan Drug Act specifically categorizes diseases with low prevalence as orphan, providing financial incentives to companies for developing treatments for these neglected diseases. In contrast, the European Union and other regions have differing thresholds and criteria, although most maintain a similar commitment to rare disease research.

Scientist in lab studying samples of rare and orphan diseases

Global Classifications: United States, United Kingdom, and Beyond

Understanding how orphan diseases and rare diseases are defined globally is vital for research and policy. In the United States, a disease or condition is legally orphan if it affects fewer than 200,000 people nationwide. In the European Union, the threshold is fewer than 5 in 10,000 people. The United Kingdom aligns with much of the EU criteria but incorporates additional rare disease policies for regulatory action. These legal frameworks influence the availability of funding, incentives for orphan drug development, and cross-border collaborative efforts in pharmaceutical research. Significantly, these distinctions dictate which patients will benefit from new therapies and which conditions remain “neglected diseases,” still waiting for meaningful attention and resources.

As the landscape of rare and orphan diseases continues to evolve, innovative communication tools are playing a growing role in connecting researchers, clinicians, and patient communities. For example, platforms like Talk Fusion’s video email solutions can help streamline updates and foster collaboration across global networks, supporting the rapid exchange of critical information in the rare disease field.

Comparison of Orphan Diseases and Rare Diseases Criteria by Country/Region
Country/Region Prevalence Threshold Key Regulatory Body Legislative Act or Policy
United States <200,000 people FDA Orphan Drug Act
European Union <5 per 10,000 people EMA Regulation (EC) No 141/2000
United Kingdom <5 per 10,000 people MHRA UK Orphan Drug Legislation (aligned with EU post-Brexit modifications)
Japan <50,000 people PMDA Orphan Drug Designation System

Orphan Diseases in Numbers: Exploring the Rare Disease Database

How Comprehensive is Our Rare Disease Database?

One promising development in patient advocacy and research is the creation of the rare disease database. Resources such as the National Organization for Rare Disorders (NORD) Database and the NIH Genetic and Rare Diseases Information Center offer crucial repositories of information. These databases categorize thousands of orphan and rare diseases, chronicling clinical trial opportunities, disease descriptions, known mutations, and approved orphan drugs.
However, gaps remain. Many rare or orphan diseases, particularly those found in resource-limited settings, are underrepresented due to insufficient reporting or research. Organizations are working to close this gap, but until data inclusivity improves, countless patients will remain invisible in policy discussions and treatment innovations.

  • Cystic fibrosis: One of the most researched genetic diseases worldwide, but still classified as orphan in many countries.
  • Duchenne muscular dystrophy: Affects fewer than 1 in 3,500 boys, with progressive muscle degeneration.
  • Sickle cell disease: Prevalence varies—rare in some countries, but more common in sub-Saharan populations.
  • Huntington’s disease: A progressive neurodegenerative disorder with limited treatment options.
  • Gaucher disease: A rare inherited metabolic disorder impacting organs and tissues.

Current Treatments for Orphan Diseases: Advances and Gaps

Breakthroughs in Treatments for Rare Diseases

The evolution of treatments for rare diseases over the last several decades has been remarkable, particularly for conditions once considered untreatable. Advances in gene therapy, enzyme replacement, and precision medicine have turned the tide for certain orphan diseases—demonstrated by breakthrough therapies for spinal muscular atrophy and cystic fibrosis. Major pharmaceutical breakthroughs, often supported by orphan drug incentives, are reshaping outcomes for a select group of rare disorder patients.
Yet, even with accelerated scientific discovery, fewer than one in twenty orphan diseases are “treatable” with approved therapies. Most remain without effective interventions, leaving a vast population in desperate need of continued innovation and clinical trials. The discrepancy between conditions with successful therapies and those with none highlights the critical need for further research and global collaboration.

Pediatric orphan disease patient with supportive doctor discussing rare disease treatments

The Role of Orphan Drugs in Modern Medicine

The introduction of orphan drugs transformed the pharmaceutical industry’s approach to neglected diseases. These specialized therapies are developed under special designations—often benefitting from regulatory incentives, such as exclusive market rights, tax credits, and rapid review processes established by the Orphan Drug Act in the US and similar laws globally. Many orphan products are biologics or precision medications tailored for genetic mutations or unique pathologies, and have dramatically improved patient survival rates in targeted populations. Nevertheless, gaps persist. Not every rare disease has a viable pathway for orphan drug development, particularly where the science is nascent or projected returns are minimal, sustaining persistent inequities across the rare disorder landscape.

