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      <invstOrSec>
        <name>Arrowhead Pharmaceuticals Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Addus HomeCare Corp</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Stemline Therapeutics Inc</name>
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      <invstOrSec>
        <name>Baxter International Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Atara Biotherapeutics Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>United Therapeutics Corp</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Laboratory Corp of America Holdings</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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        <name>Athenex Inc</name>
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        <assetCat>EC</assetCat>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Puma Biotechnology Inc</name>
        <lei>N/A</lei>
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        <assetCat>EC</assetCat>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Illumina Inc</name>
        <lei>SQ95QG8SR5Q56LSNF682</lei>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Syros Pharmaceuticals Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Patterson Cos Inc</name>
        <lei>YM48Q2087CUE26GWEK09</lei>
        <title>PATTERSON COS</title>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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        <name>NeoGenomics Inc</name>
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        <name>Inspire Medical Systems Inc</name>
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        <name>LeMaitre Vascular Inc</name>
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        <name>CRISPR Therapeutics AG</name>
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        <name>Blueprint Medicines Corp</name>
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        <name>Spectrum Pharmaceuticals Inc</name>
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        <name>Prothena Corp PLC</name>
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        <name>Amneal Pharmaceuticals Inc</name>
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        <name>Evolus Inc</name>
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        <name>Establishment Labs Holdings Inc</name>
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        <title>ESTABLISHMENT LA</title>
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        <name>Horizon Therapeutics Plc</name>
        <lei>529900P0GSQ79OOZEV53</lei>
        <title>HORIZON THERAPEU</title>
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        <isRestrictedSec>N</isRestrictedSec>

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        <name>Minerva Neurosciences Inc</name>
        <lei>54930017PANCHC5LYH79</lei>
        <title>MINERVA NEUROSCI</title>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Codexis Inc</name>
        <lei>N/A</lei>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Centene Corp</name>
        <lei>549300Z7JJ4TQSQGT333</lei>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Akorn Inc</name>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Emergent BioSolutions Inc</name>
        <lei>549300YW6TUOX8BE5103</lei>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Globus Medical Inc</name>
        <lei>5299003M2P4CIK0RF205</lei>
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        <assetCat>EC</assetCat>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Gossamer Bio Inc</name>
        <lei>549300ZOC0N2W6PSFR58</lei>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Eagle Pharmaceuticals Inc/DE</name>
        <lei>549300TN20OLYTJVP152</lei>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Zoetis Inc</name>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>GlycoMimetics Inc</name>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Option Care Health Inc</name>
        <lei>549300DI3Q5ACSYJRI17</lei>
        <title>OPTION CARE HEAL</title>
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        <assetCat>EC</assetCat>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Incyte Corp</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Tricida Inc</name>
        <lei>549300QVPFFJC8SZXG25</lei>
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        <balance>55801.00000000</balance>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Odonate Therapeutics Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

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      <invstOrSec>
        <name>Johnson &amp; Johnson</name>
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        <name>Surmodics Inc</name>
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        <name>Theravance Biopharma Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

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        <name>McKesson Corp</name>
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        <name>BioMarin Pharmaceutical Inc</name>
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        <name>Optinose Inc</name>
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        <name>Integra LifeSciences Holdings Corp</name>
        <lei>WB7IJCYY8YFTENS4O147</lei>
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        <name>Kala Pharmaceuticals Inc</name>
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        <name>Ionis Pharmaceuticals Inc</name>
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        <title>IONIS PHARMACEUT</title>
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        <name>R1 RCM Inc</name>
        <lei>549300VKOMJ3EM506212</lei>
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        <name>Five Prime Therapeutics Inc</name>
        <lei>549300Z652HXXGMB7V71</lei>
        <title>FIVE PRIME THERA</title>
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        <name>Glaukos Corp</name>
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        <name>Sangamo Therapeutics Inc</name>
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        <name>Exact Sciences Corp</name>
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        <name>HealthStream Inc</name>
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        <name>Vocera Communications Inc</name>
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        <name>iRhythm Technologies Inc</name>
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        <name>Bluebird Bio Inc</name>
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        <name>Corbus Pharmaceuticals Holdings Inc</name>
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        <name>Krystal Biotech Inc</name>
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        <name>Cantel Medical Corp</name>
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        <name>Triple-S Management Corp</name>
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        <name>Insulet Corp</name>
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        <name>Clovis Oncology Inc</name>
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        <name>Intuitive Surgical Inc</name>
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        <name>Mylan NV</name>
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        <name>Integer Holdings Corp</name>
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        <name>Global Blood Therapeutics Inc</name>
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        <name>Waters Corp</name>
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        <name>Haemonetics Corp</name>
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        <name>Geron Corp</name>
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        <name>Crinetics Pharmaceuticals Inc</name>
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        <name>Iovance Biotherapeutics Inc</name>
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        <name>Seattle Genetics Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Cardinal Health Inc</name>
        <lei>CCU46N3GJMF4OK4N7U60</lei>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Inovalon Holdings Inc</name>
        <lei>5493007H9QSF4NHIHL56</lei>
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          <isin value="US45781D1019"/>
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        <curCd>USD</curCd>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Medpace Holdings Inc</name>
        <lei>549300H8TYEUVTW14A54</lei>
        <title>MEDPACE HOLDINGS</title>
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          <isin value="US58506Q1094"/>
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        <curCd>USD</curCd>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>MacroGenics Inc</name>
        <lei>5493001KJQUA83L8MH79</lei>
        <title>MACROGENICS INC</title>
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          <isin value="US5560991094"/>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Arena Pharmaceuticals Inc</name>
        <lei>529900CVGQMPJ3A3NI85</lei>
        <title>ARENA PHARMACEUT</title>
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          <isin value="US0400476075"/>
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        <balance>146737.00000000</balance>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>MyoKardia Inc</name>
        <lei>549300OLNNNZ1NI9UY54</lei>
        <title>MYOKARDIA INC</title>
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          <isin value="US62857M1053"/>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Hanger Inc</name>
        <lei>254900ZJJJYVLHJXSZ60</lei>
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        <cusip>41043F208</cusip>
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          <isin value="US41043F2083"/>
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        <balance>95496.00000000</balance>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Xeris Pharmaceuticals Inc</name>
        <lei>5493001EPAB2LX05WW18</lei>
        <title>XERIS PHARMACEUT</title>
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          <isin value="US98422L1070"/>
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        <balance>86888.00000000</balance>
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        <curCd>USD</curCd>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>NuVasive Inc</name>
        <lei>549300C5ZB4NZ6TWM881</lei>
        <title>NUVASIVE INC</title>
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          <isin value="US6707041058"/>
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        <balance>145510.00000000</balance>
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        <curCd>USD</curCd>
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        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>Eli Lilly and Co</name>
        <lei>FRDRIPF3EKNDJ2CQJL29</lei>
        <title>ELI LILLY &amp; CO</title>
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          <isin value="US5324571083"/>
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        <balance>2414499.00000000</balance>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Gritstone Oncology Inc</name>
        <lei>5493003TER6KY3MUVY84</lei>
        <title>GRITSTONE ONCOLO</title>
        <cusip>39868T105</cusip>
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          <isin value="US39868T1051"/>
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        <balance>54473.00000000</balance>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>TherapeuticsMD Inc</name>
        <lei>5299004JS7RE49QHRW30</lei>
        <title>THERAPEUTICSMD</title>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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        <name>Penumbra Inc</name>
        <lei>549300RGE06P3ECANU72</lei>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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        <name>Quest Diagnostics Inc</name>
        <lei>8MCWUBXQ0WE04KMXBX50</lei>
        <title>QUEST DIAGNOSTIC</title>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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        <name>Concert Pharmaceuticals Inc</name>
        <lei>529900PYI5BSGQNATP82</lei>
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        <isRestrictedSec>N</isRestrictedSec>

