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          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Glaukos Corp.</name>
        <lei>5299004JA1LHE21M6T14</lei>
        <title>Glaukos Corp. COM USD0.001</title>
        <cusip>377322102</cusip>
        <identifiers>
          <isin value="US3773221029"/>
          <ticker value="GKOS"/>
          <other otherDesc="SEDOL" value="BYMWL19"/>
        </identifiers>
        <balance>264704</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>28498032.64</valUSD>
        <pctVal>0.5483288111</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      </invstOrSec>
      <invstOrSec>
        <name>Argenx SE</name>
        <lei>7245009C5FZE6G9ODQ71</lei>
        <title>Argenx SE SPON ADR EACH REP 1 ORD SHS</title>
        <cusip>04016X101</cusip>
        <identifiers>
          <isin value="US04016X1019"/>
          <ticker value="ARGX"/>
          <other otherDesc="SEDOL" value="BDVLM39"/>
        </identifiers>
        <balance>170830</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>124748607.5</valUSD>
        <pctVal>2.4002799246</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetConditional assetCat="OTHER" desc="GDR"/>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      </invstOrSec>
      <invstOrSec>
        <name>Ascendis Pharma A/S</name>
        <lei>549300B66JN3W3J8GH73</lei>
        <title>Ascendis Pharma A/S SPON ADR EACH REP 1 ORD SHS</title>
        <cusip>04351P101</cusip>
        <identifiers>
          <isin value="US04351P1012"/>
          <ticker value="ASND"/>
          <other otherDesc="SEDOL" value="BV9G6B8"/>
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        <balance>375183</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>85815607.59</valUSD>
        <pctVal>1.6511725801</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetConditional assetCat="OTHER" desc="GDR"/>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      </invstOrSec>
      <invstOrSec>
        <name>Loadsmart Inc</name>
        <lei>N/A</lei>
        <title>Curevo Inc - Series B</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="DU0US0007660"/>
          <other otherDesc="Internal ID" value="3322052"/>
        </identifiers>
        <balance>1348208</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>3538210.11</valUSD>
        <pctVal>0.0680784729</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EP</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>Y</isRestrictedSec>

        <fairValLevel>3</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Asher Biotherapeutics Inc</name>
        <lei>N/A</lei>
        <title>Asher Biotherapeutics - Series C</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="DU0US0006305"/>
          <other otherDesc="Internal ID" value="3372993"/>
        </identifiers>
        <balance>2580733</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>809963.05</valUSD>
        <pctVal>0.0155844469</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EP</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>Y</isRestrictedSec>

        <fairValLevel>3</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      </invstOrSec>
      <invstOrSec>
        <name>Thermo Fisher Scientific Inc</name>
        <lei>HCHV7422L5HDJZCRFL38</lei>
        <title>Thermo Fisher Scientific Inc COM USD1</title>
        <cusip>883556102</cusip>
        <identifiers>
          <isin value="US8835561023"/>
          <ticker value="TMO"/>
          <other otherDesc="SEDOL" value="2886907"/>
        </identifiers>
        <balance>265275</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>130390620.75</valUSD>
        <pctVal>2.5088375382</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      </invstOrSec>
      <invstOrSec>
        <name>Travere Therapeutics Inc</name>
        <lei>N/A</lei>
        <title>Travere Therapeutics Inc COM</title>
        <cusip>89422G107</cusip>
        <identifiers>
          <isin value="US89422G1076"/>
          <ticker value="TVTX"/>
          <other otherDesc="SEDOL" value="BLFGJD5"/>
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        <balance>1432164</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>42549592.44</valUSD>
        <pctVal>0.8186939684</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      </invstOrSec>
      <invstOrSec>
        <name>Globus Med Inc</name>
        <lei>5299003M2P4CIK0RF205</lei>
        <title>Globus Med Inc COM USD0.001 CL 'A'</title>
        <cusip>379577208</cusip>
        <identifiers>
          <isin value="US3795772082"/>
          <ticker value="GMED"/>
          <other otherDesc="SEDOL" value="B7D65M0"/>
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        <balance>748604</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>64499720.64</valUSD>
        <pctVal>1.2410349718</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>HCA Healthcare Inc</name>
        <lei>529900PH4ZGUH2MNEU89</lei>
        <title>HCA Healthcare Inc COM USD0.01</title>
        <cusip>40412C101</cusip>
        <identifiers>
          <isin value="US40412C1018"/>
          <ticker value="HCA"/>
          <other otherDesc="SEDOL" value="B4MGBG6"/>
        </identifiers>
        <balance>206592</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>97767598.08</valUSD>
        <pctVal>1.8811400596</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Lexeo Therapeutics Inc</name>
        <lei>N/A</lei>
        <title>Lexeo Therapeutics Inc COM</title>
        <cusip>52886X107</cusip>
        <identifiers>
          <isin value="US52886X1072"/>
          <ticker value="LXEO"/>
          <other otherDesc="SEDOL" value="BQ6C357"/>
        </identifiers>
        <balance>633486</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>3636209.64</valUSD>
        <pctVal>0.0699640756</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Mckesson Corp.</name>
        <lei>549300WZWOM80UCFSF54</lei>