“While we have seen incredible progress in treatments for rare diseases, the reality is that entire families still face impossible choices—either grapple with the unknown or hope for a breakthrough that may never come.”
– Healthcare provider specializing in rare disorders

Challenges in Orphan Diseases Research and Development

Cost and Commercial Obstacles to Orphan Drug Development

One of the foremost challenges in orphan disease research is economic feasibility. Developing an effective orphan drug can require billions in investment yet reward companies with a much smaller market than conventional medicines. This economics deters many pharmaceutical giants, despite governmental incentives, from investing in clinical trial infrastructure or comprehensive product development. Furthermore, market exclusivity—while motivating—can sometimes restrict access by keeping drug prices high and limiting competition. As a result, both patients and healthcare systems face substantial affordability issues, complicating widespread adoption of even the most promising orphan therapies. This “commercial orphaning” perpetuates a cycle where patients with the rarest disorders remain left out of scientific progress.

Healthcare administrators and researchers discussing orphan drug commercial and regulatory challenges

The Search for Effective Treatments for Rare Diseases

The journey from discovery to therapy for most rare disorders is daunting. The hurdles in research are not just financial but logistical and scientific: Identifying sufficient patient populations for clinical trials is challenging for diseases affecting fewer than 1 in 10,000 people. Additionally, limited understanding of the disease’s genetics, progression, and biomarkers stymies early-stage research.
Care providers advocate for collaborative global networks, biobank sharing, and the harmonization of rare disease databases to overcome these obstacles. However, without systematic investments or multinational policy reforms, the pace of innovation remains slow, prolonging patient suffering and missing opportunities for breakthrough discoveries that could revolutionize medicine.

  • Scarcity of research funding compared with common diseases
  • Few incentives for commercial investment in extremely rare conditions
  • Limited clinical data and lack of standard care pathways for healthcare providers
  • Delayed or missed diagnoses due to unfamiliarity with symptoms
  • High out-of-pocket treatment costs and poor reimbursement options

Policy and Advocacy for Orphan Diseases: The Role of Governments

Legislative Approaches in the United States and United Kingdom

Legislation has been pivotal in advancing orphan disease research. In the United States, the Orphan Drug Act of 1983 stands as a landmark, incentivizing new therapies through market exclusivity, research grants, and tax credits. These initiatives spurred a tenfold increase in orphan drug approvals compared to previous decades, opening hope to millions. In the United Kingdom, parallel efforts—including the Early Access to Medicines Scheme and NHS Rare Disease Framework—prioritize rapid approval and funding for high-need conditions. Across Europe and Asia, other nations have followed suit, cementing the idea that government action is essential for sustainable orphan disease research and therapy rollout.

Advocacy group in government chamber discussing orphan diseases policy and rare disease funding

The Importance of Healthcare Provider Involvement

Achieving meaningful progress for orphan diseases depends not just on funding and policy but also on the commitment of front-line healthcare providers. These experts play a critical role: driving early diagnosis, facilitating patient access to clinical trials, and connecting affected families with specialist resources. Ongoing education, inter-provider networking, and real-time access to rare disease database resources can dramatically shorten the “diagnostic odyssey” many patients endure. When care providers become advocates, it transforms entire care models—demonstrating that research advancements ultimately hinge on a well-informed, interconnected medical ecosystem championing the needs of rare disease communities.

Video alt text: Explainer video on orphan diseases research impact, rare disease statistics, and evolving treatment strategies.

People Also Ask About Orphan Diseases

What are examples of orphan diseases?

  • Cystic fibrosis: Inherited genetic disease causing severe respiratory and digestive problems.
  • Duchenne muscular dystrophy: Muscular degeneration disorder, mostly affecting boys.
  • Sickle cell disease: Blood disorder that leads to misshapen red cells; rare in some regions but more prevalent in others.
  • Gaucher disease: Metabolic disorder leading to organ damage.
  • Huntington’s disease: Neurodegenerative disorder with progressive cognitive decline.
  • Fabry disease: X-linked disorder affecting fat metabolism.

Is sickle cell disease an orphan disease?

  • Sickle cell disease is classified as an orphan disease in the United States and European Union because, despite significant prevalence in certain populations, it still meets the definition of a rare disease for regulatory purposes. The Orphan Drug Act and similar legislation have spurred the development of dedicated orphan drugs for this genetic disease, providing new hope to affected patients.

What is a rare disease orphan drug?

  • An orphan drug is a medicine or therapy developed specifically to treat rare diseases, which otherwise would be neglected due to low commercial returns. Approval processes often involve special designations, accelerated review pathways, and regulatory incentives under legislation such as the Orphan Drug Act. Orphan drugs are vital in bringing effective treatments for rare disorders where no standard therapy exists.