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        <name>Cymabay Therapeutics Inc</name>
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        <title>CYMABAY THERAPEU</title>
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        <isRestrictedSec>N</isRestrictedSec>

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        <name>Kodiak Sciences Inc</name>
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        <name>Ironwood Pharmaceuticals Inc</name>
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        <name>Intersect ENT Inc</name>
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        <name>Encompass Health Corp</name>
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        <name>Immunomedics Inc</name>
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        <name>Dynavax Technologies Corp</name>
        <lei>549300T5URIXWDILX594</lei>
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        <name>Collegium Pharmaceutical Inc</name>
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        <assetCat>EC</assetCat>
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        <name>Homology Medicines Inc</name>
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        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Vanguard Cmt Funds-Vanguard Market Liquidity Fund</name>
        <lei>1I6HV0TLSTR3A4XQ6L78</lei>
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        <cusip>N/A</cusip>
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        <assetCat>STIV</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Community Health Systems Inc</name>
        <lei>N/A</lei>
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        <curCd>USD</curCd>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Tivity Health Inc</name>
        <lei>U5UKZMHGMOP0CPFG4B24</lei>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Denali Therapeutics Inc</name>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Ensign Group Inc/The</name>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>CryoLife Inc</name>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Covetrus Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Eloxx Pharmaceuticals Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>NextGen Healthcare Inc</name>
        <lei>N/A</lei>
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          <isin value="US65343C1027"/>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>G1 Therapeutics Inc</name>
        <lei>529900TC35UPZQYRKW13</lei>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Akcea Therapeutics Inc</name>
        <lei>5299005MBXDP2HBTJY60</lei>
        <title>AKCEA THERAPEUTI</title>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
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      <invstOrSec>
        <name>Cigna Corp</name>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Magellan Health Inc</name>
        <lei>N/A</lei>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Anthem Inc</name>
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        <name>Heska Corp</name>
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        <assetCat>EC</assetCat>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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        <name>Bio-Rad Laboratories Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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        <name>Cardiovascular Systems Inc</name>
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        <name>Tabula Rasa HealthCare Inc</name>
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        <name>Cyclerion Therapeutics Inc</name>
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        <name>Danaher Corp</name>
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        <name>Lexicon Pharmaceuticals Inc</name>
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        <name>Cerus Corp</name>
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        <name>Thermo Fisher Scientific Inc</name>
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        <title>THERMO FISHER</title>
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        <name>CVS Health Corp</name>
        <lei>549300EJG376EN5NQE29</lei>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

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      <invstOrSec>
        <name>Natera Inc</name>
        <lei>N/A</lei>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Castlight Health Inc</name>
        <lei>549300K52FAO83JL0L06</lei>
        <title>CASTLIGHT HEAL-B</title>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Biohaven Pharmaceutical Holding Co Ltd</name>
        <lei>5299007STZTNN32O9920</lei>
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        <cusip>G11196105</cusip>
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          <isin value="VGG111961055"/>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Amphastar Pharmaceuticals Inc</name>
        <lei>54930055TH0ZLSAQMJ38</lei>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Axsome Therapeutics Inc</name>
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          <isin value="US05464T1043"/>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Accelerate Diagnostics Inc</name>
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          <isin value="US00430H1023"/>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Alder Biopharmaceuticals Inc</name>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>3</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Align Technology Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>HMS Holdings Corp</name>
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          <isin value="US40425J1016"/>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Silk Road Medical Inc</name>
        <lei>549300VL8KC0ZPDQHE14</lei>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>ICU Medical Inc</name>
        <lei>5493003NRW7LS2QZRH60</lei>
        <title>ICU MEDICAL</title>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Veeva Systems Inc</name>
        <lei>549300YZEXPDB92M2F02</lei>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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        <name>Avantor Inc</name>
        <lei>5493003VM0XB4U8YD238</lei>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Regeneron Pharmaceuticals Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Cooper Cos Inc/The</name>
        <lei>QJKMVPIGLH7530PCUE20</lei>
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        <assetCat>EC</assetCat>
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        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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        <name>Pacira BioSciences Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