        <title>Mckesson Corp. COM USD0.01</title>
        <cusip>58155Q103</cusip>
        <identifiers>
          <isin value="US58155Q1031"/>
          <ticker value="MCK"/>
          <other otherDesc="SEDOL" value="2378534"/>
        </identifiers>
        <balance>79818</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>69071304.48</valUSD>
        <pctVal>1.3289965221</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Merck &amp; Co., Inc</name>
        <lei>4YV9Y5M8S0BRK1RP0397</lei>
        <title>Merck &amp; Co., Inc COM USD0.50</title>
        <cusip>58933Y105</cusip>
        <identifiers>
          <isin value="US58933Y1055"/>
          <ticker value="MRK"/>
          <other otherDesc="SEDOL" value="2778844"/>
        </identifiers>
        <balance>638574</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>76814066.46</valUSD>
        <pctVal>1.4779745068</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>HeartFlow Inc.</name>
        <lei>N/A</lei>
        <title>HeartFlow Inc. COM</title>
        <cusip>42238D107</cusip>
        <identifiers>
          <isin value="US42238D1072"/>
          <ticker value="HTFL"/>
          <other otherDesc="SEDOL" value="BV6KV30"/>
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        <balance>585648</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>14248815.84</valUSD>
        <pctVal>0.2741605481</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Humana Inc.</name>
        <lei>529900YLDW34GJAO4J06</lei>
        <title>Humana Inc. COM USD0.166</title>
        <cusip>444859102</cusip>
        <identifiers>
          <isin value="US4448591028"/>
          <ticker value="HUM"/>
          <other otherDesc="SEDOL" value="2445063"/>
        </identifiers>
        <balance>52740</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>9144588.6</valUSD>
        <pctVal>0.1759504404</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>United Therapeutics Corporation</name>
        <lei>5299005C4HZL4UWROC14</lei>
        <title>United Therapeutics Corporation COM USD0.01</title>
        <cusip>91307C102</cusip>
        <identifiers>
          <isin value="US91307C1027"/>
          <ticker value="UTHR"/>
          <other otherDesc="SEDOL" value="2430412"/>
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        <balance>116721</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>69213218.58</valUSD>
        <pctVal>1.3317270822</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>UnitedHealth Group Inc.</name>
        <lei>549300GHBMY8T5GXDE41</lei>
        <title>UnitedHealth Group Inc. COM USD0.01</title>
        <cusip>91324P102</cusip>
        <identifiers>
          <isin value="US91324P1021"/>
          <ticker value="UNH"/>
          <other otherDesc="SEDOL" value="2917766"/>
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        <balance>601241</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>162689802.19</valUSD>
        <pctVal>3.1303040086</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Vaxcyte Inc</name>
        <lei>254900M7NMHTGASX8D95</lei>
        <title>Vaxcyte Inc COM</title>
        <cusip>92243G108</cusip>
        <identifiers>
          <isin value="US92243G1085"/>
          <ticker value="PCVX"/>
          <other otherDesc="SEDOL" value="BKPVGH6"/>
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        <balance>971737</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>56467637.07</valUSD>
        <pctVal>1.0864901690</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Vertex Pharmaceuticals Incorporated</name>
        <lei>54930015RAQRRZ5ZGJ91</lei>
        <title>Vertex Pharmaceuticals Incorporated COM USD0.01</title>
        <cusip>92532F100</cusip>
        <identifiers>
          <isin value="US92532F1003"/>
          <ticker value="VRTX"/>
          <other otherDesc="SEDOL" value="2931034"/>
        </identifiers>
        <balance>239922</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>107134769.88</valUSD>
        <pctVal>2.0613732091</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Xenon Pharmaceuticals Inc</name>
        <lei>549300XV44Q9Z1MIPQ03</lei>
        <title>Xenon Pharmaceuticals Inc COM NPV</title>
        <cusip>98420N105</cusip>
        <identifiers>
          <isin value="CA98420N1050"/>
          <ticker value="XENE"/>
          <other otherDesc="SEDOL" value="BRJ3GY4"/>
        </identifiers>
        <balance>348546</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>20267949.9</valUSD>
        <pctVal>0.3899743190</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Zoetis Inc.</name>
        <lei>549300HD9Q1LOC9KLJ48</lei>
        <title>Zoetis Inc. COM USD0.01 CL 'A'</title>
        <cusip>98978V103</cusip>
        <identifiers>
          <isin value="US98978V1035"/>
          <ticker value="ZTS"/>
          <other otherDesc="SEDOL" value="B95WG16"/>
        </identifiers>
        <balance>131945</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>15597218.45</valUSD>
        <pctVal>0.3001050759</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>IDEAYA Biosciences Inc.</name>
        <lei>549300ULW08F62IJML11</lei>
        <title>IDEAYA Biosciences Inc. COM USD0.0001</title>
        <cusip>45166A102</cusip>
        <identifiers>
          <isin value="US45166A1025"/>
          <ticker value="IDYA"/>
          <other otherDesc="SEDOL" value="BK0VHF6"/>
        </identifiers>
        <balance>738748</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>24615083.36</valUSD>
        <pctVal>0.4736172340</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Illumina Inc</name>
        <lei>SQ95QG8SR5Q56LSNF682</lei>
        <title>Illumina Inc COM USD0.01</title>
        <cusip>452327109</cusip>
        <identifiers>
          <isin value="US4523271090"/>
          <ticker value="ILMN"/>
          <other otherDesc="SEDOL" value="2613990"/>
        </identifiers>
        <balance>102214</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>12598897.64</valUSD>
