our surgical & sports medicine products include renu for in-office joint and tendon applications ; nucel for bony fusion in the spine and extremities ; nushield and affinity for surgical application in targeted soft tissue repairs ; and puraply am for surgical treatment of open wounds . we currently sell these products through independent agencies and our growing direct sales force . on december 10 , 2018 , avista healthcare public acquisition corp. , our predecessor company ( ahpac ) , consummated the previously announced business combination pursuant to that certain agreement and plan of merger , dated as of august 17 , 2018 ( as amended , the avista merger agreement ) , by and among ahpac , avista healthcare merger sub , inc. , a delaware corporation and a direct wholly owned subsidiary of ahpac ( avista merger sub ) and organogenesis inc. , a delaware corporation ( organogenesis inc. ) . as a result of the transactions contemplated by the avista merger agreement , avista merger sub merged with and into organogenesis inc. , with organogenesis inc. surviving the merger ( the avista merger ) . in addition , in connection with the business combination , and in accordance with section 388 of the delaware general corporation law and the cayman islands companies law ( 2018 revision ) , ahpac redomesticated as a delaware corporation ( the domestication ) . after the domestication , ahpac changed its name to organogenesis holdings inc. as a result of the avista merger , organogenesis inc. became a wholly owned direct subsidiary of organogenesis holdings inc. for periods prior to the closing of the avista merger on december 10 , 2018 , the disclosure in management 's discussion and analysis of financial condition and results of operations has been updated to give effect to the avista merger . for the year ended december 31 , 2018 , we generated $ 193.4 million of revenue and had a net loss of $ 64.8 million compared to revenue of $ 198.5 million and a net loss of $ 7.5 million for the year ended december 31 , 2017. for the year ended december 31 , 2016 , we generated $ 138.7 million of revenue and had a net loss of $ 14.8 million . we expect to incur operating losses for the foreseeable future as we expend resources as part of our efforts to grow our organization to support the planned expansion of our business . as of december 31 , 2018 , we had an accumulated deficit of $ 130.2 million . our primary sources of capital to date have been from sales of our products , borrowings from related parties and institutional lenders and proceeds from the sale of our common stock . we operate in one segment , regenerative medicine . items affecting comparability nutech medical acquisition . on march 18 , 2017 , we entered into an agreement and plan of merger pursuant to which we acquired all of the outstanding shares of capital stock of nutech medical , inc. ( nutech medical ) for aggregate consideration consisting of $ 20.0 million in cash , $ 12.0 million of which was paid at closing with the remainder to be paid on or before the fifteen-month anniversary of the closing ( less a reduction 76 of $ 0.5 million resulting from an adjustment for working capital ) ; and 3,642,746 shares of our class a common stock , 2,185,647 of which were subject to forfeiture and 728,549 of which contain put and call features , and fully vested options to purchase 137,543 shares of our class a common stock . in addition , a deferred tax liability of $ 6.8 million recorded in connection with the acquisition allowed us to release a portion of the u.s. valuation allowance resulting in a tax benefit in the same amount . upon the closing of the merger , nutech medical merged with and into prime merger sub , llc , with prime merger sub , llc surviving the merger as our wholly owned subsidiary . the results of operations for nutech medical are included in our consolidated financial statements as of march 24 , 2017 , which was the closing date of the merger . variable interest entity ( vie ) deconsolidation . we have historically consolidated the accounts of dan road associates , llc ( dan road associates ) , 85 dan road associates , llc ( 85 dan road associates ) , and 65 dan road associates , llc ( 65 dan road associates ) as variable interest entities . we refer to these variable interest entities collectively as the real estate entities. the real estate entities , which are controlled by certain of our affiliates , are special purpose entities that hold real estate that is leased by us . we do not hold any capital stock of the real estate entities . based on the nature of the leases and the mortgages held by these affiliates , we determined that the real estate entities were variable interest entities , which required consolidation . following the removal of certain personal guarantees provided by these affiliates in respect of mortgage loans related to the property held by the real estate entities , we