we believe that our customers will continue to outsource a greater part of their activities to transform their value chain away from a vertically integrated model and focus on their core competencies to lower risk and improve return , with a focus on selecting outsourcing partners that are able to demonstrate the ability to provide flexible and efficient delivery models that leverage patient data to help biopharmaceutical companies deliver more effective patient outcomes . we believe that increased demand will create new opportunities for biopharmaceutical services companies , particularly those with a global reach . 41 integrated healthcare services historically has focused on biopharmaceutical companies seeking to commercialize their products . the total market served by integrated healthcare services is diverse , which makes it difficult to estimate the current amount of outsourced integrated healthcare services and the expected growth in such services . however , based on our knowledge of these markets we believe that , while the rate of outsourcing penetration varies by market within integrated healthcare services , the overall outsourcing penetration of the estimated $ 94 billion addressable market is not more than 20 % . we believe that the market for real-world and late phase research and other healthcare services will evolve and expand , and as a result , there will be opportunities to grow our revenues and expand our service offerings , including to payers who are looking to improve the cost-effectiveness of drug therapies and providers who are looking to make evidence-based decisions regarding treatment decisions . as business models continue to evolve in the healthcare sector , we believe that the growth rate for outsourcing across the integrated healthcare services markets will be similar to the growth in clinical development . acquisitions we completed a number of acquisitions in 2011 , 2012 and 2013 to enhance our capabilities and offerings in certain areas . in october 2011 , we acquired outcome , for approximately $ 164.9 million ( net of approximately $ 12.1 million of acquired cash ) to strengthen our late phase research offerings and vcg & a , inc. and its wholly owned subsidiary , vcg bio , inc. , or collectively vcg , for $ 8.7 million to strengthen our commercial services . in november 2011 , we acquired advion bioservices , inc. , for $ 54.9 million to enhance our biomarker and other advanced testing capabilities . in august 2012 , we acquired expression analysis for $ 39.7 million to enhance our genetic sequencing and advanced bioinformatics expertise . in september 2013 , we acquired novella for approximately $ 146.6 million ( net of approximately $ 26.2 million of acquired cash ) ( with contingent consideration of up to $ 21.0 million ) to complement our clinical service offerings through its focus on emerging companies and by adding expertise in oncology and medical devices . see note 14 to our audited consolidated financial statements found elsewhere in this annual report on form 10-k for additional information with respect to these acquisitions . the results of operations of acquired businesses have been included since the date of acquisition and were not significant to our consolidated results of operations . sources of revenue total revenues are comprised of service revenues and revenues from reimbursed expenses . service revenues primarily include the revenue we earn from providing product development and commercialization services to our customers , with product development services representing 76.7 % of our 2013 service revenues and commercialization services representing 22.2 % of our 2013 service revenues . our service revenues also include , or have historically included , product sales and commercial rights and royalties revenues . product sales , which are approximately 1 % or less of consolidated service revenues for all periods presented , represent sales of pharmaceutical products pursuant to distribution agreements . reimbursed expenses are comprised principally of payments to physicians ( investigators ) who oversee clinical trials and travel expenses for our clinical monitors and sales representatives . reimbursed expenses may fluctuate from period-to-period due , in part , to where we are in the lifecycle of the many contracts that are in progress at a particular point in time . for instance , these pass-through costs tend to be higher during the early phases of clinical trials as a result of patient recruitment efforts . as reimbursed expenses are pass-through costs to our customers with little to no profit and we believe that the fluctuations from period to period are not meaningful to our underlying performance , we do not provide analysis of the fluctuations in these items or their impact on our financial results . costs and expenses our costs and expenses are comprised primarily of our costs of revenues and selling , general and administrative expenses . our costs of revenues consist of service costs and reimbursed expenses . service costs include compensation and benefits for billable employees , depreciation of assets used in generating revenue and other expenses directly related to service contracts such as courier fees , laboratory supplies , professional services , travel expenses and the cost of products sold under distribution agreements . as noted above , reimbursed expenses are comprised principally of payments to physicians ( investigators ) who oversee clinical trials and travel expenses for our clinical monitors and sales representatives . selling , general and administrative expenses include costs related to administrative functions including compensation and benefits , travel , professional services , training and expenses for advertising , it , facilities and depreciation and amortization . foreign currency fluctuations the impact from foreign currency fluctuations and constant currency information assumes constant foreign currency exchange rates based on the rates in effect for the comparable prior-year period were used in translation . we believe that providing the impact of fluctuations in foreign currency rates on certain financial results can facilitate analysis of period-to-period comparisons of business performance . story_separator_special_tag we reevaluated this assertion following the ipo , as a portion of the ipo proceeds were used to pay down debt held in the united states as well as the fact we do not anticipate paying dividends in the foreseeable future , which had been significant in the past . with this reduction of debt and related interest expense and the change in approach related to payment of dividends , we expect to be able to support the cash needs of our domestic subsidiaries without repatriating cash from the affected foreign subsidiaries . we expect to utilize the cash generated outside of the united states to fund growth outside of the united states . as a result of the assertion change , we recorded an $ 8.1 million income tax benefit in the second quarter of 2013 to reverse the deferred income tax liability previously recorded on undistributed foreign earnings prior to 2013 that are now considered indefinitely reinvested outside of the united states . the favorable rate in 2011 was primarily due to an approximately $ 48.7 million benefit from the recognition of foreign tax credits related to prior years due to an increase in projected foreign source income as a result of improved operational results and the favorable impact of the 2011 refinancing transaction on future results . the rate was also favorably impacted due to a $ 16.4 million benefit for the release of foreign uncertain tax positions due to the expiration of the statute of limitations . the rate in 2011 was unfavorably impacted by $ 21.7 million of income tax expense related to the gain on the sale of our investment in invida . for financial reporting purposes , the gain on the sale is included in equity in earnings from unconsolidated affiliates ; however , our income tax on the gain is included in income tax expense . equity in ( losses ) earnings of unconsolidated affiliates replace_table_token_16_th in 2011 , we sold our investment in invida for approximately $ 103.6 million of net proceeds resulting in a gain of approximately $ 74.9 million . segments service revenues and income from operations by segment are as follows ( dollars in millions ) : replace_table_token_17_th 47 certain costs are not allocated to our segments and are reported as general corporate and unallocated expenses . these costs primarily consist of share-based compensation and expenses for corporate office functions such as senior leadership , finance , human resources , it , facilities and legal , as well as certain expenses incurred in the second quarter of 2013 including the $ 25.0 million fee incurred in connection with the termination of the management agreement with affiliates of certain shareholders and the $ 1.5 million fee paid in connection with the modification of an agreement for the business usage of an airplane owned by gfm . product development replace_table_token_18_th service revenues 2013 compared to 2012 product development 's service revenues were $ 2.9 billion in 2013 , an increase of $ 191.0 million , or 7.0 % , over 2012. this increase is comprised of constant currency revenue growth of $ 214.6 million , or 7.9 % , partially offset by a negative impact of approximately $ 23.6 million due to the effect of foreign currency fluctuations . the constant currency service revenues growth was primarily a result of a volume-related increase of $ 191.4 million in clinical solutions and services and $ 52.4 million from businesses acquired in the third quarters of 2012 and 2013 , which were partially offset by a decrease of $ 29.2 million from consulting services . our clinical solutions and services growth for 2013 was concentrated in europe and the americas . this growth was due largely to growth in the overall market as well as a consistent history of year-over-year growth in net new business , including strong inflow of net new business in 2013. this growth was tempered by a decrease in service revenues from consulting services resulting primarily from the winding down of a project assisting a customer on a regulatory compliance matter , and from a large clinical solutions project on which we were executing in 2012 and 2013 , but that is now nearing completion . 