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        <name>GenMark Diagnostics Inc</name>
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        <title>GENMARK DIAGNOST</title>
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        <name>Edwards Lifesciences Corp</name>
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        <title>EDWARDS LIFE</title>
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        <name>Zimmer Biomet Holdings Inc</name>
        <lei>2P2YLDVPES3BXQ1FRB91</lei>
        <title>ZIMMER BIOMET HO</title>
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        <name>Translate Bio Inc</name>
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        <name>Myovant Sciences Ltd</name>
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        <title>MYOVANT SCIENCES</title>
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        <name>BioCryst Pharmaceuticals Inc</name>
        <lei>549300Z0INP1Z5NP6J59</lei>
        <title>BIOCRYST PHARM</title>
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        <name>Novocure Ltd</name>
        <lei>213800YPP55UMHWA4826</lei>
        <title>NOVOCURE LTD</title>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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        <name>Dicerna Pharmaceuticals Inc</name>
        <lei>549300CTZMJMPH28WN39</lei>
        <title>DICERNA PHARMACE</title>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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        <name>Inovio Pharmaceuticals Inc</name>
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        <name>National Research Corp</name>
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      <invstOrSec>
        <name>ImmunoGen Inc</name>
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      <invstOrSec>
        <name>Premier Inc</name>
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      <invstOrSec>
        <name>Viking Therapeutics Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

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        <name>Flexion Therapeutics Inc</name>
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        <name>Quanterix Corp</name>
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        <name>Invacare Corp</name>
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        <fairValLevel>1</fairValLevel>
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        <name>Rhythm Pharmaceuticals Inc</name>
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      <invstOrSec>
        <name>Brookdale Senior Living Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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        <name>Hologic Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Acceleron Pharma Inc</name>
        <lei>529900TQRID2UY164805</lei>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>AnaptysBio Inc</name>
        <lei>529900HH4WQT03IG1A12</lei>
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        <name>Corcept Therapeutics Inc</name>
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        <name>Guardant Health Inc</name>
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        <name>Precigen Inc</name>
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        <name>Intra-Cellular Therapies Inc</name>
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        <name>Nektar Therapeutics</name>
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        <name>Advaxis Inc</name>
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        <name>Gilead Sciences Inc</name>
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        <name>Accuray Inc</name>
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        <name>Heron Therapeutics Inc</name>
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        <name>MEDNAX Inc</name>
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        <name>Universal Health Services Inc</name>
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        <name>Principia Biopharma Inc</name>
        <lei>549300WHPKRLU16IRE69</lei>
        <title>PRINCIPIA BIOPHA</title>
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        <name>DENTSPLY SIRONA Inc</name>
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      <invstOrSec>
        <name>AMAG Pharmaceuticals Inc</name>
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      <invstOrSec>
        <name>OPKO Health Inc</name>
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        <name>Acadia Healthcare Co Inc</name>
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        <name>Envista Holdings Corp</name>
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        <isRestrictedSec>N</isRestrictedSec>

