<?xml version="1.0" encoding="us-ascii"?>
<informationTable xmlns:xsd="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://www.sec.gov/edgar/document/thirteenf/informationtable">
    <infoTable>
        <nameOfIssuer>AAR CORP</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>000361105</cusip>
        <value>5035160</value>
        <shrsOrPrnAmt>
            <sshPrnamt>46000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>46000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ABIVAX SA</nameOfIssuer>
        <titleOfClass>SPONSORED ADS</titleOfClass>
        <cusip>00370M103</cusip>
        <value>222700</value>
        <shrsOrPrnAmt>
            <sshPrnamt>2000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>2000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ACADIA HEALTHCARE COMPANY IN</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>00404A109</cusip>
        <value>40623752</value>
        <shrsOrPrnAmt>
            <sshPrnamt>1736800</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>1736800</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ADAPTIVE BIOTECHNOLOGIES COR</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>00650F109</cusip>
        <value>152680</value>
        <shrsOrPrnAmt>
            <sshPrnamt>11000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>11000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>AFFIRM HLDGS INC</nameOfIssuer>
        <titleOfClass>COM CL A</titleOfClass>
        <cusip>00827B106</cusip>
        <value>4948560</value>
        <shrsOrPrnAmt>
            <sshPrnamt>108000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>108000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>AGIOS PHARMACEUTICALS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>00847X104</cusip>
        <value>192289720</value>
        <shrsOrPrnAmt>
            <sshPrnamt>5684000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>5684000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ALEANNA INC</nameOfIssuer>
        <titleOfClass>*W EXP 12/13/202</titleOfClass>
        <cusip>01444V111</cusip>
        <value>801900</value>
        <shrsOrPrnAmt>
            <sshPrnamt>990000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>990000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ALEANNA INC</nameOfIssuer>
        <titleOfClass>COM CL A</titleOfClass>
        <cusip>01444V103</cusip>
        <value>649936</value>
        <shrsOrPrnAmt>
            <sshPrnamt>78400</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>78400</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ALKERMES PLC</nameOfIssuer>
        <titleOfClass>SHS</titleOfClass>
        <cusip>G01767105</cusip>
        <value>735488</value>
        <shrsOrPrnAmt>
            <sshPrnamt>20800</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>20800</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ALPHABET INC</nameOfIssuer>
        <titleOfClass>CAP STK CL C</titleOfClass>
        <cusip>02079K107</cusip>
        <value>285778825</value>
        <shrsOrPrnAmt>
            <sshPrnamt>996231</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>996231</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ALTIMMUNE INC</nameOfIssuer>
        <titleOfClass>COM NEW</titleOfClass>
        <cusip>02155H200</cusip>
        <value>85008</value>
        <shrsOrPrnAmt>
            <sshPrnamt>27600</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>27600</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ALUMIS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>022307102</cusip>
        <value>242330</value>
        <shrsOrPrnAmt>
            <sshPrnamt>11000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>11000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ALVOTECH</nameOfIssuer>
        <titleOfClass>ORDINARY SHARES</titleOfClass>
        <cusip>L01800108</cusip>
        <value>684885</value>
        <shrsOrPrnAmt>
            <sshPrnamt>199675</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>199675</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>AMAZON COM INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>023135106</cusip>
        <value>878564918</value>
        <shrsOrPrnAmt>
            <sshPrnamt>4218394</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>4218394</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>AMICUS THERAPEUTIC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>03152W109</cusip>
        <value>231360</value>
        <shrsOrPrnAmt>
            <sshPrnamt>16000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>16000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>AMKOR TECHNOLOGY INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>031652100</cusip>
        <value>4683120</value>
        <shrsOrPrnAmt>
            <sshPrnamt>104000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>104000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>AON PLC</nameOfIssuer>
        <titleOfClass>SHS CL A</titleOfClass>
        <cusip>G0403H108</cusip>
        <value>811029294</value>
        <shrsOrPrnAmt>
            <sshPrnamt>2512638</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>2512638</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>APELLIS PHARMACEUTICALS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>03753U106</cusip>
        <value>241380</value>
        <shrsOrPrnAmt>
            <sshPrnamt>6000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>6000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ARAMARK</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>03852U106</cusip>
        <value>248730373</value>
        <shrsOrPrnAmt>
            <sshPrnamt>6135431</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>6135431</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ARCUTIS BIOTHERAPEUTICS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>03969K108</cusip>
        <value>612560</value>
        <shrsOrPrnAmt>
            <sshPrnamt>26000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>26000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ARDELYX INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>039697107</cusip>
        <value>137770</value>
        <shrsOrPrnAmt>
            <sshPrnamt>23000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>23000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ARROWHEAD PHARMACEUTICALS IN</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>04280A100</cusip>