2012 compared to 2011 product development 's service revenues were $ 2.7 billion in 2012 , an increase of $ 290.9 million , or 11.9 % , over 2011. this increase is comprised of constant currency revenue growth of $ 328.6 million , or 13.5 % , partially offset by a negative impact of approximately $ 37.7 million due to the effect of foreign currency fluctuations . the constant currency service revenues growth was primarily a result of a volume-related increase of $ 238.5 million in clinical solutions and services , $ 55.3 million from consulting services and $ 34.8 million from businesses acquired in the fourth quarter of 2011 and the third quarter of 2012. our clinical solutions and services experienced growth in all regions including the americas , europe and the asia-pacific . this growth was due largely to growth in the overall market as well as a consistent history of year-over-year growth in net new business that resulted in delivery in 2012 on the higher backlog as we entered the year . also impacting the growth was an increase in global laboratories test volumes and an increase in the delivery of clinical solutions and services provided on a functional basis , principally due to the expansion of services and geographic deployment of resources on existing projects , and from the ramp up of new projects . this growth was partially offset by lower revenues from early clinical development services and was also tempered by a competitive pricing environment . service revenues from consulting services increased primarily as a result of approximately $ 47.3 million of revenue related to assisting a customer with a regulatory compliance project . 48 costs of service revenues 2013 compared to 2012 product development 's

cash flow from operating activities replace_table_token_20_th 2013 compared to 2012 cash provided by operating activities increased by $ 61.7 million in 2013 as compared 2012. the increase in operating cash flow reflects lower payments for income taxes ( $ 33.0 million ) and interest ( $ 11.6 million ) in 2013. in addition , net income increased despite including cash expenses totaling $ 32.5 million for a fee paid in connection with the termination of our management agreement with affiliates of certain of our shareholders ( $ 25.0 million ) , a fee paid in connection with the modification of an agreement for the business usage of an airplane owned by gfm ( $ 1.5 million ) , and a termination fee for the repayment of the $ 300.0 million term loan ( $ 6.0 million ) . these improvements in operating cash flow were partially offset by higher cash used in days sales outstanding , or dso ( $ 74.1 million ) . this higher cash used reflected a five-day increase in dso in 2013. the net impact on cash from the increase in dso resulted from the fact that we have continued to experience a trend toward longer payment terms on our contracts . dso can shift significantly at each reporting period depending on the timing of cash receipts under contractual payment terms relative to the recognition of revenue over a project lifecycle .


 Write a concise suspicious activity report of the following text delimited by triple backquotes. Return your response as a formal report which covers the key points highlighting the location,dates,entity names and account holder information in chronological order of the text.
     ```cash flow from operating activities replace_table_token_20_th 2013 compared to 2012 cash provided by operating activities increased by $ 61.7 million in 2013 as compared 2012. the increase in operating cash flow reflects lower payments for income taxes ( $ 33.0 million ) and interest ( $ 11.6 million ) in 2013. in addition , net income increased despite including cash expenses totaling $ 32.5 million for a fee paid in connection with the termination of our management agreement with affiliates of certain of our shareholders ( $ 25.0 million ) , a fee paid in connection with the modification of an agreement for the business usage of an airplane owned by gfm ( $ 1.5 million ) , and a termination fee for the repayment of the $ 300.0 million term loan ( $ 6.0 million ) . these improvements in operating cash flow were partially offset by higher cash used in days sales outstanding , or dso ( $ 74.1 million ) . this higher cash used reflected a five-day increase in dso in 2013. the net impact on cash from the increase in dso resulted from the fact that we have continued to experience a trend toward longer payment terms on our contracts . dso can shift significantly at each reporting period depending on the timing of cash receipts under contractual payment terms relative to the recognition of revenue over a project lifecycle .