        <pctVal>0.2424145783</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Immunome Inc</name>
        <lei>N/A</lei>
        <title>Immunome Inc COM</title>
        <cusip>45257U108</cusip>
        <identifiers>
          <isin value="US45257U1088"/>
          <ticker value="IMNM"/>
          <other otherDesc="SEDOL" value="BM8FWX7"/>
        </identifiers>
        <balance>368708</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>8063643.96</valUSD>
        <pctVal>0.1551520542</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Insulet Corporation</name>
        <lei>549300TZTYD2PYN92D43</lei>
        <title>Insulet Corporation COM STK USD0.001</title>
        <cusip>45784P101</cusip>
        <identifiers>
          <isin value="US45784P1012"/>
          <ticker value="PODD"/>
          <other otherDesc="SEDOL" value="B1XGNW4"/>
        </identifiers>
        <balance>59223</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>12427354.32</valUSD>
        <pctVal>0.2391139243</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Intuitive Surgical Inc.</name>
        <lei>54930052SRG011710797</lei>
        <title>Intuitive Surgical Inc. COM USD0.001</title>
        <cusip>46120E602</cusip>
        <identifiers>
          <isin value="US46120E6023"/>
          <ticker value="ISRG"/>
          <other otherDesc="SEDOL" value="2871301"/>
        </identifiers>
        <balance>227319</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>104791785.81</valUSD>
        <pctVal>2.0162920034</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Janux Therapeutics Inc</name>
        <lei>N/A</lei>
        <title>Janux Therapeutics Inc COM</title>
        <cusip>47103J105</cusip>
        <identifiers>
          <isin value="US47103J1051"/>
          <ticker value="JANX"/>
          <other otherDesc="SEDOL" value="BMFX8Y7"/>
        </identifiers>
        <balance>720074</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>10009028.6</valUSD>
        <pctVal>0.1925830748</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Johnson &amp; Johnson</name>
        <lei>549300G0CFPGEF6X2043</lei>
        <title>Johnson &amp; Johnson COM USD1.00</title>
        <cusip>478160104</cusip>
        <identifiers>
          <isin value="US4781601046"/>
          <ticker value="JNJ"/>
          <other otherDesc="SEDOL" value="2475833"/>
        </identifiers>
        <balance>1550240</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>378940665.6</valUSD>
        <pctVal>7.2911729475</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Lantheus Holdings Inc</name>
        <lei>5299005HUB5IOJGO7S39</lei>
        <title>Lantheus Holdings Inc COM USD0.01</title>
        <cusip>516544103</cusip>
        <identifiers>
          <isin value="US5165441032"/>
          <ticker value="LNTH"/>
          <other otherDesc="SEDOL" value="BP8S8J5"/>
        </identifiers>
        <balance>518786</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>39349918.1</valUSD>
        <pctVal>0.7571292405</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Janus Henderson Cash Liquidity Fund LLC</name>
        <lei>N/A</lei>
        <title>Janus Henderson Cash Liquidity Fund LLC</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="Internal ID" value="895"/>
        </identifiers>
        <balance>20152769.7059</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>20152769.71</valUSD>
        <pctVal>0.3877581444</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>PF</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Abbott Laboratories</name>
        <lei>HQD377W2YR662HK5JX27</lei>
        <title>Abbott Laboratories COM NPV</title>
        <cusip>002824100</cusip>
        <identifiers>
          <isin value="US0028241000"/>
          <ticker value="ABT"/>
          <other otherDesc="SEDOL" value="2002305"/>
        </identifiers>
        <balance>1212497</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>124487066.99</valUSD>
        <pctVal>2.3952476405</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>AbbVie Inc.</name>
        <lei>FR5LCKFTG8054YNNRU85</lei>
        <title>AbbVie Inc. COM USD0.01</title>
        <cusip>00287Y109</cusip>
        <identifiers>
          <isin value="US00287Y1091"/>
          <ticker value="ABBV"/>
          <other otherDesc="SEDOL" value="B92SR70"/>
        </identifiers>
        <balance>967983</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>210526622.67</valUSD>
        <pctVal>4.0507291914</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Amgen Inc.</name>
        <lei>62QBXGPJ34PQ72Z12S66</lei>
        <title>Amgen Inc. COM USD0.0001</title>
        <cusip>031162100</cusip>
        <identifiers>
          <isin value="US0311621009"/>
          <ticker value="AMGN"/>
          <other otherDesc="SEDOL" value="2023607"/>
        </identifiers>
        <balance>270089</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>95030814.65</valUSD>
        <pctVal>1.8284817858</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>AstraZeneca PLC</name>
        <lei>PY6ZZQWO2IZFZC3IOL08</lei>
        <title>AstraZeneca PLC ORD USD0.25</title>
        <cusip>G0593M107</cusip>
        <identifiers>
          <isin value="GB0009895292"/>
          <ticker value="AZN"/>
          <other otherDesc="SEDOL" value="0989529"/>
        </identifiers>
        <balance>1221946</balance>
        <units>NS</units>
        <currencyConditional curCd="GBP" exchangeRt="0.75563"/>
        <valUSD>238631842.21</valUSD>
        <pctVal>4.5914999109</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>GB</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>PFIZER INC</name>
        <lei>N/A</lei>
        <title>PFIZER INC-CVR</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="DU0US0005090"/>
          <ticker value="2596459D"/>
          <other otherDesc="Internal ID" value="3332853"/>
        </identifiers>