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        <name>Molina Healthcare Inc</name>
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        <name>Halozyme Therapeutics Inc</name>
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      <invstOrSec>
        <name>ANI Pharmaceuticals Inc</name>
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        <name>Innoviva Inc</name>
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        <name>Supernus Pharmaceuticals Inc</name>
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        <name>Mirati Therapeutics Inc</name>
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        <name>NextCure Inc</name>
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        <name>BioTelemetry Inc</name>
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        <name>Kadmon Holdings Inc</name>
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        <name>Inogen Inc</name>
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        <name>Exelixis Inc</name>
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        <name>Biogen Inc</name>
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        <name>Agilent Technologies Inc</name>
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        <name>CytomX Therapeutics Inc</name>
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        <name>Elanco Animal Health Inc</name>
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        <title>ELANCO ANIMAL HE</title>
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        <name>Alexion Pharmaceuticals Inc</name>
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        <name>Charles River Laboratories International Inc</name>
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        <name>Avalon GloboCare Corp</name>
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        <name>Hill-Rom Holdings Inc</name>
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        <name>Antares Pharma Inc</name>
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        <name>PhaseBio Pharmaceuticals Inc</name>
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        <name>Providence Service Corp/The</name>
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        <name>Assembly Biosciences Inc</name>
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        <name>Intellia Therapeutics Inc</name>
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        <name>ChemoCentryx Inc</name>
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        <name>Kura Oncology Inc</name>
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        <name>Radius Health Inc</name>
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        <name>Humana Inc</name>
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        <name>Omnicell Inc</name>
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        <name>Tilray Inc</name>
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        <name>PRA Health Sciences Inc</name>
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        <name>SIGA Technologies Inc</name>
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        <name>Chemed Corp</name>
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        <name>National HealthCare Corp</name>
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        <name>Marker Therapeutics Inc</name>
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        <name>PDL BioPharma Inc</name>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>PerkinElmer Inc</name>
        <lei>549300IKL1SDPFI7N655</lei>
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        <cusip>714046109</cusip>
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          <isin value="US7140461093"/>
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        <balance>307101.00000000</balance>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>Avanos Medical Inc</name>
        <lei>549300YCXWOM7NEWMQ58</lei>
        <title>AVANOS MEDICAL I</title>
        <cusip>05350V106</cusip>
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          <isin value="US05350V1061"/>
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        <balance>132422.00000000</balance>
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        <curCd>USD</curCd>
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        <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>Phibro Animal Health Corp</name>
        <lei>549300U24SP4AF2JUX52</lei>
        <title>PHIBRO ANIMAL-A</title>
        <cusip>71742Q106</cusip>
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          <isin value="US71742Q1067"/>
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        <balance>56012.00000000</balance>
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        <curCd>USD</curCd>
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        <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>Amedisys Inc</name>
        <lei>5299001RBS9GK9STN379</lei>
        <title>AMEDISYS INC</title>
        <cusip>023436108</cusip>
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          <isin value="US0234361089"/>
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        <balance>90092.00000000</balance>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
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        <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>Jazz Pharmaceuticals PLC</name>
        <lei>635400GAUMJCLEZRRV50</lei>
        <title>JAZZ PHARMACEUTI</title>
        <cusip>G50871105</cusip>
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          <isin value="IE00B4Q5ZN47"/>
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        <balance>158173.00000000</balance>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
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        <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>FibroGen Inc</name>
        <lei>549300Q914ULWWY95822</lei>
        <title>FIBROGEN INC</title>
        <cusip>31572Q808</cusip>
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          <isin value="US31572Q8087"/>
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        <balance>218116.00000000</balance>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Forest Laboratories Inc</name>
        <lei>5493007MEBIHDTVX7474</lei>
        <title>CLINICAL DATA IN</title>
        <cusip>187CVR998</cusip>
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          <other otherDesc="VID" value="V1002011601"/>
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        <balance>8685.00000000</balance>
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        <curCd>USD</curCd>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>3</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Henry Schein Inc</name>
        <lei>VGO3WGL8H45T73F4RR92</lei>
        <title>HENRY SCHEIN INC</title>
        <cusip>806407102</cusip>
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          <isin value="US8064071025"/>
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        <balance>410697.00000000</balance>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Bio-Techne Corp</name>
        <lei>54930073RLKQ51TILZ35</lei>
        <title>BIO-TECHNE CORP</title>
        <cusip>09073M104</cusip>
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          <isin value="US09073M1045"/>
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        <balance>105749.00000000</balance>
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        <curCd>USD</curCd>
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        <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>Lantheus Holdings Inc</name>
        <lei>5299005HUB5IOJGO7S39</lei>
        <title>LANTHEUS HOLDING</title>
        <cusip>516544103</cusip>
        <identifiers>
          <isin value="US5165441032"/>
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        <balance>108417.00000000</balance>
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        <curCd>USD</curCd>
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        <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>CryoPort Inc</name>
        <lei>N/A</lei>
        <title>CRYOPORT</title>
        <cusip>229050307</cusip>
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          <isin value="US2290503075"/>
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        <balance>99280.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>Ligand Pharmaceuticals Inc</name>
        <lei>5493008K7TB0IKP37H79</lei>
        <title>LIGAND PHARM</title>
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          <isin value="US53220K5048"/>
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        <balance>49107.00000000</balance>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Vanguard Cmt Funds-Vanguard Market Liquidity Fund</name>
        <lei>1I6HV0TLSTR3A4XQ6L78</lei>
        <title>Vanguard Market Liquidity Fund</title>
        <cusip>N/A</cusip>
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          <other otherDesc="FAID" value="CMT001142"/>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>STIV</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Tandem Diabetes Care Inc</name>
        <lei>549300JEPFOD0K4D3I05</lei>
        <title>TANDEM DIABETES</title>
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        <balance>148021.00000000</balance>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Portola Pharmaceuticals Inc</name>
        <lei>549300BM3O4O0CNBGJ64</lei>
        <title>PORTOLA PHARMACE</title>
        <cusip>737010108</cusip>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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        <name>Meridian Bioscience Inc</name>
        <lei>549300ELSRZEFFFRX195</lei>
        <title>MERIDIAN BIOSCI</title>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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        <name>Natus Medical Inc</name>
        <lei>549300ZW3JLSJGT2D838</lei>
        <title>NATUS MEDICAL</title>
        <cusip>639050103</cusip>
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        <assetCat>EC</assetCat>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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        <name>US Physical Therapy Inc</name>
        <lei>N/A</lei>
        <title>US PHYSICAL THER</title>
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        <assetCat>EC</assetCat>
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        <name>Rigel Pharmaceuticals Inc</name>
        <lei>529900KPTNUS5J8K9K66</lei>
        <title>RIGEL PHARMACEUT</title>
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        <name>Varex Imaging Corp</name>
        <lei>549300CWYWPVCT8E9W67</lei>
        <title>VAREX IMAGIN</title>
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        <assetCat>EC</assetCat>
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        <name>Neogen Corp</name>
        <lei>549300HJT9FC36N4UW43</lei>
        <title>NEOGEN CORP</title>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