Are orphan diseases treatable?

  • While there have been significant breakthroughs in treatments for rare diseases—especially in genetic, metabolic, and enzyme-replacement therapies—the vast majority of orphan diseases remain without a cure. Many have only supportive treatments or palliative options. Ongoing research, clinical trials, and advocacy for improved funding are essential for developing more effective therapies in the future.

Table: Orphan Disease Statistics and Orphan Drug Approvals by Country

Orphan Disease Statistics and Orphan Drug Approvals (2022)
Country/Region Estimated Patients # Recognized Orphan Diseases # Approved Orphan Drugs Key Policy Framework
United States 25-30 million 7,000+ >800 Orphan Drug Act
European Union 30+ million 6,000+ >200 EC Regulation 141/2000
Japan 2 million 2,000+ ~400 Orphan Drug Designation
Global 300+ million 7,000-8,000 ~1,200 Various national policies

Quote: Insights from a Leading Expert in Rare Diseases

"Research into orphan diseases is not just a necessity—it is a moral imperative." - Renowned rare disease specialist

Key Takeaways: Why Orphan Diseases Research Demands Urgent Attention

  • Millions of people lack treatments for life-threatening orphan diseases.
  • Legislation like the Orphan Drug Act has made progress, but gaps persist globally.
  • Equitable, inclusive, and well-funded research is essential to closing care disparities.
  • Healthcare providers and policy makers must remain committed to advocacy and innovation.
  • Tackling rare and orphan diseases benefits all of medical science by fostering new discoveries and therapeutic breakthroughs.

FAQs: What Everyone Needs to Know About Orphan Diseases

  • What is an orphan disease?
    An orphan disease is one that affects a small percentage of the population and is often overlooked in medical research and treatment development. The Orphan Drug Act and similar policies help incentivize research in these fields.
  • Who decides if a disease is “orphan” or “rare”?
    Government regulators, such as the US FDA, EU EMA, and Japan’s PMDA, determine disease status using population prevalence thresholds and disease impact criteria.
  • Where can patients and families find support?
    Leading organizations like NORD and EURORDIS offer information, patient networks, and advocacy resources for people affected by orphan diseases.

Video alt text: Documentary video featuring interviews with orphan disease patients and their families, highlighting daily challenges and hope for new treatments.

Conclusion: The Future of Orphan Diseases Research and Its Critical Importance

Orphan diseases research is not just essential—it is the gateway to lifesaving innovation, equity, and hope for millions waiting in the shadows of medicine.

As the world of medical research continues to advance, staying connected and informed is more important than ever—especially for those navigating the complexities of rare and orphan diseases. Leveraging modern communication platforms can empower advocacy groups, researchers, and families to share breakthroughs and support in real time. If you’re interested in exploring how innovative video email technology can enhance your outreach or collaboration efforts, discover the possibilities with Talk Fusion’s video communication tools. Embracing new ways to connect can accelerate progress and bring the rare disease community closer together, fostering hope and action for the future.

Learn More About Ongoing Orphan Diseases Research or Find Support Now

Discover the latest research, connect with advocacy groups, or join rare disease clinical trials through trusted resources:

  • NIH Genetic and Rare Diseases Information Center
  • National Organization for Rare Disorders (NORD)
  • EURORDIS – Rare Diseases Europe

Sources

  • NIH Genetic and Rare Diseases Information Center – https://rarediseases.info.nih.gov/
  • National Organization for Rare Disorders (NORD) – https://rarediseases.org/
  • FDA – https://www.fda.gov/industry/developing-products-rare-diseases-conditions
  • EURORDIS – https://eurordis.org/
  • National Center for Biotechnology Information – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5654455/

Orphan diseases, also known as rare diseases, affect fewer than 200,000 individuals in the United States. Collectively, over 7,000 such diseases impact more than 30 million Americans. (fda.gov) Despite their prevalence, many of these conditions lack effective treatments, underscoring the critical need for dedicated research and development.

The Orphan Drug Act of 1983 was a pivotal legislative measure aimed at incentivizing the development of treatments for rare diseases. This act provides benefits such as tax credits for clinical testing, exemption from user fees, and potential seven-year market exclusivity upon approval. (fda.gov) These incentives have significantly increased the number of orphan drugs available, offering hope to many patients.