        <balance>390971</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>1915757.9</valUSD>
        <pctVal>0.0368609744</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetConditional assetCat="OTHER" desc="Rights"/>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>3</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>4D Molecular Therapeutics Inc</name>
        <lei>N/A</lei>
        <title>4D Molecular Therapeutics Inc COM</title>
        <cusip>35104E100</cusip>
        <identifiers>
          <isin value="US35104E1001"/>
          <ticker value="FDMT"/>
          <other otherDesc="SEDOL" value="BKLXFX5"/>
        </identifiers>
        <balance>843751</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>7855321.81</valUSD>
        <pctVal>0.1511437412</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Alkermes PLC</name>
        <lei>N/A</lei>
        <title>ALKERMES PLC-CVR</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="USG29CVR0199"/>
          <ticker value="2602644D"/>
          <other otherDesc="Internal ID" value="5504879"/>
        </identifiers>
        <balance>450200</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>288128</valUSD>
        <pctVal>0.0055438523</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetConditional assetCat="OTHER" desc="Rights"/>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>3</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Sanofi SA</name>
        <lei>549300E9PC51EN656011</lei>
        <title>Sanofi SA EUR2</title>
        <cusip>F5548N101</cusip>
        <identifiers>
          <isin value="FR0000120578"/>
          <ticker value="SNYNF"/>
          <other otherDesc="SEDOL" value="5671735"/>
        </identifiers>
        <balance>1116972</balance>
        <units>NS</units>
        <currencyConditional curCd="EUR" exchangeRt="0.86528"/>
        <valUSD>107723985.6</valUSD>
        <pctVal>2.0727102708</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>FR</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Olema Pharmaceuticals Inc.</name>
        <lei>N/A</lei>
        <title>Olema Pharmaceuticals Inc. COM</title>
        <cusip>68062P106</cusip>
        <identifiers>
          <isin value="US68062P1066"/>
          <ticker value="OLMA"/>
          <other otherDesc="SEDOL" value="BMZ4LN0"/>
        </identifiers>
        <balance>669297</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>9979218.27</valUSD>
        <pctVal>0.1920094962</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>PTC Therapeutics, Inc.</name>
        <lei>549300UJLWOIWFDGB318</lei>
        <title>PTC Therapeutics, Inc. COM USD0.001</title>
        <cusip>69366J200</cusip>
        <identifiers>
          <isin value="US69366J2006"/>
          <ticker value="PTCT"/>
          <other otherDesc="SEDOL" value="B17VCN9"/>
        </identifiers>
        <balance>1024173</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>69776906.49</valUSD>
        <pctVal>1.3425729650</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Penumbra Inc.</name>
        <lei>549300RGE06P3ECANU72</lei>
        <title>Penumbra Inc. COM USD0.001</title>
        <cusip>70975L107</cusip>
        <identifiers>
          <isin value="US70975L1070"/>
          <ticker value="PEN"/>
          <other otherDesc="SEDOL" value="BZ0V201"/>
        </identifiers>
        <balance>73736</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>24212690.32</valUSD>
        <pctVal>0.4658748154</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Praxis Precision Medicines Inc</name>
        <lei>N/A</lei>
        <title>Praxis Precision Medicines Inc COM NEW</title>
        <cusip>74006W207</cusip>
        <identifiers>
          <isin value="US74006W2070"/>
          <ticker value="PRAX"/>
          <other otherDesc="SEDOL" value="BQ721R4"/>
        </identifiers>
        <balance>394970</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>127255384.3</valUSD>
        <pctVal>2.4485126556</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Scholar Rock Holding Corp.</name>
        <lei>549300Z1FLPGL4OWJ459</lei>
        <title>Scholar Rock Holding Corp. COM USD0.001</title>
        <cusip>80706P103</cusip>
        <identifiers>
          <isin value="US80706P1030"/>
          <ticker value="SRRK"/>
          <other otherDesc="SEDOL" value="BFZQ0L8"/>
        </identifiers>
        <balance>341699</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>16797922.84</valUSD>
        <pctVal>0.3232077518</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Soleno Therapeutics Inc</name>
        <lei>5493003LCY77N7FXK844</lei>
        <title>Soleno Therapeutics Inc COM</title>
        <cusip>834203309</cusip>
        <identifiers>
          <isin value="US8342033094"/>
          <ticker value="SLNO"/>
          <other otherDesc="SEDOL" value="BL6JK96"/>
        </identifiers>
        <balance>987780</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>33070874.4</valUSD>
        <pctVal>0.6363145650</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Stryker Corporation</name>
        <lei>5493002F0SC4JTBU5137</lei>
        <title>Stryker Corporation COM USD0.10</title>
        <cusip>863667101</cusip>
        <identifiers>
          <isin value="US8636671013"/>
          <ticker value="SYK"/>
          <other otherDesc="SEDOL" value="2853688"/>
        </identifiers>
        <balance>260843</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>85710401.37</valUSD>
        <pctVal>1.6491483140</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Protagonist Therapeutics Inc</name>
        <lei>N/A</lei>
        <title>Protagonist Therapeutics Inc COM USD0.00001</title>
        <cusip>74366E102</cusip>
        <identifiers>
          <isin value="US74366E1029"/>
          <ticker value="PTGX"/>
          <other otherDesc="SEDOL" value="BDCBCD8"/>
        </identifiers>
        <balance>160299</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>16895514.6</valUSD>