        <value>990660</value>
        <shrsOrPrnAmt>
            <sshPrnamt>15800</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>15800</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ASSEMBLY BIOSCIENCES INC</nameOfIssuer>
        <titleOfClass>COM NEW</titleOfClass>
        <cusip>045396207</cusip>
        <value>34065623</value>
        <shrsOrPrnAmt>
            <sshPrnamt>1227590</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>1227590</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ASTRAZENECA PLC</nameOfIssuer>
        <titleOfClass>ORD</titleOfClass>
        <cusip>G0593M107</cusip>
        <value>44670133</value>
        <shrsOrPrnAmt>
            <sshPrnamt>226499</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>226499</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ATRIUM THERAPEUTICS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>04965N104</cusip>
        <value>4670943</value>
        <shrsOrPrnAmt>
            <sshPrnamt>349360</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>349360</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>AVALO THERAPEUTICS INC</nameOfIssuer>
        <titleOfClass>COM NEW</titleOfClass>
        <cusip>05338F306</cusip>
        <value>13675880</value>
        <shrsOrPrnAmt>
            <sshPrnamt>916000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>916000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>AXSOME THERAPEUTICS INC.</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>05464T104</cusip>
        <value>676080</value>
        <shrsOrPrnAmt>
            <sshPrnamt>4000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>4000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>BAIDU INC</nameOfIssuer>
        <titleOfClass>SPON ADR REP A</titleOfClass>
        <cusip>056752108</cusip>
        <value>49446525</value>
        <shrsOrPrnAmt>
            <sshPrnamt>443785</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>443785</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>BEAM THERAPEUTICS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>07373V105</cusip>
        <value>241509806</value>
        <shrsOrPrnAmt>
            <sshPrnamt>10134696</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>10134696</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>BELITE BIO INC</nameOfIssuer>
        <titleOfClass>SPONSORED ADS</titleOfClass>
        <cusip>07782B104</cusip>
        <value>207272</value>
        <shrsOrPrnAmt>
            <sshPrnamt>1300</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>1300</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>BEONE MEDICINES LTD</nameOfIssuer>
        <titleOfClass>SPONSORED ADS</titleOfClass>
        <cusip>07725L102</cusip>
        <value>326667</value>
        <shrsOrPrnAmt>
            <sshPrnamt>1100</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>1100</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>BETA BIONICS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>08659B102</cusip>
        <value>36151358</value>
        <shrsOrPrnAmt>
            <sshPrnamt>3607920</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>3607920</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>BEYOND MEAT INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>08862E109</cusip>
        <value>13330</value>
        <shrsOrPrnAmt>
            <sshPrnamt>19000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>19000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>BIOCRYST PHARMACEUTICALS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>09058V103</cusip>
        <value>228480</value>
        <shrsOrPrnAmt>
            <sshPrnamt>24000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>24000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>BITWISE 10 CRYPTO INDEX ETF</nameOfIssuer>
        <titleOfClass>UNIT BENEFICIAL</titleOfClass>
        <cusip>091749101</cusip>
        <value>26898021</value>
        <shrsOrPrnAmt>
            <sshPrnamt>603000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>603000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>BLUE GOLD LTD</nameOfIssuer>
        <titleOfClass>*W EXP 04/01/203</titleOfClass>
        <cusip>G1331C112</cusip>
        <value>60000</value>
        <shrsOrPrnAmt>
            <sshPrnamt>300000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>300000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>BOSTON SCIENTIFIC CORP</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>101137107</cusip>
        <value>468785421</value>
        <shrsOrPrnAmt>
            <sshPrnamt>7470684</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>7470684</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>BRIDGEBIO PHARMA INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>10806X102</cusip>
        <value>695479282</value>
        <shrsOrPrnAmt>
            <sshPrnamt>9365463</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>9365463</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>BRIGHTSPRING HEALTH SVCS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>10950A106</cusip>
        <value>68900370</value>
        <shrsOrPrnAmt>
            <sshPrnamt>1617000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>1617000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>BROADCOM INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>11135F101</cusip>
        <value>550773045</value>
        <shrsOrPrnAmt>
            <sshPrnamt>1779500</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>1779500</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>C4 THERAPEUTICS INC</nameOfIssuer>
        <titleOfClass>COM STK</titleOfClass>
        <cusip>12529R107</cusip>
        <value>73640</value>
        <shrsOrPrnAmt>
            <sshPrnamt>28000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>28000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>CANOPY GROWTH CORPORATION</nameOfIssuer>
        <titleOfClass>COM NEW</titleOfClass>
        <cusip>138035704</cusip>
        <value>28476</value>
        <shrsOrPrnAmt>
            <sshPrnamt>30000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>30000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>CAPRICOR THERAPEUTICS INC</nameOfIssuer>
        <titleOfClass>COM NEW</titleOfClass>
        <cusip>14070B309</cusip>
        <value>1246400</value>
        <shrsOrPrnAmt>