Organizations like the National Organization for Rare Disorders (NORD) play a vital role in supporting individuals with rare diseases by advocating for research, education, and networking among service providers. (en.wikipedia.org) Additionally, Orphanet serves as a comprehensive database dedicated to rare diseases, providing valuable information on diagnosis, orphan drugs, clinical trials, and expert networks. (orpha.net)

Investing in orphan disease research not only addresses the unmet needs of millions but also drives medical innovation, potentially leading to breakthroughs that benefit a broader spectrum of health conditions.

Health & Medicine

12 Views

0 Comments

Write A Comment

*
*
Please complete the captcha to submit your comment.
Related Posts All Posts
05.29.2026

Charlotte's Web Transaction with BAT: What Shareholders Should Know

Update Charlotte's Web: A Turning Point in Shareholder EngagementCharlotte's Web Holdings, Inc., a leading name in botanical wellness, published results from its 2026 annual general and special meeting of shareholders on May 28, 2026. This meeting, held via live audio webcast, underscored the increasing importance of transparency and engagement in corporate governance as shareholders put forward their opinions on key corporate actions.Key Highlights from the MeetingWhat stood out at this year’s meeting was the notable approval of the BAT transaction, which was illustrated by a substantial vote count—96,513,512, representing 60.12% of total outstanding voting shares, signaling strong shareholder confidence in the direction the company is taking.CEO Bill Morachnick’s remarks encapsulated the meeting's significance, emphasizing that the approved amendments to the convertible debenture with British American Tobacco (BAT) would bolster the company’s balance sheet. This transaction aims to simplify capital structures and position Charlotte's Web for enhanced financial agility.Understanding the BAT TransactionThe approval encompassed a series of financial maneuvers, including the amendment of a **C$75,341,080** principal amount convertible debenture issued to BAT, alongside a concurrent equity investment. The shareholders overwhelmingly supported the issuance of common shares to BAT, effectively representing 40.6% of the combined total shares post-transaction.This strategic partnership with BAT is not merely a financial transaction but binds Charlotte's Web to a wider market presence, further solidifying its industry leadership in hemp extract wellness products.The Importance of Shareholder SupportThe voting results revealed a promising trend in shareholder loyalty, with majorities firmly backing nominee elections and item resolutions. This emphasizes the growing need for companies to foster good relationships with shareholders.In this regard, Charlotte's Web displayed exceptional corporate responsibility. The re-elections of directors like Matthew McCarthy and Maureen Usifer, receiving an impressive 96% and 96% of votes for re-election respectively, showcase their performance and alignment with shareholder interests.Insights from the Private SectorThe corporate governance debate about how decisions are made and executed is more relevant than ever. For companies like Charlotte's Web, engaging shareholders during significant decisions reflects a broader trend in public companies aiming for transparency and trustworthiness.Shareholder meetings no longer merely serve as a box-ticking exercise but have evolved into platforms that reflect a company's health, approach, and vision.Future Predictions and Opportunities AheadWith the successful approval of key financial strategies, Charlotte's Web is well-positioned for future growth. The collaboration with a conglomerate like BAT may allow for shared technological advancements and resources that can propel the company into new markets.Anticipating shifts in consumer demands towards sustainable and health-focused products, Charlotte's Web aligns its offerings to meet these trends. Addressing these evolving consumer attitudes can create numerous opportunities for growth in years to come.Possible Risks and ChallengesHowever, the path ahead is not without challenges. Increased scrutiny and the regulatory landscape surrounding hemp and CBD products entail both risk management and proactive engagement with regulators to ensure compliance and market access.Additionally, the potential volatility in share prices and competition within the cannabis industry necessitate that Charlotte's Web remain vigilant and continue innovating.Conclusion: Take ActionAs stakeholders and potential investors in the expanding wellness market, following developments at Charlotte's Web represents an opportunity to engage with a company positioned for significant growth due to its proactive governance and strategic partnerships. They welcome enthusiastic participation and inquiries regarding their innovative pharmaceutical approaches, which continue to set industry standards.

05.29.2026

Charlotte's Web Gains Millions from British American Tobacco: What's Next?