        <pctVal>0.3250855085</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      </invstOrSec>
      <invstOrSec>
        <name>Regeneron Pharmaceuticals, Inc.</name>
        <lei>549300RCBFWIRX3HYQ56</lei>
        <title>Regeneron Pharmaceuticals, Inc. COM USD0.001</title>
        <cusip>75886F107</cusip>
        <identifiers>
          <isin value="US75886F1075"/>
          <ticker value="REGN"/>
          <other otherDesc="SEDOL" value="2730190"/>
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        <balance>23991</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>18536406.24</valUSD>
        <pctVal>0.3566577989</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      </invstOrSec>
      <invstOrSec>
        <name>Revolution Medicines Inc</name>
        <lei>549300JU3X0LBCQ65892</lei>
        <title>Revolution Medicines Inc COM</title>
        <cusip>76155X100</cusip>
        <identifiers>
          <isin value="US76155X1000"/>
          <ticker value="RVMD"/>
          <other otherDesc="SEDOL" value="BL71K91"/>
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        <balance>1088018</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>105809750.5</valUSD>
        <pctVal>2.0358785965</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      </invstOrSec>
      <invstOrSec>
        <name>Rhythm Pharmaceuticals Inc</name>
        <lei>529900JPNWXQ8DPLA551</lei>
        <title>Rhythm Pharmaceuticals Inc COM USD0.001</title>
        <cusip>76243J105</cusip>
        <identifiers>
          <isin value="US76243J1051"/>
          <ticker value="RYTM"/>
          <other otherDesc="SEDOL" value="BF2YWG4"/>
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        <balance>160804</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>13985123.88</valUSD>
        <pctVal>0.2690868681</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      </invstOrSec>
      <invstOrSec>
        <name>Steris PLC</name>
        <lei>N/A</lei>
        <title>Steris PLC ORD USD0.001</title>
        <cusip>G8473T100</cusip>
        <identifiers>
          <isin value="IE00BFY8C754"/>
          <ticker value="STE"/>
          <other otherDesc="SEDOL" value="BFY8C75"/>
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        <balance>81916</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>18114085.08</valUSD>
        <pctVal>0.3485319447</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      </invstOrSec>
      <invstOrSec>
        <name>Roche Holding AG</name>
        <lei>549300U41AUUVOAAOB37</lei>
        <title>Roche Holding AG CHF0.001</title>
        <cusip>H69293266</cusip>
        <identifiers>
          <isin value="CH1499059983"/>
          <ticker value="RHHVF"/>
          <other otherDesc="SEDOL" value="BTMJD19"/>
        </identifiers>
        <balance>290904</balance>
        <units>NS</units>
        <currencyConditional curCd="CHF" exchangeRt="0.7994"/>
        <valUSD>114896793.77</valUSD>
        <pctVal>2.2107218109</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EP</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>CH</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      </invstOrSec>
      <invstOrSec>
        <name>Cencora Inc</name>
        <lei>AI8GXW8LG5WK7E9UD086</lei>
        <title>Cencora Inc COM USD0.01</title>
        <cusip>03073E105</cusip>
        <identifiers>
          <isin value="US03073E1055"/>
          <ticker value="COR"/>
          <other otherDesc="SEDOL" value="2795393"/>
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        <balance>139138</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>43708811.32</valUSD>
        <pctVal>0.8409984243</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>Elevance Health Inc.</name>
        <lei>8MYN82XMYQH89CTMTH67</lei>
        <title>Elevance Health Inc. COM USD0.01</title>
        <cusip>036752103</cusip>
        <identifiers>
          <isin value="US0367521038"/>
          <ticker value="ELV"/>
          <other otherDesc="SEDOL" value="BSPHGL4"/>
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        <balance>165285</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>48387183.75</valUSD>
        <pctVal>0.9310146870</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
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      </invstOrSec>
      <invstOrSec>
        <name>Becton, Dickinson and Company</name>
        <lei>ICE2EP6D98PQUILVRZ91</lei>
        <title>Becton, Dickinson and Company COM USD1.00</title>
        <cusip>075887109</cusip>
        <identifiers>
          <isin value="US0758871091"/>
          <ticker value="BDX"/>
          <other otherDesc="SEDOL" value="2087807"/>
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        <balance>181577</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>28549351.71</valUSD>
        <pctVal>0.5493162380</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Boston Scientific Corporation</name>
        <lei>Y6ZDD9FP4P8JSSJMW954</lei>
        <title>Boston Scientific Corporation COM USD0.01</title>
        <cusip>101137107</cusip>
        <identifiers>
          <isin value="US1011371077"/>
          <ticker value="BSX"/>
          <other otherDesc="SEDOL" value="2113434"/>
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        <balance>1520117</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>95387341.75</valUSD>
        <pctVal>1.8353417008</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Bridgebio Pharma Inc</name>
        <lei>54930028YG89VTY2J114</lei>
        <title>Bridgebio Pharma Inc COM USD0.001</title>
        <cusip>10806X102</cusip>
        <identifiers>
          <isin value="US10806X1028"/>
          <ticker value="BBIO"/>
          <other otherDesc="SEDOL" value="BK1KWG8"/>
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        <balance>1551141</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>115187730.66</valUSD>