determined that the real estate entities no longer met the definition of variable interest entities and we deconsolidated them from our financial statements as of june 1 , 2017. credit agreement and ml agreement . in march 2017 , we entered into a credit agreement with silicon valley bank , as amended , the credit agreement . the credit agreement provides for a revolving credit facility of up to $ 30 million and a term loan of up to $ 5.0 million . story_separator_special_tag in connection with the consummation of the avista merger in december 2018 and the transactions contemplated by the exchange agreement , outstanding principal of $ 45.7 million related to the affiliate debt was exchanged for 6,502,679 shares of orgo class a common stock and a cash payment of $ 35.6 million , representing $ 22.0 million of principal and $ 13.6 million of accrued interest related to all aforementioned affiliate debt and accrued affiliate loan fees as of and through the closing date of the avista merger . following the consummation of these transactions , the affiliate debt was deemed fully paid and satisfied in full and was discharged and terminated . we incurred a loss of $ 2.1 million on the extinguishment of the affiliate debt in connection with the write off of unamortized debt issuance costs and the difference in the carrying value of the affiliate debt converted to class a common stock and the fair value of the class a common stock issued in the conversion . income taxes we account for income taxes using an asset and liability approach . deferred income taxes reflect the net tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes . valuation allowances are provided when necessary to reduce net deferred tax assets to an amount that is more likely than not to be realized . in determining whether a valuation allowance for deferred tax assets is necessary , management analyzes both positive and negative evidence related to the realization of deferred tax assets and inherent in that , assesses the likelihood of sufficient future taxable income . management also considers the expected reversal of deferred tax liabilities and analyzes the period in which these would be expected to reverse to determine whether the taxable temporary difference amounts serve as an adequate source of future taxable income to support realizability of the deferred tax assets . in addition , management considers whether it is more likely than not that the tax position will be sustained on examination by taxing authorities based on the technical merits of the 81 position . based on a consideration of the factors discussed above , including the fact that through the year-ended december 31 , 2018 , our results reflected a three-year cumulative loss position , management has determined that a valuation allowance is necessary against the full amount of our net deferred tax assets , excluding alternative minimum tax credits . on december 22 , 2017 , the united states enacted new tax reform ( tax act ) and as a result alternative minimum tax credits will be refundable beginning with the 2018 tax return . the alternative minimum tax credits will be realized , regardless of future taxable income , and thus no valuation allowance has been provided against this asset . results of operations the following table sets forth , for the periods indicated , our results of operations : replace_table_token_4_th 82 ebitda and adjusted ebitda the following table presents a reconciliation of adjusted ebitda to net loss attributable to organogenesis holdings inc. , the most directly comparable gaap measure , for each of the periods presented : replace_table_token_5_th ( 1 ) amount reflects the change in fair value of the common shares associated with the shares issued in connection with the acquisition of nutech medical that are forfeitable by the sole stockholder of nutech medical upon the occurrence of the fda requiring approval of certain products acquired from nutech medical . ( 2 ) amount reflects the change in fair value of our interest rate swaps that the real estate entities entered into to manage the economic impact of fluctuations in interest rate . we do not use interest rate swaps for speculative or trading purposes and as such , the fair value of these instruments is recorded as an asset or liability on the consolidated balance sheet with change in the fair value of the instruments recognized as income or expense in the current period as a component of other income ( expense ) , net in the consolidated statement of operations . ( 3 ) in connection with our 2016 loans ( as defined below ) , we classified the warrants issued to purchase our common stock to the lenders , who are affiliates of ours as a liability on our consolidated balance sheet . amounts reflect the change in fair value of the warrant liability . ( 4 ) amount reflects a one-time write-off in the quarter ended june 30 , 2018 of costs accumulated in connection with a proposed initial public offering of organogenesis inc. that was abandoned . the ipo process was abandoned and was replaced with the avista merger transaction . ( 5 ) amount reflects legal and professional fees incurred primarily in the second half of the year ended december 31 , 2018 related directly to the avista merger were expensed as incurred . ( 6 ) amount reflects the write off of unamortized debt issuance costs upon repayment of affiliate debt in december 2018 and the difference in the carrying value of the affiliate debt converted to class a common stock and the fair value of the class a common stock issued in the conversion in december 2018 . 