```    
 Suspicious Activity Report : we believe that our customers will continue to outsource a greater part of their activities to transform their value chain away from a vertically integrated model and focus on their core competencies to lower risk and improve return , with a focus on selecting outsourcing partners that are able to demonstrate the ability to provide flexible and efficient delivery models that leverage patient data to help biopharmaceutical companies deliver more effective patient outcomes . we believe that increased demand will create new opportunities for biopharmaceutical services companies , particularly those with a global reach . 41 integrated healthcare services historically has focused on biopharmaceutical companies seeking to commercialize their products . the total market served by integrated healthcare services is diverse , which makes it difficult to estimate the current amount of outsourced integrated healthcare services and the expected growth in such services . however , based on our knowledge of these markets we believe that , while the rate of outsourcing penetration varies by market within integrated healthcare services , the overall outsourcing penetration of the estimated $ 94 billion addressable market is not more than 20 % . we believe that the market for real-world and late phase research and other healthcare services will evolve and expand , and as a result , there will be opportunities to grow our revenues and expand our service offerings , including to payers who are looking to improve the cost-effectiveness of drug therapies and providers who are looking to make evidence-based decisions regarding treatment decisions . as business models continue to evolve in the healthcare sector , we believe that the growth rate for outsourcing across the integrated healthcare services markets will be similar to the growth in clinical development . acquisitions we completed a number of acquisitions in 2011 , 2012 and 2013 to enhance our capabilities and offerings in certain areas . in october 2011 , we acquired outcome , for approximately $ 164.9 million ( net of approximately $ 12.1 million of acquired cash ) to strengthen our late phase research offerings and vcg & a , inc. and its wholly owned subsidiary , vcg bio , inc. , or collectively vcg , for $ 8.7 million to strengthen our commercial services . in november 2011 , we acquired advion bioservices , inc. , for $ 54.9 million to enhance our biomarker and other advanced testing capabilities . in august 2012 , we acquired expression analysis for $ 39.7 million to enhance our genetic sequencing and advanced bioinformatics expertise . in september 2013 , we acquired novella for approximately $ 146.6 million ( net of approximately $ 26.2 million of acquired cash ) ( with contingent consideration of up to $ 21.0 million ) to complement our clinical service offerings through its focus on emerging companies and by adding expertise in oncology and medical devices . see note 14 to our audited consolidated financial statements found elsewhere in this annual report on form 10-k for additional information with respect to these acquisitions . the results of operations of acquired businesses have been included since the date of acquisition and were not significant to our consolidated results of operations . sources of revenue total revenues are comprised of service revenues and revenues from reimbursed expenses . service revenues primarily include the revenue we earn from providing product development and commercialization services to our customers , with product development services representing 76.7 % of our 2013 service revenues and commercialization services representing 22.2 % of our 2013 service revenues . our service revenues also include , or have historically included , product sales and commercial rights and royalties revenues . product sales , which are approximately 1 % or less of consolidated service revenues for all periods presented , represent sales of pharmaceutical products pursuant to distribution agreements . reimbursed expenses are comprised principally of payments to physicians ( investigators ) who oversee clinical trials and travel expenses for our clinical monitors and sales representatives . reimbursed expenses may fluctuate from period-to-period due , in part , to where we are in the lifecycle of the many contracts that are in progress at a particular point in time . for instance , these pass-through costs tend to be higher during the early phases of clinical trials as a result of patient recruitment efforts . as reimbursed expenses are pass-through costs to our customers with little to no profit and we believe that the fluctuations from period to period are not meaningful to our underlying performance , we do not provide analysis of the fluctuations in these items or their impact on our financial results . costs and expenses our costs and expenses are comprised primarily of our costs of revenues and selling , general and administrative expenses . our costs of revenues consist of service costs and reimbursed expenses . service costs include compensation and benefits for billable employees , depreciation of assets used in generating revenue and other expenses directly related to service contracts such as courier fees , laboratory supplies , professional services , travel expenses and the cost of products sold under distribution agreements . as noted above , reimbursed expenses are comprised principally of payments to physicians ( investigators ) who oversee clinical trials and travel expenses for our clinical monitors and sales representatives . selling , general and administrative expenses include costs related to administrative functions including compensation and benefits , travel , professional services , training and expenses for advertising , it , facilities and depreciation and amortization . foreign currency fluctuations the impact from foreign currency fluctuations and constant currency information assumes constant foreign currency exchange rates based on the rates in effect for the comparable prior-year period were used in