            <sshPrnamt>41000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>41000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>CARDINAL HEALTH INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>14149Y108</cusip>
        <value>77762080</value>
        <shrsOrPrnAmt>
            <sshPrnamt>368000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>368000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>CECO ENVIRONMENTAL CORP</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>125141101</cusip>
        <value>13941720</value>
        <shrsOrPrnAmt>
            <sshPrnamt>234000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>234000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>CELCUITY INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>15102K100</cusip>
        <value>456560</value>
        <shrsOrPrnAmt>
            <sshPrnamt>4000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>4000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>CENCORA INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>03073E105</cusip>
        <value>314140</value>
        <shrsOrPrnAmt>
            <sshPrnamt>1000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>1000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>CENTESSA PHARMACEUTICALS PLC</nameOfIssuer>
        <titleOfClass>SPONSORED ADS</titleOfClass>
        <cusip>152309100</cusip>
        <value>191013480</value>
        <shrsOrPrnAmt>
            <sshPrnamt>4809000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>4809000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>CG ONCOLOGY INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>156944900</cusip>
        <value>13536000</value>
        <shrsOrPrnAmt>
            <sshPrnamt>200000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <putCall>Call</putCall>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>200000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>CG ONCOLOGY INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>156944100</cusip>
        <value>45616320</value>
        <shrsOrPrnAmt>
            <sshPrnamt>674000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>674000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>CITIGROUP INC</nameOfIssuer>
        <titleOfClass>COM NEW</titleOfClass>
        <cusip>172967424</cusip>
        <value>5330270</value>
        <shrsOrPrnAmt>
            <sshPrnamt>47000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>47000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>COGENT BIOSCIENCES INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>19240Q201</cusip>
        <value>654330</value>
        <shrsOrPrnAmt>
            <sshPrnamt>17000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>17000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>CRINETICS PHARMACEUTICALS IN</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>22663K107</cusip>
        <value>302839719</value>
        <shrsOrPrnAmt>
            <sshPrnamt>8338098</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>8338098</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>CUMMINS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>231021106</cusip>
        <value>4842180</value>
        <shrsOrPrnAmt>
            <sshPrnamt>9000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>9000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>DIANTHUS THERAPEUTICS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>252828108</cusip>
        <value>70157120</value>
        <shrsOrPrnAmt>
            <sshPrnamt>836000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>836000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>DISNEY WALT CO</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>254687106</cusip>
        <value>231465341</value>
        <shrsOrPrnAmt>
            <sshPrnamt>2401591</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>2401591</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>DYNE THERAPEUTICS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>26818M108</cusip>
        <value>181300</value>
        <shrsOrPrnAmt>
            <sshPrnamt>10000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>10000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ENANTA PHARMACEUTICALS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>29251M106</cusip>
        <value>36271617</value>
        <shrsOrPrnAmt>
            <sshPrnamt>2871862</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>2871862</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ENCOMPASS HEALTH CORP</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>29261A100</cusip>
        <value>290190</value>
        <shrsOrPrnAmt>
            <sshPrnamt>3000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>3000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ENTEGRIS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>29362U104</cusip>
        <value>5334420</value>
        <shrsOrPrnAmt>
            <sshPrnamt>45500</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>45500</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ERASCA INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>29479A108</cusip>
        <value>291240</value>
        <shrsOrPrnAmt>
            <sshPrnamt>18000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>18000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>EVOLENT HEALTH INC</nameOfIssuer>
        <titleOfClass>CL A</titleOfClass>
        <cusip>30050B101</cusip>
        <value>31920</value>
        <shrsOrPrnAmt>
            <sshPrnamt>14000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>14000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>EXELIXIS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>30161Q104</cusip>
        <value>562331219</value>
        <shrsOrPrnAmt>
            <sshPrnamt>13111010</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>13111010</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>FISERV INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>337738108</cusip>
        <value>4798800</value>
        <shrsOrPrnAmt>
            <sshPrnamt>86000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>86000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>FLEXTRONICS INTL LTD</nameOfIssuer>
        <titleOfClass>ORD</titleOfClass>
        <cusip>Y2573F102</cusip>
        <value>5105880</value>
        <shrsOrPrnAmt>