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        <name>Varian Medical Systems Inc</name>
        <lei>TK3LAKL7I0QNTCVWSY07</lei>
        <title>VARIAN MEDICAL S</title>
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        <name>Kiniksa Pharmaceuticals Ltd</name>
        <lei>N/A</lei>
        <title>KINIKSA PHARMA-A</title>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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        <name>Coherus Biosciences Inc</name>
        <lei>5493007IL8W5MV932D26</lei>
        <title>COHERUS BIOSCIEN</title>
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        <assetCat>EC</assetCat>
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        <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>Catalent Inc</name>
        <lei>N/A</lei>
        <title>CATALENT INC</title>
        <cusip>148806102</cusip>
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          <isin value="US1488061029"/>
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        <balance>408850.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>31779910.50000000</valUSD>
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        <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>Y-mAbs Therapeutics Inc</name>
        <lei>N/A</lei>
        <title>Y-MABS THERAPEUT</title>
        <cusip>984241109</cusip>
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          <isin value="US9842411095"/>
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        <balance>54251.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
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        <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>STAAR Surgical Co</name>
        <lei>5299006LRHI7OJ8BY308</lei>
        <title>STAAR SURGICAL</title>
        <cusip>852312305</cusip>
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          <isin value="US8523123052"/>
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        <balance>93757.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
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        <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>LivaNova PLC</name>
        <lei>2138001K2FX6SHK2B339</lei>
        <title>LIVANOVA PLC</title>
        <cusip>G5509L101</cusip>
        <identifiers>
          <isin value="GB00BYMT0J19"/>
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        <balance>135323.00000000</balance>
        <units>NS</units>
        <curCd>USD</curCd>
        <valUSD>7238427.27000000</valUSD>
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        <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>Solid Biosciences Inc</name>
        <lei>N/A</lei>
        <title>SOLID BIOSCIENCE</title>
        <cusip>83422E105</cusip>
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          <isin value="US83422E1055"/>
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        <balance>57516.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>169672.20000000</valUSD>
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        <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>Vanda Pharmaceuticals Inc</name>
        <lei>529900AY8VOOQBKJ0O70</lei>
        <title>VANDA PHARMACEUT</title>
        <cusip>921659108</cusip>
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          <isin value="US9216591084"/>
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        <balance>130871.00000000</balance>
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        <curCd>USD</curCd>
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        <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>Agenus Inc</name>
        <lei>529900NDQQGU5H4UJK81</lei>
        <title>AGENUS INC</title>
        <cusip>00847G705</cusip>
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          <isin value="US00847G7051"/>
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        <balance>314476.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>1172995.48000000</valUSD>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>Madrigal Pharmaceuticals Inc</name>
        <lei>549300CHIMT2EUSNJB60</lei>
        <title>MADRIGAL PHARMAC</title>
        <cusip>558868105</cusip>
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          <isin value="US5588681057"/>
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        <balance>23464.00000000</balance>
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        <curCd>USD</curCd>
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        <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>
          <loanByFundCondition isLoanByFund="Y" loanVal="2448022.00000000"/>
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      <invstOrSec>
        <name>TCR2 Therapeutics Inc</name>
        <lei>5493007TR1ORJAZ8YK34</lei>
        <title>TCR2 THERAPEUTIC</title>
        <cusip>87808K106</cusip>
        <identifiers>
          <isin value="US87808K1060"/>
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        <balance>29427.00000000</balance>
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        <curCd>USD</curCd>
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        <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>Change Healthcare Inc</name>
        <lei>549300GS1BPJEDOZHM07</lei>
        <title>CHANGE HEALTHCAR</title>
        <cusip>15912K100</cusip>
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          <isin value="US15912K1007"/>
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        <balance>629664.00000000</balance>
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        <curCd>USD</curCd>
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        <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>CareDx Inc</name>
        <lei>549300NQOFKL9NON0U06</lei>
        <title>CAREDX INC</title>
        <cusip>14167L103</cusip>
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          <isin value="US14167L1035"/>
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        <balance>105628.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>3392771.36000000</valUSD>
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        <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>Syneos Health Inc</name>
        <lei>549300F1ZGKDS8P6GU13</lei>
        <title>SYNEOS HEALTH IN</title>
        <cusip>87166B102</cusip>
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          <isin value="US87166B1026"/>
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        <balance>172193.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>10502051.07000000</valUSD>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>Neuronetics Inc</name>
        <lei>549300T0911ILTTG7P06</lei>
        <title>NEURONETICS INC</title>
        <cusip>64131A105</cusip>
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        <balance>23353.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>42735.99000000</valUSD>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>AbbVie Inc</name>
        <lei>FR5LCKFTG8054YNNRU85</lei>
        <title>ABBVIE INC</title>
        <cusip>00287Y109</cusip>
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        <balance>4751878.00000000</balance>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>AngioDynamics Inc</name>
        <lei>549300W3VKC5ZKMO8C28</lei>
        <title>ANGIODYNAMICS IN</title>
        <cusip>03475V101</cusip>
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        <balance>103928.00000000</balance>
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        <curCd>USD</curCd>
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        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Sarepta Therapeutics Inc</name>
        <lei>549300IKDPIED8J8IG21</lei>
        <title>SAREPTA THERAPEU</title>
        <cusip>803607100</cusip>
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        <balance>208265.00000000</balance>
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        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Nevro Corp</name>
        <lei>254900SH91I4BOYKUE38</lei>
        <title>NEVRO CORP</title>
        <cusip>64157F103</cusip>
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        <balance>86967.00000000</balance>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>STERIS PLC</name>
        <lei>N/A</lei>
        <title>STERIS PLC</title>
        <cusip>G8473T100</cusip>
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        <balance>237230.00000000</balance>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Amicus Therapeutics Inc</name>
        <lei>549300MRD1SMUTNBPQ53</lei>
        <title>AMICUS THERAPEUT</title>
        <cusip>03152W109</cusip>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>LHC Group Inc</name>
        <lei>5299009NPLWAMRQYZX73</lei>
        <title>LHC GROUP INC</title>
        <cusip>50187A107</cusip>
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        <curCd>USD</curCd>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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        <name>Allscripts Healthcare Solutions Inc</name>
        <lei>Y68YJHVB1GU4TAU3C223</lei>