Update How Charlotte's Web Strengthens Its Future with British American Tobacco Charlotte's Web Holdings, a leading name in the hemp extract wellness industry, recently made headlines with its strategic transaction involving British American Tobacco (BAT). This move not only marks a significant financial shift but also sets the stage for the company's future growth, particularly in the realm of CBD accessibility through healthcare. A Landmark Investment As of May 28, 2026, Charlotte's Web closed a pivotal agreement with BAT that entails a dual approach of converting approximately US$65 million in convertible debentures into common shares at a conversion price of C$0.94 per share, along with a concurrent US$10 million equity investment. This transaction, upon shareholder approval, results in BAT acquiring around 40% of Charlotte's Web's shares, fundamentally enhancing its capital structure and eliminating significant debt. Implications for the CBD Market This partnership gives Charlotte's Web the financial backing necessary to participate in the anticipated CMMI Medicare pilot program, aimed at increasing access to CBD products for eligible Medicare beneficiaries. As Charlotte's Web's CEO Bill Morachnick stated, the transaction strengthens their balance sheet and increases financial flexibility, creating opportunities for expanded access to CBD wellness products. Future Predictions: Where Is Charlotte's Web Headed? With increased operational funding and the ability to execute long-term strategies, Charlotte's Web is poised for significant growth in the coming years. The anticipated CMMI pilot program can pave the way for CBD products being integrated into mainstream medical treatments, potentially improving the health outcomes for many patients. Decisions Influenced by Investment The collaboration with BAT signals a broader trend in the industry where traditional tobacco companies see value in the health-focused innovations that companies like Charlotte's Web promote. This shift could lead to other major players exploring similar partnership models, focusing on expanding their reach in the rapidly growing CBD market. Counterarguments: Concerns about Corporate Influence However, this investment also raises potential counterarguments. Critics express concerns about the influence of large corporations like BAT in the wellness sector, fearing that profit motives might overshadow health necessities. The ongoing dialogue about ethical investment and corporate responsibility will be crucial as Charlotte's Web navigates its future with BAT. Key Insights for the Industry The strategic investment from BAT reflects a critical juncture for the cannabis industry as the push for broader acceptance of CBD continues. Investors and stakeholders should pay attention to how Charlotte's Web manages this relationship and whether it aligns with their core values of promoting health and wellness. In summary, Charlotte's Web stands at the intersection of innovation and traditional investment, aiming to redefine the landscape of CBD accessibility. As they advance towards participation in critical healthcare initiatives, the company’s commitment to ethical practices will be pivotal in shaping perceptions and securing consumer trust.

05.29.2026

Trump's Threats Over Strait of Hormuz Fees: A Geopolitical Flashpoint

Update Trump's Ultimatum: A Dangerous New Phase in Hormuz Politics In a shocking escalation of rhetoric, President Donald Trump recently declared that Oman could face dire consequences if it continues to engage in discussions with Iran regarding fees for navigating the Strait of Hormuz. This nearly unprecedented threat to a long-standing ally underscores the increasing geopolitical tensions surrounding one of the world’s most critical waterways. A Shifting Landscape in Persian Gulf Diplomacy Historically, Oman has served as a mediator between Washington and Tehran, maintaining a neutral stance and facilitating discreet dialogues. Trump's alarming remarks highlight a significant shift, suggesting that any arrangement allowing Iran to control this vital maritime corridor is non-negotiable. His claim that "Oman will behave just like everybody else or we’ll have to blow ’em up" reflects an alarming transactional view of international relations, particularly as it pertains to security and maritime law. With the Strait of Hormuz accounting for about 20% of global oil and liquefied natural gas shipments, the stakes are incredibly high. If Iran and Oman proceed with their talks on maritime fees, it could pave the way for a framework that grants Iran indirect control over a crucial international waterway, thereby diminishing U.S. influence. The Implications of Charging Fees Trump's threats came amidst reports that Iran and Oman were discussing a potential maritime fee structure. Trump's staunch opposition to any Iranian control over the strait points to a broader concern; the idea of a toll, whether viewed as a "service fee" or otherwise, represents a potential violation of international laws regulating maritime traffic. Legal experts warn that charging ships to pass through this critical passage could be viewed as extortion, further complicating diplomatic relations between the United States, Oman, and Iran. As Gulf nations anxiously monitor these developments, the voices of regional players like the United Arab Emirates have already spoken up against such arrangements, claiming that they threaten the principle of free passage in international waters. Looking Ahead: A Dangerous Dance The situation in the Strait of Hormuz exemplifies the complexities of contemporary geopolitics where military, economic, and legal factors intersect. Trump's statements are not merely bluster but reflect a profound anxiety about the future balance of power in the Gulf and the influence of Iran. As the U.S. maintains a firm stance against any arrangements that would allow Iranian control over the strait, it's evident that the upcoming interactions concerning Hormuz will be laden with tension and potential conflict. Where do we go from here? With the U.S. drawing red lines and regional powers vying for influence, the groundwork is being laid for possibly one of the most crucial diplomatic challenges of our time.

Terms of Service

Privacy Policy

Core Modal Title

Sorry, no results found

You Might Find These Articles Interesting

T
Please Check Your Email
We Will Be Following Up Shortly
*
*
*