            <sshPrnamt>78000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>78000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>FORMFACTOR INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>346375108</cusip>
        <value>5479935</value>
        <shrsOrPrnAmt>
            <sshPrnamt>56500</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>56500</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>GARRETT MOTION INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>366505105</cusip>
        <value>4996750</value>
        <shrsOrPrnAmt>
            <sshPrnamt>275000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>275000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>GDS HLDGS LTD</nameOfIssuer>
        <titleOfClass>SPONSORED ADS</titleOfClass>
        <cusip>36165L108</cusip>
        <value>11764680</value>
        <shrsOrPrnAmt>
            <sshPrnamt>292000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>292000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>GE HEALTHCARE TECHNOLOGIES I</nameOfIssuer>
        <titleOfClass>COMMON STOCK</titleOfClass>
        <cusip>36266G107</cusip>
        <value>213540</value>
        <shrsOrPrnAmt>
            <sshPrnamt>3000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>3000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>GENEDX HOLDINGS CORP</nameOfIssuer>
        <titleOfClass>COM CL A</titleOfClass>
        <cusip>81663L200</cusip>
        <value>321100</value>
        <shrsOrPrnAmt>
            <sshPrnamt>5000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>5000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>GERON CORP</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>374163103</cusip>
        <value>64070</value>
        <shrsOrPrnAmt>
            <sshPrnamt>43000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>43000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>GLAUKOS CORP</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>377322102</cusip>
        <value>279916</value>
        <shrsOrPrnAmt>
            <sshPrnamt>2600</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>2600</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>GLOBALFOUNDRIES INC</nameOfIssuer>
        <titleOfClass>ORDINARY SHARES</titleOfClass>
        <cusip>G39387108</cusip>
        <value>4670400</value>
        <shrsOrPrnAmt>
            <sshPrnamt>105000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>105000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>GLOBUS MED INC</nameOfIssuer>
        <titleOfClass>CL A</titleOfClass>
        <cusip>379577208</cusip>
        <value>344640</value>
        <shrsOrPrnAmt>
            <sshPrnamt>4000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>4000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>GRAIL INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>384747101</cusip>
        <value>168150389</value>
        <shrsOrPrnAmt>
            <sshPrnamt>3253684</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>3253684</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>GRIFOLS S A</nameOfIssuer>
        <titleOfClass>SP ADR REP B NVT</titleOfClass>
        <cusip>398438408</cusip>
        <value>224560</value>
        <shrsOrPrnAmt>
            <sshPrnamt>28000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>28000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>GUARDANT HEALTH INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>40131M109</cusip>
        <value>738960</value>
        <shrsOrPrnAmt>
            <sshPrnamt>8000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>8000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>HEALTHCARE RLTY TR</nameOfIssuer>
        <titleOfClass>CL A COM</titleOfClass>
        <cusip>42226K105</cusip>
        <value>203880</value>
        <shrsOrPrnAmt>
            <sshPrnamt>12000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>12000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>HEALTHEQUITY INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>42226A107</cusip>
        <value>233996</value>
        <shrsOrPrnAmt>
            <sshPrnamt>2800</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>2800</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>HIMS &amp; HERS HEALTH INC</nameOfIssuer>
        <titleOfClass>COM CL A</titleOfClass>
        <cusip>433000106</cusip>
        <value>207600</value>
        <shrsOrPrnAmt>
            <sshPrnamt>10000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>10000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>HYATT HOTELS CORP</nameOfIssuer>
        <titleOfClass>COM CL A</titleOfClass>
        <cusip>448579102</cusip>
        <value>5176440</value>
        <shrsOrPrnAmt>
            <sshPrnamt>36000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>36000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>IMMUNOVANT INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>45258J102</cusip>
        <value>38402640</value>
        <shrsOrPrnAmt>
            <sshPrnamt>1546000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>1546000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>INTER &amp; CO INC</nameOfIssuer>
        <titleOfClass>CLASS A COM</titleOfClass>
        <cusip>G4R20B107</cusip>
        <value>4891420</value>
        <shrsOrPrnAmt>
            <sshPrnamt>614500</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>614500</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>INVESCO EXCHANGE TRADED FD T</nameOfIssuer>
        <titleOfClass>S&amp;P500 EQL WGT</titleOfClass>
        <cusip>46137V957</cusip>
        <value>690912000</value>
        <shrsOrPrnAmt>
            <sshPrnamt>3600000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <putCall>Put</putCall>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>3600000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>IONIS PHARMACEUTICALS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>462222100</cusip>
        <value>360432</value>
        <shrsOrPrnAmt>
            <sshPrnamt>4800</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>4800</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>IOVANCE BIOTHERAPEUTICS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>462260100</cusip>
        <value>91260</value>
        <shrsOrPrnAmt>
            <sshPrnamt>26000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>26000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>IRONWOOD PHARMACEUTICALS INC</nameOfIssuer>