        <title>ALLSCRIPTS HEALT</title>
        <cusip>01988P108</cusip>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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        <name>Anika Therapeutics Inc</name>
        <lei>529900R9LS3Z0O6QH455</lei>
        <title>ANIKA THERAPEUTI</title>
        <cusip>035255108</cusip>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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        <name>Arvinas Inc</name>
        <lei>N/A</lei>
        <title>ARVINAS INC</title>
        <cusip>04335A105</cusip>
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        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
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      <invstOrSec>
        <name>Pennant Group Inc/The</name>
        <lei>5493007H2OYR6BYLDA64</lei>
        <title>PENNANT GROUP-WI</title>
        <cusip>70805E109</cusip>
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        <balance>73169.00000000</balance>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isNonCashCollateral>N</isNonCashCollateral>
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      </invstOrSec>
      <invstOrSec>
        <name>Fate Therapeutics Inc</name>
        <lei>549300L14Q4UHOODLA90</lei>
        <title>FATE THERAPEUTIC</title>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>ViewRay Inc</name>
        <lei>5493006XTUBSKFU3W106</lei>
        <title>VIEWRAY INC</title>
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          <isin value="US92672L1070"/>
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        <balance>310388.00000000</balance>
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        <curCd>USD</curCd>
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        <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>
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      </invstOrSec>
      <invstOrSec>
        <name>Simulations Plus Inc</name>
        <lei>N/A</lei>
        <title>SIMULATIONS PLUS</title>
        <cusip>829214105</cusip>
        <identifiers>
          <isin value="US8292141053"/>
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        <balance>35031.00000000</balance>
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        <curCd>USD</curCd>
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        <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>Endo International PLC</name>
        <lei>5493007TBMWZWGZIB256</lei>
        <title>ENDO INTERNATION</title>
        <cusip>G30401106</cusip>
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          <isin value="IE00BJ3V9050"/>
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        <balance>562919.00000000</balance>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>Progenics Pharmaceuticals Inc</name>
        <lei>5299005B0KKBVJ0B2156</lei>
        <title>PROGENICS PHARM</title>
        <cusip>743187106</cusip>
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          <isin value="US7431871067"/>
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        <balance>239039.00000000</balance>
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        <curCd>USD</curCd>
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        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>Repligen Corp</name>
        <lei>54930006QJ0T5AUO1E71</lei>
        <title>REPLIGEN CORP</title>
        <cusip>759916109</cusip>
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          <isin value="US7599161095"/>
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        <balance>130098.00000000</balance>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>Xencor Inc</name>
        <lei>549300V5IF65437JKG30</lei>
        <title>XENCOR INC</title>
        <cusip>98401F105</cusip>
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          <isin value="US98401F1057"/>
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        <balance>141292.00000000</balance>
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        <curCd>USD</curCd>
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        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>Orthofix Medical Inc</name>
        <lei>N/A</lei>
        <title>ORTHOFIX MEDICAL</title>
        <cusip>68752M108</cusip>
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          <isin value="US68752M1080"/>
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        <balance>52702.00000000</balance>
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        <curCd>USD</curCd>
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        <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>West Pharmaceutical Services Inc</name>
        <lei>5493007NKRGM1RJQ1P16</lei>
        <title>WEST PHARMACEUT</title>
        <cusip>955306105</cusip>
        <identifiers>
          <isin value="US9553061055"/>
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        <balance>206952.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>44709910.08000000</valUSD>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>Scholar Rock Holding Corp</name>
        <lei>549300Z1FLPGL4OWJ459</lei>
        <title>SCHOLAR ROCK HOL</title>
        <cusip>80706P103</cusip>
        <identifiers>
          <isin value="US80706P1030"/>
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        <balance>53341.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>981474.40000000</valUSD>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>MediciNova Inc</name>
        <lei>N/A</lei>
        <title>MEDICINOVA INC</title>
        <cusip>58468P206</cusip>
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          <isin value="US58468P2065"/>
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        <balance>104976.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>560571.84000000</valUSD>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>Akero Therapeutics Inc</name>
        <lei>549300SI3KG74LBE2955</lei>
        <title>AKERO THERAPEUTI</title>
        <cusip>00973Y108</cusip>
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          <isin value="US00973Y1082"/>
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        <balance>27847.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>707870.74000000</valUSD>
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        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>AMN Healthcare Services Inc</name>
        <lei>529900W3ARRTCNFH2I39</lei>
        <title>AMN HEALTHCARE</title>
        <cusip>001744101</cusip>
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          <isin value="US0017441017"/>
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        <balance>130961.00000000</balance>
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        <curCd>USD</curCd>
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        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>ZIOPHARM Oncology Inc</name>
        <lei>N/A</lei>
        <title>ZIOPHARM ONCOLOG</title>
        <cusip>98973P101</cusip>
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        <balance>576123.00000000</balance>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Sorrento Therapeutics Inc</name>
        <lei>549300RH23PRR3M13410</lei>
        <title>SORRENTO THERAPE</title>
        <cusip>83587F202</cusip>
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        <balance>301192.00000000</balance>
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        <curCd>USD</curCd>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>UnitedHealth Group Inc</name>
        <lei>549300GHBMY8T5GXDE41</lei>
        <title>UNITEDHEALTH GRP</title>
        <cusip>91324P102</cusip>
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          <isin value="US91324P1021"/>
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        <balance>2647322.00000000</balance>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>IQVIA Holdings Inc</name>
        <lei>549300W3R20NM4KQPH86</lei>
        <title>IQVIA HOLDINGS I</title>
        <cusip>46266C105</cusip>
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          <isin value="US46266C1053"/>
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        <balance>459315.00000000</balance>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>CorVel Corp</name>
        <lei>N/A</lei>
        <title>CORVEL CORP</title>
        <cusip>221006109</cusip>
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        <assetCat>EC</assetCat>
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        <name>PTC Therapeutics Inc</name>
        <lei>549300UJLWOIWFDGB318</lei>
        <title>PTC THERAPEUTICS</title>
        <cusip>69366J200</cusip>
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        <assetCat>EC</assetCat>
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      <invstOrSec>
        <name>Alkermes PLC</name>
        <lei>N/A</lei>
        <title>ALKERMES PLC</title>
        <cusip>G01767105</cusip>
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        <assetCat>EC</assetCat>
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        <isRestrictedSec>N</isRestrictedSec>