translation . we believe that providing the impact of fluctuations in foreign currency rates on certain financial results can facilitate analysis of period-to-period comparisons of business performance . story_separator_special_tag we reevaluated this assertion following the ipo , as a portion of the ipo proceeds were used to pay down debt held in the united states as well as the fact we do not anticipate paying dividends in the foreseeable future , which had been significant in the past . with this reduction of debt and related interest expense and the change in approach related to payment of dividends , we expect to be able to support the cash needs of our domestic subsidiaries without repatriating cash from the affected foreign subsidiaries . we expect to utilize the cash generated outside of the united states to fund growth outside of the united states . as a result of the assertion change , we recorded an $ 8.1 million income tax benefit in the second quarter of 2013 to reverse the deferred income tax liability previously recorded on undistributed foreign earnings prior to 2013 that are now considered indefinitely reinvested outside of the united states . the favorable rate in 2011 was primarily due to an approximately $ 48.7 million benefit from the recognition of foreign tax credits related to prior years due to an increase in projected foreign source income as a result of improved operational results and the favorable impact of the 2011 refinancing transaction on future results . the rate was also favorably impacted due to a $ 16.4 million benefit for the release of foreign uncertain tax positions due to the expiration of the statute of limitations . the rate in 2011 was unfavorably impacted by $ 21.7 million of income tax expense related to the gain on the sale of our investment in invida . for financial reporting purposes , the gain on the sale is included in equity in earnings from unconsolidated affiliates ; however , our income tax on the gain is included in income tax expense . equity in ( losses ) earnings of unconsolidated affiliates replace_table_token_16_th in 2011 , we sold our investment in invida for approximately $ 103.6 million of net proceeds resulting in a gain of approximately $ 74.9 million . segments service revenues and income from operations by segment are as follows ( dollars in millions ) : replace_table_token_17_th 47 certain costs are not allocated to our segments and are reported as general corporate and unallocated expenses . these costs primarily consist of share-based compensation and expenses for corporate office functions such as senior leadership , finance , human resources , it , facilities and legal , as well as certain expenses incurred in the second quarter of 2013 including the $ 25.0 million fee incurred in connection with the termination of the management agreement with affiliates of certain shareholders and the $ 1.5 million fee paid in connection with the modification of an agreement for the business usage of an airplane owned by gfm . product development replace_table_token_18_th service revenues 2013 compared to 2012 product development 's service revenues were $ 2.9 billion in 2013 , an increase of $ 191.0 million , or 7.0 % , over 2012. this increase is comprised of constant currency revenue growth of $ 214.6 million , or 7.9 % , partially offset by a negative impact of approximately $ 23.6 million due to the effect of foreign currency fluctuations . the constant currency service revenues growth was primarily a result of a volume-related increase of $ 191.4 million in clinical solutions and services and $ 52.4 million from businesses acquired in the third quarters of 2012 and 2013 , which were partially offset by a decrease of $ 29.2 million from consulting services . our clinical solutions and services growth for 2013 was concentrated in europe and the americas . this growth was due largely to growth in the overall market as well as a consistent history of year-over-year growth in net new business , including strong inflow of net new business in 2013. this growth was tempered by a decrease in service revenues from consulting services resulting primarily from the winding down of a project assisting a customer on a regulatory compliance matter , and from a large clinical solutions project on which we were executing in 2012 and 2013 , but that is now nearing completion . 2012 compared to 2011 product development 's service revenues were $ 2.7 billion in 2012 , an increase of $ 290.9 million , or 11.9 % , over 2011. this increase is comprised of constant currency revenue growth of $ 328.6 million , or 13.5 % , partially offset by a negative impact of approximately $ 37.7 million due to the effect of foreign currency fluctuations . the constant currency service revenues growth was primarily a result of a volume-related increase of $ 238.5 million in clinical solutions and services , $ 55.3 million from consulting services and $ 34.8 million from businesses acquired in the fourth quarter of 2011 and the third quarter of 2012. our clinical solutions and services experienced growth in all regions including the americas , europe and the asia-pacific . this growth was due largely to growth in the overall market as well as a consistent history of year-over-year growth in net new business that resulted in delivery in 2012 on the higher backlog as we entered the year . also impacting the growth was an increase in global laboratories test volumes and an increase in the delivery of clinical solutions and services provided on a functional basis , principally due to the expansion of services and geographic deployment of resources on existing projects , and from the ramp up of new projects . this growth was partially offset by lower revenues from early clinical development services and was also tempered by a competitive pricing environment . service revenues from consulting services increased primarily as a result of approximately $ 47.3 million of revenue related to assisting a customer with a regulatory compliance project . 48 costs of service revenues 2013 compared to 2012 product development 's