        <titleOfClass>COM CL A</titleOfClass>
        <cusip>46333X108</cusip>
        <value>45630</value>
        <shrsOrPrnAmt>
            <sshPrnamt>13000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>13000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>JOHNSON &amp; JOHNSON</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>478160104</cusip>
        <value>36177120</value>
        <shrsOrPrnAmt>
            <sshPrnamt>148000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>148000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>JOYY INC</nameOfIssuer>
        <titleOfClass>ADS REPSTG COM A</titleOfClass>
        <cusip>46591M109</cusip>
        <value>33761098</value>
        <shrsOrPrnAmt>
            <sshPrnamt>578200</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>578200</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>KKR &amp; CO INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>48251W104</cusip>
        <value>432141500</value>
        <shrsOrPrnAmt>
            <sshPrnamt>4671800</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>4671800</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>KRYSTAL BIOTECH INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>501147102</cusip>
        <value>258320</value>
        <shrsOrPrnAmt>
            <sshPrnamt>1000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>1000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>LANTHEUS HLDGS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>516544103</cusip>
        <value>423506882</value>
        <shrsOrPrnAmt>
            <sshPrnamt>5583479</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>5583479</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>LIQUIDIA CORPORATION</nameOfIssuer>
        <titleOfClass>COM NEW</titleOfClass>
        <cusip>53635D202</cusip>
        <value>326678874</value>
        <shrsOrPrnAmt>
            <sshPrnamt>8656038</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>8656038</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>LITTELFUSE INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>537008104</cusip>
        <value>5090250</value>
        <shrsOrPrnAmt>
            <sshPrnamt>15000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>15000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>LIVANOVA PLC</nameOfIssuer>
        <titleOfClass>SHS</titleOfClass>
        <cusip>G5509L101</cusip>
        <value>381360</value>
        <shrsOrPrnAmt>
            <sshPrnamt>6000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>6000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>MADRIGAL PHARMACEUTICALS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>558868105</cusip>
        <value>1737397</value>
        <shrsOrPrnAmt>
            <sshPrnamt>3319</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>3319</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>MASTEC INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>576323109</cusip>
        <value>5469580</value>
        <shrsOrPrnAmt>
            <sshPrnamt>17000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>17000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>MASTERCARD INCORPORATED</nameOfIssuer>
        <titleOfClass>CL A</titleOfClass>
        <cusip>57636Q104</cusip>
        <value>217387576</value>
        <shrsOrPrnAmt>
            <sshPrnamt>435071</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>435071</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>MAZE THERAPEUTICS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>578784100</cusip>
        <value>11134050</value>
        <shrsOrPrnAmt>
            <sshPrnamt>373000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>373000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>MCKESSON CORP</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>58155Q103</cusip>
        <value>202753848</value>
        <shrsOrPrnAmt>
            <sshPrnamt>234300</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>234300</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>MERCK &amp; CO INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>58933Y105</cusip>
        <value>43424690</value>
        <shrsOrPrnAmt>
            <sshPrnamt>361000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>361000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>MERIT MED SYS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>589889104</cusip>
        <value>206790</value>
        <shrsOrPrnAmt>
            <sshPrnamt>3000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>3000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>MICROSOFT CORP</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>594918104</cusip>
        <value>867966842</value>
        <shrsOrPrnAmt>
            <sshPrnamt>2344779</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>2344779</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>MINERVA NEUROSCIENCES INC</nameOfIssuer>
        <titleOfClass>COM NEW</titleOfClass>
        <cusip>603380205</cusip>
        <value>14249125</value>
        <shrsOrPrnAmt>
            <sshPrnamt>2365000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>2365000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>MIRUM PHARMACEUTICALS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>604749101</cusip>
        <value>277140</value>
        <shrsOrPrnAmt>
            <sshPrnamt>3000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>3000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>MOLINA HEALTHCARE INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>60855R100</cusip>
        <value>4665500</value>
        <shrsOrPrnAmt>
            <sshPrnamt>35000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>35000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>NATERA INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>632307104</cusip>
        <value>641441126</value>
        <shrsOrPrnAmt>
            <sshPrnamt>3207366</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>3207366</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>NEKTAR THERAPEUTICS</nameOfIssuer>
        <titleOfClass>COM NEW</titleOfClass>
        <cusip>640268306</cusip>
        <value>287800</value>
        <shrsOrPrnAmt>
            <sshPrnamt>4000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>4000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>NEOGENOMICS INC</nameOfIssuer>