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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>AtriCure Inc</name>
        <lei>N/A</lei>
        <title>ATRICURE INC</title>
        <cusip>04963C209</cusip>
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        <assetCat>EC</assetCat>
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        <isRestrictedSec>N</isRestrictedSec>

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          <isCashCollateral>N</isCashCollateral>
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        <name>Tactile Systems Technology Inc</name>
        <lei>54930069VDTITHOTKJ98</lei>
        <title>TACTILE SYSTEMS</title>
        <cusip>87357P100</cusip>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Abbott Laboratories</name>
        <lei>HQD377W2YR662HK5JX27</lei>
        <title>ABBOTT LABS</title>
        <cusip>002824100</cusip>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Prevail Therapeutics Inc</name>
        <lei>N/A</lei>
        <title>PREVAIL THERAPEU</title>
        <cusip>74140Y101</cusip>
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        <balance>28514.00000000</balance>
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        <valUSD>475613.52000000</valUSD>
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        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Boston Scientific Corp</name>
        <lei>Y6ZDD9FP4P8JSSJMW954</lei>
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        <name>DaVita Inc</name>
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        <name>Cerner Corp</name>
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        <name>Pfizer Inc</name>
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        <name>Cross Country Healthcare Inc</name>
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        <name>Rocket Pharmaceuticals Inc</name>
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        <name>uniQure NV</name>
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        <name>Vertex Pharmaceuticals Inc</name>
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        <name>IDEXX Laboratories Inc</name>
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        <name>Revance Therapeutics Inc</name>
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        <name>Alnylam Pharmaceuticals Inc</name>
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        <name>Pacific Biosciences of California Inc</name>
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        <name>Aerie Pharmaceuticals Inc</name>
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        <name>REGENXBIO Inc</name>
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        <name>Mettler-Toledo International Inc</name>
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        <name>Ultragenyx Pharmaceutical Inc</name>
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        <name>Karuna Therapeutics Inc</name>
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        <name>Insmed Inc</name>
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        <name>OrthoPediatrics Corp</name>
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      <invstOrSec>
        <name>TransMedics Group Inc</name>
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        <name>ACADIA Pharmaceuticals Inc</name>
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        <name>Reata Pharmaceuticals Inc</name>
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        <name>Neurocrine Biosciences Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