        <pctVal>2.2163197089</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>CVS Health Corp</name>
        <lei>549300EJG376EN5NQE29</lei>
        <title>CVS Health Corp COM USD0.01</title>
        <cusip>126650100</cusip>
        <identifiers>
          <isin value="US1266501006"/>
          <ticker value="CVS"/>
          <other otherDesc="SEDOL" value="2577609"/>
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        <balance>1071894</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>76983427.08</valUSD>
        <pctVal>1.4812331636</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Centene Corp.</name>
        <lei>549300Z7JJ4TQSQGT333</lei>
        <title>Centene Corp. COM USD0.001</title>
        <cusip>15135B101</cusip>
        <identifiers>
          <isin value="US15135B1017"/>
          <ticker value="CNC"/>
          <other otherDesc="SEDOL" value="2807061"/>
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        <balance>340855</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>11159592.7</valUSD>
        <pctVal>0.2147210046</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Cogent Biosciences Inc.</name>
        <lei>N/A</lei>
        <title>Cogent Biosciences Inc. COM</title>
        <cusip>19240Q201</cusip>
        <identifiers>
          <isin value="US19240Q2012"/>
          <ticker value="COGT"/>
          <other otherDesc="SEDOL" value="BLR6XK8"/>
        </identifiers>
        <balance>498576</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>19190190.24</valUSD>
        <pctVal>0.3692372148</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>The Cooper Companies, Inc.</name>
        <lei>QJKMVPIGLH7530PCUE20</lei>
        <title>The Cooper Companies, Inc. COM</title>
        <cusip>216648501</cusip>
        <identifiers>
          <isin value="US2166485019"/>
          <ticker value="COO"/>
          <other otherDesc="SEDOL" value="BQPDXR3"/>
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        <balance>281740</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>20144410</valUSD>
        <pctVal>0.3875972957</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Crinetics Pharmaceuticals Inc.</name>
        <lei>549300Q1CNFXK5P31D28</lei>
        <title>Crinetics Pharmaceuticals Inc. COM USD0.001</title>
        <cusip>22663K107</cusip>
        <identifiers>
          <isin value="US22663K1079"/>
          <ticker value="CRNX"/>
          <other otherDesc="SEDOL" value="BDD19F8"/>
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        <balance>394286</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>14320467.52</valUSD>
        <pctVal>0.2755391935</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Danaher Corporation</name>
        <lei>S4BKK9OTCEWQ3YHPFM11</lei>
        <title>Danaher Corporation COM USD0.01</title>
        <cusip>235851102</cusip>
        <identifiers>
          <isin value="US2358511028"/>
          <ticker value="DHR"/>
          <other otherDesc="SEDOL" value="2250870"/>
        </identifiers>
        <balance>448567</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>85048303.2</valUSD>
        <pctVal>1.6364089258</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>DexCom Inc</name>
        <lei>549300YSK3QDSFR5EU59</lei>
        <title>DexCom Inc COM USD0.001</title>
        <cusip>252131107</cusip>
        <identifiers>
          <isin value="US2521311074"/>
          <ticker value="DXCM"/>
          <other otherDesc="SEDOL" value="B0796X4"/>
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        <balance>561491</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>35261634.8</valUSD>
        <pctVal>0.6784668448</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Dyne Therapeutics Inc.</name>
        <lei>N/A</lei>
        <title>Dyne Therapeutics Inc. COM</title>
        <cusip>26818M108</cusip>
        <identifiers>
          <isin value="US26818M1080"/>
          <ticker value="DYN"/>
          <other otherDesc="SEDOL" value="BN15WD1"/>
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        <balance>2528224</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>45836701.12</valUSD>
        <pctVal>0.8819410149</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Edgewise Therapeutics Inc.</name>
        <lei>N/A</lei>
        <title>Edgewise Therapeutics Inc. COM</title>
        <cusip>28036F105</cusip>
        <identifiers>
          <isin value="US28036F1057"/>
          <ticker value="EWTX"/>
          <other otherDesc="SEDOL" value="BKY5JZ8"/>
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        <balance>659507</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>20774470.5</valUSD>
        <pctVal>0.3997202493</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Edwards Lifesciences Corporation</name>
        <lei>YA13X31F3V31L8TMPR58</lei>
        <title>Edwards Lifesciences Corporation COM USD1</title>
        <cusip>28176E108</cusip>
        <identifiers>
          <isin value="US28176E1082"/>
          <ticker value="EW"/>
          <other otherDesc="SEDOL" value="2567116"/>
        </identifiers>
        <balance>465579</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>37283566.32</valUSD>
        <pctVal>0.7173706989</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Element Biosciences Inc</name>
        <lei>N/A</lei>
        <title>Element Biosciences Inc</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="DU0000104465"/>
          <ticker value="1726116D"/>
          <other otherDesc="Internal ID" value="3312013"/>
        </identifiers>
        <balance>425023</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>2461308.19</valUSD>
        <pctVal>0.0473578724</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EP</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>Y</isRestrictedSec>

        <fairValLevel>3</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Magnolia Medical Technologies</name>
        <lei>N/A</lei>