        <titleOfClass>COM NEW</titleOfClass>
        <cusip>64049M209</cusip>
        <value>140980</value>
        <shrsOrPrnAmt>
            <sshPrnamt>19000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>19000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>NETEASE COM INC</nameOfIssuer>
        <titleOfClass>SPONSORED ADS</titleOfClass>
        <cusip>64110W102</cusip>
        <value>32599055</value>
        <shrsOrPrnAmt>
            <sshPrnamt>291219</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>291219</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>NOVAVAX INC</nameOfIssuer>
        <titleOfClass>COM NEW</titleOfClass>
        <cusip>670002401</cusip>
        <value>179080</value>
        <shrsOrPrnAmt>
            <sshPrnamt>22000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>22000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>NOVO-NORDISK A S</nameOfIssuer>
        <titleOfClass>ADR</titleOfClass>
        <cusip>670100205</cusip>
        <value>28738500</value>
        <shrsOrPrnAmt>
            <sshPrnamt>782000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>782000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>NUVALENT INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>670703107</cusip>
        <value>307350</value>
        <shrsOrPrnAmt>
            <sshPrnamt>3000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>3000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>NUVATION BIO INC</nameOfIssuer>
        <titleOfClass>COM CL A</titleOfClass>
        <cusip>67080N101</cusip>
        <value>124410</value>
        <shrsOrPrnAmt>
            <sshPrnamt>29000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>29000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>NVNI GROUP LIMITED</nameOfIssuer>
        <titleOfClass>*W EXP 11/01/202</titleOfClass>
        <cusip>G50716110</cusip>
        <value>17813</value>
        <shrsOrPrnAmt>
            <sshPrnamt>375000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>375000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>OCULAR THERAPEUTIX INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>67576A100</cusip>
        <value>152460</value>
        <shrsOrPrnAmt>
            <sshPrnamt>18000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>18000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>OMEROS CORP</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>682143102</cusip>
        <value>242880</value>
        <shrsOrPrnAmt>
            <sshPrnamt>23000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>23000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>OPUS GENETICS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>67577R102</cusip>
        <value>4550000</value>
        <shrsOrPrnAmt>
            <sshPrnamt>1000000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>1000000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>OSCAR HEALTH INC</nameOfIssuer>
        <titleOfClass>CL A</titleOfClass>
        <cusip>687793109</cusip>
        <value>126170</value>
        <shrsOrPrnAmt>
            <sshPrnamt>11000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>11000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>PACIFIC BIOSCIENCES CALIF IN</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>69404D108</cusip>
        <value>178200</value>
        <shrsOrPrnAmt>
            <sshPrnamt>135000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>135000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>PERCEPTIVE CAP SOLUTIONS COR</nameOfIssuer>
        <titleOfClass>CL A ORD SHS</titleOfClass>
        <cusip>G70077105</cusip>
        <value>24682500</value>
        <shrsOrPrnAmt>
            <sshPrnamt>2250000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>2250000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>PIPER SANDLER COMPANIES</nameOfIssuer>
        <titleOfClass>COM NEW</titleOfClass>
        <cusip>724078209</cusip>
        <value>5052300</value>
        <shrsOrPrnAmt>
            <sshPrnamt>66000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>66000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>PRECIGEN INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>74017N105</cusip>
        <value>193500</value>
        <shrsOrPrnAmt>
            <sshPrnamt>50000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>50000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>PRIME MEDICINE INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>74168J101</cusip>
        <value>4318134</value>
        <shrsOrPrnAmt>
            <sshPrnamt>1240843</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>1240843</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>PROGYNY INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>74340E103</cusip>
        <value>305640</value>
        <shrsOrPrnAmt>
            <sshPrnamt>18000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>18000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>PROTAGONIST THERAPEUTICS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>74366E102</cusip>
        <value>669174692</value>
        <shrsOrPrnAmt>
            <sshPrnamt>6348906</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>6348906</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>RANI THERAPEUTICS HLDGS INC</nameOfIssuer>
        <titleOfClass>COM CL A</titleOfClass>
        <cusip>753018100</cusip>
        <value>57314</value>
        <shrsOrPrnAmt>
            <sshPrnamt>78000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>78000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>REVOLUTION MEDICINES INC</nameOfIssuer>
        <titleOfClass>*W EXP 12/17/202</titleOfClass>
        <cusip>76155X118</cusip>
        <value>208948</value>
        <shrsOrPrnAmt>
            <sshPrnamt>120085</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>120085</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>REVOLUTION MEDICINES INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>76155X100</cusip>
        <value>1323066411</value>
        <shrsOrPrnAmt>
            <sshPrnamt>13604796</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>13604796</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>RIO TINTO PLC</nameOfIssuer>
        <titleOfClass>SPONSORED ADR</titleOfClass>
        <cusip>767204100</cusip>
        <value>5019002</value>
        <shrsOrPrnAmt>