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        <name>Omeros Corp</name>
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        <name>Masimo Corp</name>
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        <name>Luminex Corp</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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      <invstOrSec>
        <name>Precision BioSciences Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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        <name>Calyxt Inc</name>
        <lei>N/A</lei>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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        <name>Teladoc Health Inc</name>
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        <fairValLevel>1</fairValLevel>
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        <name>Allogene Therapeutics Inc</name>
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        <name>Select Medical Holdings Corp</name>
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        <name>Morphic Holding Inc</name>
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        <name>Agios Pharmaceuticals Inc</name>
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        <name>Zogenix Inc</name>
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        <name>OraSure Technologies Inc</name>
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        <name>Personalis Inc</name>
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        <name>MeiraGTx Holdings plc</name>
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        <name>Surgery Partners Inc</name>
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        <name>Aimmune Therapeutics Inc</name>
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        <name>WaVe Life Sciences Ltd</name>
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        <name>KalVista Pharmaceuticals Inc</name>
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        <name>DexCom Inc</name>
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        <title>DEXCOM</title>
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        <issuerCat>CORP</issuerCat>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Axogen Inc</name>
        <lei>N/A</lei>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Vericel Corp</name>
        <lei>54930076YM3PLTDR4B91</lei>
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          <isin value="US92346J1088"/>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Akebia Therapeutics Inc</name>
        <lei>549300CBQEHMKEEGNX42</lei>
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          <isin value="US00972D1054"/>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Computer Programs and Systems Inc</name>
        <lei>5493005Q6CJC78TGL805</lei>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Teleflex Inc</name>
        <lei>UUL85LWXB4NGSWWXIQ25</lei>
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          <isin value="US8793691069"/>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Bruker Corp</name>
        <lei>LEBZ6VLQ6I8XB1NHVY15</lei>
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          <isin value="US1167941087"/>
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        <curCd>USD</curCd>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Wright Medical Group NV</name>
        <lei>549300JGCCQ1HTDOXU32</lei>
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          <isin value="NL0011327523"/>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Acorda Therapeutics Inc</name>
        <lei>5493007NPB5YRM8QGL53</lei>
        <title>ACORDA THERAPEUT</title>
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        <curCd>USD</curCd>
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        <assetCat>EC</assetCat>
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        <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>Perrigo Co PLC</name>
        <lei>549300IFOQS6R1QLY196</lei>
        <title>PERRIGO CO PLC</title>
        <cusip>G97822103</cusip>
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          <isin value="IE00BGH1M568"/>
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        <balance>361379.00000000</balance>
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        <curCd>USD</curCd>
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        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>AmerisourceBergen Corp</name>
        <lei>AI8GXW8LG5WK7E9UD086</lei>
        <title>AMERISOURCEBERGE</title>
        <cusip>03073E105</cusip>
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          <isin value="US03073E1055"/>
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        <balance>431340.00000000</balance>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Turning Point Therapeutics Inc</name>
        <lei>N/A</lei>
        <title>TURNING POINT TH</title>
        <cusip>90041T108</cusip>
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          <isin value="US90041T1088"/>
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        <balance>65641.00000000</balance>
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        <curCd>USD</curCd>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>Retrophin Inc</name>
        <lei>N/A</lei>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>Apollo Medical Holdings Inc</name>
        <lei>5493008O4R82Q4STJ936</lei>
        <title>APOLLO MEDICAL H</title>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Cara Therapeutics Inc</name>
        <lei>549300COVOY41P0GZ881</lei>
        <title>CARA THERAPEUTIC</title>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>SI-BONE Inc</name>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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        <name>Quidel Corp</name>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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        <name>ResMed Inc</name>
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        <title>RESMED INC</title>
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        <fairValLevel>1</fairValLevel>
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        <name>Voyager Therapeutics Inc</name>
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        <name>HCA Healthcare Inc</name>
        <lei>529900PH4ZGUH2MNEU89</lei>
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        <name>Allakos Inc</name>
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        <name>Tenet Healthcare Corp</name>
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        <title>TENET HEALTHCARE</title>
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        <name>PetIQ Inc</name>
        <lei>549300GROACFGKVYOX14</lei>
        <title>PETIQ INC</title>
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        <name>ABIOMED Inc</name>
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        <title>ABIOMED INC</title>
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        <isRestrictedSec>N</isRestrictedSec>

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        <name>Replimune Group Inc</name>
        <lei>549300AY704NEIRC4K64</lei>
        <title>REPLIMUNE GROUP</title>
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        <assetCat>EC</assetCat>
        <issuerCat>CORP</issuerCat>
        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

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        <name>Editas Medicine Inc</name>
        <lei>5299000AON4Q9NT2JE42</lei>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
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        <lei>5493000JX4BJS9W6CN35</lei>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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        <name>CONMED Corp</name>
        <lei>Z6C0YCECH9DCU5ZIQW84</lei>
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          <isin value="US2074101013"/>
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        <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>Shockwave Medical Inc</name>
        <lei>549300LDXO56IC5Y1538</lei>
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        <cusip>82489T104</cusip>
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          <isin value="US82489T1043"/>
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        <balance>21428.00000000</balance>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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        <name>Bristol-Myers Squibb Co</name>
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          <isin value="US1101221083"/>
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        <balance>6551254.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>391240888.88000000</valUSD>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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      <invstOrSec>
        <name>Cytokinetics Inc</name>
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          <isin value="US23282W6057"/>
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        <balance>139699.00000000</balance>
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        <curCd>USD</curCd>
        <valUSD>2893166.29000000</valUSD>
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        <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>TG Therapeutics Inc</name>
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          <isin value="US88322Q1085"/>
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        <balance>250427.00000000</balance>
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        <curCd>USD</curCd>
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        <payoffProfile>Long</payoffProfile>
        <assetCat>EC</assetCat>
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        <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>Mesa Laboratories Inc</name>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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        <name>Invitae Corp</name>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Avrobio Inc</name>
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        <assetCat>EC</assetCat>
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        <invCountry>US</invCountry>

        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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      <invstOrSec>
        <name>Axonics Modulation Technologies Inc</name>
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        <assetCat>EC</assetCat>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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        <name>Veracyte Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

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        <fairValLevel>1</fairValLevel>
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        <name>Medtronic PLC</name>
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        <assetCat>EC</assetCat>
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        <fairValLevel>1</fairValLevel>
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        <name>N/A</name>
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        <title>Receive ABBVIE INC Pay ICE LIBOR USD 1 Month</title>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>2</fairValLevel>
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        <name>Prestige Consumer Healthcare Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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        <name>Evofem Biosciences Inc</name>
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        <assetCat>EC</assetCat>
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        <isRestrictedSec>N</isRestrictedSec>

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        <name>Enanta Pharmaceuticals Inc</name>
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        <name>Myriad Genetics Inc</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
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          <isCashCollateral>N</isCashCollateral>
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          <isLoanByFund>N</isLoanByFund>
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        <name>Twist Bioscience Corp</name>
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        <assetCat>EC</assetCat>
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        <name>Becton Dickinson and Co</name>
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        <isRestrictedSec>N</isRestrictedSec>

        <fairValLevel>1</fairValLevel>
        <securityLending>
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    </invstOrSecs>
    <signature>
      <ncom:dateSigned>2020-06-30</ncom:dateSigned>
      <ncom:nameOfApplicant>VANGUARD WORLD FUND</ncom:nameOfApplicant>
      <ncom:signature>Christine M. Buchanan</ncom:signature>
      <ncom:signerName>Christine M. Buchanan</ncom:signerName>
      <ncom:title>Treasurer</ncom:title>
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  </formData>
  <documents>XXXX</documents>
</edgarSubmission>