83 comparison of the year ended december 31 , 2018 and 2017 revenue replace_table_token_6_th net revenue from our advanced wound care products decreased by $ 14.6 million , or 8 % , to $ 164.3 million in the year ended december 31 , 2018 from $ 178.9 million in the year ended december 31 , 2017. our decrease in advanced wound care net revenue was primarily attributable to the loss of pass-through reimbursement status for puraply during the first nine months of 2018. this decrease was partially offset by the introduction of amniotic products acquired from nutech medical . net revenue from our surgical & sports medicine products increased

cash flows the following table summarizes our cash flows for each of the periods presented : replace_table_token_18_th operating activities during the year ended december 31 , 2018 , net cash used in operating activities was $ 60.7 million , resulting from our net loss of $ 64.8 million and net cash used in connection with changes in our operating assets and liabilities of $ 22.4 million , partially offset by non-cash charges of $ 26.5 million . net cash used in connection with changes in our operating assets and liabilities include a decrease in accrued interest on affiliate debt of $ 9.2 million , an increase in accounts receivable of $ 7.1 million , an increase in inventory of $ 5.0 million , an increase in prepaid expenses and other current assets of $ 1.4 million , an increase in accrued expenses of $ 0.4 million , an increase in other liabilities of $ 0.1 million , all of which were offset by a decrease in accounts payable of $ 0.1 million . during the year ended december 31 , 2017 , net cash used in operating activities was $ 3.6 million , resulting from our net loss of $ 7.5 million and net cash provided by changes in our operating assets and liabilities of $ 5.2 million , partially offset by non-cash charges of $ 9.2 million . net cash used in connection with changes in our operating assets and liabilities include an increase in accounts receivable of $ 7.0 million , an increase in inventory of $ 3.8 million due to an improvement in inventory management processes and an increase in prepaid expense and other current assets of $ 2.7 million . the increases were partially offset by an increase in accounts payable of $ 3.9 million , an increase in accrued interest on affiliate debt of $ 3.2 million and an increase in accrued expenses of $ 1.0 million .


 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 flows the following table summarizes our cash flows for each of the periods presented : replace_table_token_18_th operating activities during the year ended december 31 , 2018 , net cash used in operating activities was $ 60.7 million , resulting from our net loss of $ 64.8 million and net cash used in connection with changes in our operating assets and liabilities of $ 22.4 million , partially offset by non-cash charges of $ 26.5 million . net cash used in connection with changes in our operating assets and liabilities include a decrease in accrued interest on affiliate debt of $ 9.2 million , an increase in accounts receivable of $ 7.1 million , an increase in inventory of $ 5.0 million , an increase in prepaid expenses and other current assets of $ 1.4 million , an increase in accrued expenses of $ 0.4 million , an increase in other liabilities of $ 0.1 million , all of which were offset by a decrease in accounts payable of $ 0.1 million . during the year ended december 31 , 2017 , net cash used in operating activities was $ 3.6 million , resulting from our net loss of $ 7.5 million and net cash provided by changes in our operating assets and liabilities of $ 5.2 million , partially offset by non-cash charges of $ 9.2 million . net cash used in connection with changes in our operating assets and liabilities include an increase in accounts receivable of $ 7.0 million , an increase in inventory of $ 3.8 million due to an improvement in inventory management processes and an increase in prepaid expense and other current assets of $ 2.7 million . the increases were partially offset by an increase in accounts payable of $ 3.9 million , an increase in accrued interest on affiliate debt of $ 3.2 million and an increase in accrued expenses of $ 1.0 million .