            <sshPrnamt>53800</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>53800</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ROIVANT SCIENCES LTD</nameOfIssuer>
        <titleOfClass>SHS</titleOfClass>
        <cusip>G76279101</cusip>
        <value>267997500</value>
        <shrsOrPrnAmt>
            <sshPrnamt>9675000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>9675000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ROLLINS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>775711104</cusip>
        <value>4967130</value>
        <shrsOrPrnAmt>
            <sshPrnamt>93000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>93000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>ROYALTY PHARMA PLC</nameOfIssuer>
        <titleOfClass>SHS CLASS A</titleOfClass>
        <cusip>G7709Q104</cusip>
        <value>23649210</value>
        <shrsOrPrnAmt>
            <sshPrnamt>493000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>493000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>S&amp;P GLOBAL INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>78409V104</cusip>
        <value>5104080</value>
        <shrsOrPrnAmt>
            <sshPrnamt>12000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>12000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>SABRA HEALTH CARE REIT INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>78573L106</cusip>
        <value>269220</value>
        <shrsOrPrnAmt>
            <sshPrnamt>14000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>14000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>SCHOLAR ROCK HLDG CORP</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>80706P103</cusip>
        <value>344120</value>
        <shrsOrPrnAmt>
            <sshPrnamt>7000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>7000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>SCHRODINGER INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>80810D103</cusip>
        <value>193120</value>
        <shrsOrPrnAmt>
            <sshPrnamt>17000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>17000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>SCHWAB CHARLES CORP</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>808513105</cusip>
        <value>371752645</value>
        <shrsOrPrnAmt>
            <sshPrnamt>3955657</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>3955657</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>SELLAS LIFE SCIENCES GROUP I</nameOfIssuer>
        <titleOfClass>COM NEW</titleOfClass>
        <cusip>81642T209</cusip>
        <value>169200</value>
        <shrsOrPrnAmt>
            <sshPrnamt>40000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>40000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>SERVICENOW INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>81762P102</cusip>
        <value>4286550</value>
        <shrsOrPrnAmt>
            <sshPrnamt>41000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>41000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>SOLID POWER INC</nameOfIssuer>
        <titleOfClass>*W EXP 12/08/202</titleOfClass>
        <cusip>83422N113</cusip>
        <value>88359</value>
        <shrsOrPrnAmt>
            <sshPrnamt>405316</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>405316</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>STATE STR SPDR S&amp;P 500 ETF T</nameOfIssuer>
        <titleOfClass>TR UNIT</titleOfClass>
        <cusip>78462F953</cusip>
        <value>1495782000</value>
        <shrsOrPrnAmt>
            <sshPrnamt>2300000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <putCall>Put</putCall>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>2300000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>STOKE THERAPEUTICS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>86150R107</cusip>
        <value>293040</value>
        <shrsOrPrnAmt>
            <sshPrnamt>9000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>9000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>STRATEGY INC</nameOfIssuer>
        <titleOfClass>NOTE 12/0</titleOfClass>
        <cusip>594972AS0</cusip>
        <value>32877339</value>
        <shrsOrPrnAmt>
            <sshPrnamt>39500000</sshPrnamt>
            <sshPrnamtType>PRN</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>39500000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>SUMMIT MIDSTREAM CORPORATION</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>86614G101</cusip>
        <value>1760391</value>
        <shrsOrPrnAmt>
            <sshPrnamt>58214</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>58214</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>SUPERNUS PHARMACEUTICALS</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>868459108</cusip>
        <value>206760</value>
        <shrsOrPrnAmt>
            <sshPrnamt>4000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>4000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>SYNDAX PHARMACEUTICALS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>87164F105</cusip>
        <value>233600</value>
        <shrsOrPrnAmt>
            <sshPrnamt>10000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>10000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>SYNOPSYS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>871607107</cusip>
        <value>481049184</value>
        <shrsOrPrnAmt>
            <sshPrnamt>1213300</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>1213300</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>TANGO THERAPEUTICS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>87583X109</cusip>
        <value>190317838</value>
        <shrsOrPrnAmt>
            <sshPrnamt>9097411</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>9097411</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>TENABLE HLDGS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>88025T102</cusip>
        <value>4482475</value>
        <shrsOrPrnAmt>
            <sshPrnamt>265000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>265000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>TENET HEALTHCARE CORP</nameOfIssuer>
        <titleOfClass>COM NEW</titleOfClass>
        <cusip>88033G407</cusip>
        <value>85325793</value>
        <shrsOrPrnAmt>
            <sshPrnamt>452153</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>452153</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>TERNS PHARMACEUTICALS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>880881107</cusip>