        <title>Magnolia Medical Technologies</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="DU0000105108"/>
          <other otherDesc="Internal ID" value="3334924"/>
        </identifiers>
        <balance>1</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>0</valUSD>
        <pctVal>0.0000000000</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>Y</isRestrictedSec>

        <fairValLevel>3</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Mirum Pharmaceuticals Inc</name>
        <lei>N/A</lei>
        <title>Mirum Pharmaceuticals Inc</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="DU0US0005655"/>
          <other otherDesc="Internal ID" value="3337087"/>
        </identifiers>
        <balance>123782</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>11434981.16</valUSD>
        <pctVal>0.2200197362</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Attralus Inc</name>
        <lei>N/A</lei>
        <title>Attralus Inc</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="DU0000104336"/>
          <ticker value="1829635D"/>
          <other otherDesc="Internal ID" value="3344845"/>
        </identifiers>
        <balance>669935</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>415359.7</valUSD>
        <pctVal>0.0079919092</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EP</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>Y</isRestrictedSec>

        <fairValLevel>3</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Novo Nordisk A/S</name>
        <lei>N/A</lei>
        <title>NOVO NORDISK A/S - CVR</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="DU0US0008635"/>
          <ticker value="2600057D"/>
          <other otherDesc="Internal ID" value="3347118"/>
        </identifiers>
        <balance>569281</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>370032.65</valUSD>
        <pctVal>0.0071197744</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetConditional assetCat="OTHER" desc="Rights"/>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>3</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Freenome Holdings Inc</name>
        <lei>N/A</lei>
        <title>Freenome Holdings Inc - Series D</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="DU0000104596"/>
          <ticker value="1411948D"/>
          <other otherDesc="Internal ID" value="3357975"/>
        </identifiers>
        <balance>342803</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>1016205.21</valUSD>
        <pctVal>0.0195527390</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EP</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>Y</isRestrictedSec>

        <fairValLevel>3</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Magnolia Medical Technologies</name>
        <lei>N/A</lei>
        <title>Magnolia Medical Technologies</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="DU0000105101"/>
          <ticker value="1426815D"/>
          <other otherDesc="Internal ID" value="3380143"/>
        </identifiers>
        <balance>1821717</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>2568620.97</valUSD>
        <pctVal>0.0494226707</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EP</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>Y</isRestrictedSec>

        <fairValLevel>3</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Asher Biotherapeutics Inc</name>
        <lei>N/A</lei>
        <title>Asher Biotherapeutics Inc</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="DU0000101918"/>
          <ticker value="1741988D"/>
          <other otherDesc="Internal ID" value="3921287"/>
        </identifiers>
        <balance>1214301</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>381108.37</valUSD>
        <pctVal>0.0073328816</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EP</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>Y</isRestrictedSec>

        <fairValLevel>3</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Freenome Holdings Inc</name>
        <lei>N/A</lei>
        <title>Freenome Holdings Inc - Series C</title>
        <cusip>N/A</cusip>
        <identifiers>
          <isin value="DU0000103893"/>
          <other otherDesc="Internal ID" value="3927974"/>
        </identifiers>
        <balance>337474</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>997910.62</valUSD>
        <pctVal>0.0192007340</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EP</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>Y</isRestrictedSec>

        <fairValLevel>3</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Eli Lilly &amp; Co.</name>
        <lei>FRDRIPF3EKNDJ2CQJL29</lei>
        <title>Eli Lilly &amp; Co. COM NPV</title>
        <cusip>532457108</cusip>
        <identifiers>
          <isin value="US5324571083"/>
          <ticker value="LLY"/>
          <other otherDesc="SEDOL" value="2516152"/>
        </identifiers>
        <balance>499479</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>459405799.83</valUSD>
        <pctVal>8.8393974142</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Madrigal Pharmaceuticals Inc</name>
        <lei>549300CHIMT2EUSNJB60</lei>
        <title>Madrigal Pharmaceuticals Inc USD0.0001</title>
        <cusip>558868105</cusip>
        <identifiers>
          <isin value="US5588681057"/>
          <ticker value="MDGL"/>
          <other otherDesc="SEDOL" value="BD59BS7"/>
        </identifiers>
        <balance>149195</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>78099106.65</valUSD>
        <pctVal>1.5026998824</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Medline Inc.</name>
        <lei>984500FAN6J1P8566D43</lei>
        <title>Medline Inc. COM CL A</title>
        <cusip>58507V107</cusip>
        <identifiers>
          <isin value="US58507V1070"/>
          <ticker value="MDLN"/>
          <other otherDesc="SEDOL" value="BNBV4B1"/>
        </identifiers>
        <balance>864511</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>38470739.5</valUSD>