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 Suspicious Activity Report : our surgical & sports medicine products include renu for in-office joint and tendon applications ; nucel for bony fusion in the spine and extremities ; nushield and affinity for surgical application in targeted soft tissue repairs ; and puraply am for surgical treatment of open wounds . we currently sell these products through independent agencies and our growing direct sales force . on december 10 , 2018 , avista healthcare public acquisition corp. , our predecessor company ( ahpac ) , consummated the previously announced business combination pursuant to that certain agreement and plan of merger , dated as of august 17 , 2018 ( as amended , the avista merger agreement ) , by and among ahpac , avista healthcare merger sub , inc. , a delaware corporation and a direct wholly owned subsidiary of ahpac ( avista merger sub ) and organogenesis inc. , a delaware corporation ( organogenesis inc. ) . as a result of the transactions contemplated by the avista merger agreement , avista merger sub merged with and into organogenesis inc. , with organogenesis inc. surviving the merger ( the avista merger ) . in addition , in connection with the business combination , and in accordance with section 388 of the delaware general corporation law and the cayman islands companies law ( 2018 revision ) , ahpac redomesticated as a delaware corporation ( the domestication ) . after the domestication , ahpac changed its name to organogenesis holdings inc. as a result of the avista merger , organogenesis inc. became a wholly owned direct subsidiary of organogenesis holdings inc. for periods prior to the closing of the avista merger on december 10 , 2018 , the disclosure in management 's discussion and analysis of financial condition and results of operations has been updated to give effect to the avista merger . for the year ended december 31 , 2018 , we generated $ 193.4 million of revenue and had a net loss of $ 64.8 million compared to revenue of $ 198.5 million and a net loss of $ 7.5 million for the year ended december 31 , 2017. for the year ended december 31 , 2016 , we generated $ 138.7 million of revenue and had a net loss of $ 14.8 million . we expect to incur operating losses for the foreseeable future as we expend resources as part of our efforts to grow our organization to support the planned expansion of our business . as of december 31 , 2018 , we had an accumulated deficit of $ 130.2 million . our primary sources of capital to date have been from sales of our products , borrowings from related parties and institutional lenders and proceeds from the sale of our common stock . we operate in one segment , regenerative medicine . items affecting comparability nutech medical acquisition . on march 18 , 2017 , we entered into an agreement and plan of merger pursuant to which we acquired all of the outstanding shares of capital stock of nutech medical , inc. ( nutech medical ) for aggregate consideration consisting of $ 20.0 million in cash , $ 12.0 million of which was paid at closing with the remainder to be paid on or before the fifteen-month anniversary of the closing ( less a reduction 76 of $ 0.5 million resulting from an adjustment for working capital ) ; and 3,642,746 shares of our class a common stock , 2,185,647 of which were subject to forfeiture and 728,549 of which contain put and call features , and fully vested options to purchase 137,543 shares of our class a common stock . in addition , a deferred tax liability of $ 6.8 million recorded in connection with the acquisition allowed us to release a portion of the u.s. valuation allowance resulting in a tax benefit in the same amount . upon the closing of the merger , nutech medical merged with and into prime merger sub , llc , with prime merger sub , llc surviving the merger as our wholly owned subsidiary . the results of operations for nutech medical are included in our consolidated financial statements as of march 24 , 2017 , which was the closing date of the merger . variable interest entity ( vie ) deconsolidation . we have historically consolidated the accounts of dan road associates , llc ( dan road associates ) , 85 dan road associates , llc ( 85 dan road associates ) , and 65 dan road associates , llc ( 65 dan road associates ) as variable interest entities . we refer to these variable interest entities collectively as the real estate entities. the real estate entities , which are controlled by certain of our affiliates , are special purpose entities that hold real estate that is leased by us . we do not hold any capital stock of the real estate entities . based on the nature of the leases and the mortgages held by these affiliates , we determined that the real estate entities were variable interest entities , which required consolidation . following the removal of certain personal guarantees provided by these affiliates in respect of mortgage loans related to the property held by the real estate entities , we determined that the real estate entities no longer met the definition of variable interest entities and we deconsolidated them from our financial statements as of june 1 , 2017. credit agreement and ml agreement . in march 2017 , we entered into a credit agreement with silicon valley bank , as amended , the credit agreement . the credit agreement provides for a revolving credit facility of up to $ 30 million and a term loan of up to $ 5.0 million . story_separator_special_tag in connection with the consummation of the avista merger in december 2018 and the transactions contemplated by the exchange agreement , outstanding principal of $ 45.7 million related to the affiliate debt was exchanged for 6,502,679 shares of orgo class a common stock and a cash payment of $ 35.6 million , representing $ 22.0 million of principal and $ 13.6 million of accrued interest related to all aforementioned affiliate debt and accrued affiliate loan fees as of and through the closing date of the avista merger . following the consummation of these transactions , the affiliate debt was deemed fully paid and satisfied in full and was discharged and terminated . we incurred a loss of $ 2.1 million on the extinguishment of the affiliate debt in connection with the write off of unamortized debt issuance costs and the difference in the carrying value of the affiliate debt converted to class a common stock and the fair value of the class a common stock issued in the conversion . income taxes we account for income taxes using an asset and liability approach . deferred income taxes reflect the net tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes . valuation allowances are provided when necessary to reduce net deferred tax assets to an amount that is more likely than not to be realized . in determining whether a valuation allowance for deferred tax assets is necessary , management analyzes both positive and negative evidence related to the realization of deferred tax assets and inherent in that , assesses the likelihood of sufficient future taxable income . management also considers the expected reversal of deferred tax liabilities and analyzes the period in which these would be expected to reverse to determine whether the taxable temporary difference amounts serve as an adequate source of future taxable income to support realizability of the deferred tax assets . in addition , management considers whether it is more likely than not that the tax position will be sustained on examination by taxing authorities based on the technical merits of the 81 position . based on a consideration of the factors discussed above , including the fact that through the year-ended december 31 , 2018 , our results reflected a three-year cumulative loss position , management has determined that a valuation allowance is necessary against the full amount of our net deferred tax assets , excluding alternative minimum tax credits . on december 22 , 2017 , the united states enacted new tax reform ( tax act ) and as a result alternative minimum tax credits will be refundable beginning with the 2018 tax return . the alternative minimum tax credits will be realized , regardless of future taxable income , and thus no valuation allowance has been provided against this asset . results of operations the following table sets forth , for the periods indicated , our results of operations : replace_table_token_4_th 82 ebitda and adjusted ebitda the following table presents a reconciliation of adjusted ebitda to net loss attributable to organogenesis holdings inc. , the most directly comparable gaap measure , for each of the periods presented : replace_table_token_5_th ( 1 ) amount reflects the change in fair value of the common shares associated with the shares issued in connection with the acquisition of nutech medical that are forfeitable by the sole stockholder of nutech medical upon the occurrence of the fda requiring approval of certain products acquired from nutech medical . ( 2 ) amount reflects the change in fair value of our interest rate swaps that the real estate entities entered into to manage the economic impact of fluctuations in interest rate . we do not use interest rate swaps for speculative or trading purposes and as such , the fair value of these instruments is recorded as an asset or liability on the consolidated balance sheet with change in the fair value of the instruments recognized as income or expense in the current period as a component of other income ( expense ) , net in the consolidated statement of operations . ( 3 ) in connection with our 2016 loans ( as defined below ) , we classified the warrants issued to purchase our common stock to the lenders , who are affiliates of ours as a liability on our consolidated balance sheet . amounts reflect the change in fair value of the warrant liability . ( 4 ) amount reflects a one-time write-off in the quarter ended june 30 , 2018 of costs accumulated in connection with a proposed initial public offering of organogenesis inc. that was abandoned . the ipo process was abandoned and was replaced with the avista merger transaction . ( 5 ) amount reflects legal and professional fees incurred primarily in the second half of the year ended december 31 , 2018 related directly to the avista merger were expensed as incurred . ( 6 ) amount reflects the write off of unamortized debt issuance costs upon repayment of affiliate debt in december 2018 and the difference in the carrying value of the affiliate debt converted to class a common stock and the fair value of the class a common stock issued in the conversion in december 2018 . 83 comparison of the year ended december 31 , 2018 and 2017 revenue replace_table_token_6_th net revenue from our advanced wound care products decreased by $ 14.6 million , or 8 % , to $ 164.3 million in the year ended december 31 , 2018 from $ 178.9 million in the year ended december 31 , 2017. our decrease in advanced wound care net revenue was primarily attributable to the loss of pass-through reimbursement status for puraply during the first nine months of 2018. this decrease was partially offset by the introduction of amniotic products acquired from nutech medical . net revenue from our surgical & sports medicine products increased