        <value>369040</value>
        <shrsOrPrnAmt>
            <sshPrnamt>7000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>7000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>TEVA PHARMACEUTICAL INDS LTD</nameOfIssuer>
        <titleOfClass>SPONSORED ADS</titleOfClass>
        <cusip>881624209</cusip>
        <value>10662480</value>
        <shrsOrPrnAmt>
            <sshPrnamt>354000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>354000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>THERMO FISHER SCIENTIFIC INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>883556102</cusip>
        <value>433276322</value>
        <shrsOrPrnAmt>
            <sshPrnamt>881485</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>881485</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>TIMKEN CO</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>887389104</cusip>
        <value>5129070</value>
        <shrsOrPrnAmt>
            <sshPrnamt>51000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>51000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>TRAVERE THERAPEUTICS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>89422G107</cusip>
        <value>356520</value>
        <shrsOrPrnAmt>
            <sshPrnamt>12000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>12000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>TVARDI THERAPEUTICS INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>140755307</cusip>
        <value>68173</value>
        <shrsOrPrnAmt>
            <sshPrnamt>21438</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>21438</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>TWIST BIOSCIENCE CORP</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>90184D100</cusip>
        <value>67841928</value>
        <shrsOrPrnAmt>
            <sshPrnamt>1427650</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>1427650</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>TYRA BIOSCIENCES INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>90240B106</cusip>
        <value>137145329</value>
        <shrsOrPrnAmt>
            <sshPrnamt>3580818</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>3580818</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>UNIQURE NV</nameOfIssuer>
        <titleOfClass>SHS</titleOfClass>
        <cusip>N90064101</cusip>
        <value>228900</value>
        <shrsOrPrnAmt>
            <sshPrnamt>14000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>14000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>UNITEDHEALTH GROUP INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>91324P102</cusip>
        <value>492935427</value>
        <shrsOrPrnAmt>
            <sshPrnamt>1821706</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>1821706</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>UROGEN PHARMA LTD</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>M96088105</cusip>
        <value>197780</value>
        <shrsOrPrnAmt>
            <sshPrnamt>11000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>11000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>VAXCYTE INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>92243G108</cusip>
        <value>73276710</value>
        <shrsOrPrnAmt>
            <sshPrnamt>1261000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>1261000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>VERACYTE INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>92337F107</cusip>
        <value>225470</value>
        <shrsOrPrnAmt>
            <sshPrnamt>7000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>7000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>VERTIV HOLDINGS CO</nameOfIssuer>
        <titleOfClass>COM CL A</titleOfClass>
        <cusip>92537N108</cusip>
        <value>4761020</value>
        <shrsOrPrnAmt>
            <sshPrnamt>19000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>19000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>VIR BIOTECHNOLOGY INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>92764N102</cusip>
        <value>197120</value>
        <shrsOrPrnAmt>
            <sshPrnamt>22000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>22000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>VISA INC</nameOfIssuer>
        <titleOfClass>COM CL A</titleOfClass>
        <cusip>92826C839</cusip>
        <value>254096190</value>
        <shrsOrPrnAmt>
            <sshPrnamt>840710</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>840710</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>VNET GROUP INC</nameOfIssuer>
        <titleOfClass>NOTE 2.000%10/0</titleOfClass>
        <cusip>90138AAE3</cusip>
        <value>44515553</value>
        <shrsOrPrnAmt>
            <sshPrnamt>45000000</sshPrnamt>
            <sshPrnamtType>PRN</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>45000000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>VNET GROUP INC</nameOfIssuer>
        <titleOfClass>SPONSORED ADS A</titleOfClass>
        <cusip>90138A103</cusip>
        <value>5229881</value>
        <shrsOrPrnAmt>
            <sshPrnamt>623347</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>623347</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>WABTEC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>929740108</cusip>
        <value>402205904</value>
        <shrsOrPrnAmt>
            <sshPrnamt>1609403</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>1609403</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>WELLTOWER INC</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>95040Q104</cusip>
        <value>39542000</value>
        <shrsOrPrnAmt>
            <sshPrnamt>200000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>200000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
    <infoTable>
        <nameOfIssuer>WESTERN ALLIANCE BANCORP</nameOfIssuer>
        <titleOfClass>COM</titleOfClass>
        <cusip>957638109</cusip>
        <value>5172050</value>
        <shrsOrPrnAmt>
            <sshPrnamt>73000</sshPrnamt>
            <sshPrnamtType>SH</sshPrnamtType>
        </shrsOrPrnAmt>
        <investmentDiscretion>OTR</investmentDiscretion>
        <votingAuthority>
            <Sole>73000</Sole>
            <Shared>0</Shared>
            <None>0</None>
        </votingAuthority>
    </infoTable>
</informationTable>