        <pctVal>0.7402130217</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Mirum Pharmaceuticals Inc.</name>
        <lei>254900YZKR40F7F27K81</lei>
        <title>Mirum Pharmaceuticals Inc. COM USD0.0001</title>
        <cusip>604749101</cusip>
        <identifiers>
          <isin value="US6047491013"/>
          <ticker value="MIRM"/>
          <other otherDesc="SEDOL" value="BJDX8Y8"/>
        </identifiers>
        <balance>685482</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>63324827.16</valUSD>
        <pctVal>1.2184289220</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Neurocrine Biosciences Inc</name>
        <lei>549300FECER0XBN49756</lei>
        <title>Neurocrine Biosciences Inc COM USD0.001</title>
        <cusip>64125C109</cusip>
        <identifiers>
          <isin value="US64125C1099"/>
          <ticker value="NBIX"/>
          <other otherDesc="SEDOL" value="2623911"/>
        </identifiers>
        <balance>136901</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>18035337.74</valUSD>
        <pctVal>0.3470167722</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Novartis AG</name>
        <lei>5493007HIVTX6SY6XD66</lei>
        <title>Novartis AG ADR-REP 1 CHF0.5 (REGD)</title>
        <cusip>66987V109</cusip>
        <identifiers>
          <isin value="US66987V1098"/>
          <ticker value="NVS"/>
          <other otherDesc="SEDOL" value="2620105"/>
        </identifiers>
        <balance>971619</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>148414802.25</valUSD>
        <pctVal>2.8556396539</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetConditional assetCat="OTHER" desc="GDR"/>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Nuvalent Inc</name>
        <lei>N/A</lei>
        <title>Nuvalent Inc COM</title>
        <cusip>670703107</cusip>
        <identifiers>
          <isin value="US6707031075"/>
          <ticker value="NUVL"/>
          <other otherDesc="SEDOL" value="BMVBZD3"/>
        </identifiers>
        <balance>128313</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>13145666.85</valUSD>
        <pctVal>0.2529349294</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Daiichi Sankyo Co Ltd.</name>
        <lei>353800XGIU2IHQGC9504</lei>
        <title>Daiichi Sankyo Co Ltd. NPV</title>
        <cusip>J11257102</cusip>
        <identifiers>
          <isin value="JP3475350009"/>
          <ticker value="DSKYF"/>
          <other otherDesc="SEDOL" value="B0J7D91"/>
        </identifiers>
        <balance>1047000</balance>
        <units>NS</units>
        <currencyConditional curCd="JPY" exchangeRt="158.69"/>
        <valUSD>18460849.35</valUSD>
        <pctVal>0.3552040137</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>JP</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Biohaven Ltd</name>
        <lei>N/A</lei>
        <title>Biohaven Ltd COM</title>
        <cusip>G1110E107</cusip>
        <identifiers>
          <isin value="VGG1110E1079"/>
          <ticker value="BHVN"/>
          <other otherDesc="SEDOL" value="BPLZ7S5"/>
        </identifiers>
        <balance>2220238</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>18783213.48</valUSD>
        <pctVal>0.3614066012</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Medtronic PLC</name>
        <lei>549300GX3ZBSQWUXY261</lei>
        <title>Medtronic PLC USD0.0001</title>
        <cusip>G5960L103</cusip>
        <identifiers>
          <isin value="IE00BTN1Y115"/>
          <ticker value="MDT"/>
          <other otherDesc="SEDOL" value="BTN1Y11"/>
        </identifiers>
        <balance>583432</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>50554382.8</valUSD>
        <pctVal>0.9727136244</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Euro Member Countries Cash Balance</name>
        <lei>N/A</lei>
        <title>Euro Member Countries Cash Balance</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="Internal ID" value="EUR Cash"/>
        </identifiers>
        <balance>287.13</balance>
        <units>OU</units>
        <descOthUnits>Currency</descOthUnits>
        <currencyConditional curCd="EUR" exchangeRt="0.86528"/>
        <valUSD>287.13</valUSD>
        <pctVal>0.0000055246</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>STIV</assetCat>
        <issuerConditional desc="Foreign Currencies" issuerCat="OTHER"/>
        <invCountry>XX</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
      <invstOrSec>
        <name>Japan Yen Cash Balance</name>
        <lei>N/A</lei>
        <title>Japan Yen Cash Balance</title>
        <cusip>N/A</cusip>
        <identifiers>
          <other otherDesc="Internal ID" value="JPY Cash"/>
        </identifiers>
        <balance>21344</balance>
        <units>OU</units>
        <descOthUnits>Currency</descOthUnits>
        <currencyConditional curCd="JPY" exchangeRt="158.69"/>
        <valUSD>21344</valUSD>
        <pctVal>0.0004106785</pctVal>
        <payoffProfile>Long</payoffProfile>
        <assetCat>STIV</assetCat>
        <issuerConditional desc="Foreign Currencies" issuerCat="OTHER"/>
        <invCountry>JP</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
          <isNonCashCollateral>N</isNonCashCollateral>
          <isLoanByFund>N</isLoanByFund>
        </securityLending>
      </invstOrSec>
    </invstOrSecs>
    <explntrNotes>
      <explntrNote note="Monthly returns presented in Item B.5(a) have been calculated without deducting any applicable sales loads or redemption fees." noteItem="B.5.a"/>
    </explntrNotes>
    <signature>
      <ncom:dateSigned>2026-05-15</ncom:dateSigned>
      <ncom:nameOfApplicant>JANUS INVESTMENT FUND</ncom:nameOfApplicant>
      <ncom:signature>JESPER NERGAARD</ncom:signature>
      <ncom:signerName>JESPER NERGAARD</ncom:signerName>
      <ncom:title>VP, CFO, TREASURER, AND PRINCIPAL ACCOUNTING OFFICER</ncom:title>
    </signature>
  </formData>
</edgarSubmission>
