we undertake no obligation to revise or update any forward-looking statements to reflect any event or circumstance that arises after the date of this report , or to conform such statements to actual results or changes in our expectations . overview we are a commercial drug delivery company committed to improving the quality of life for patients with ear , nose and throat conditions . our fda approved products are steroid releasing implants designed to treat adult patients suffering from chronic sinusitis , who are managed by ent physicians . these products include our propel ® family of products ( propel ® , propel ® mini and propel ® contour ) and the sinuva ® ( mometasone furoate ) sinus implant . the propel family of products are used in conjunction with sinus surgery primarily in hospitals and ambulatory surgery centers and sinuva is designed to be used in the physician 's office setting of care to treat adult patients who have had ethmoid sinus surgery yet suffer from recurrent sinus obstruction due to polyps . the propel family of products are devices approved under a premarket approval , or pma and sinuva is a drug that was approved under a new drug application , or nda . our propel family of steroid releasing implants are clinically proven to improve outcomes for chronic sinusitis patients following sinus surgery . propel implants mechanically prop open the sinuses and release mometasone furoate , an advanced corticosteroid with anti-inflammatory properties , directly into the sinus lining , and then dissolve . propel 's safety and effectiveness is supported by level 1-a clinical evidence from multiple clinical trials , which demonstrates that propel implants reduce inflammation and scarring after surgery , thereby reducing the need for postoperative oral steroids and repeat surgical interventions . more than 280,000 patients have been treated with propel products to-date . propel clinical outcomes have been reported in a meta-analysis of prospective , multicenter , randomized , controlled , double-blind clinical studies to improve surgical outcomes , demonstrating a 35 % relative reduction in the need for postoperative interventions compared to surgery alone . a physician may treat a patient with propel by inserting it into the ethmoid sinuses . propel is a self-expanding implant designed to conform to and hold open the surgically enlarged sinus while gradually releasing an anti-inflammatory steroid over a period of approximately 30 days and is absorbed into the body over a period of approximately six weeks . propel mini has also been shown by our clinical studies to reduce the need for postoperative interventions , including a 38 % relative reduction in the need for postoperative interventions in the frontal sinus , compared to surgery alone with standard postoperative care . propel mini is a smaller version of propel and is approved for use in both the ethmoid and frontal sinuses . propel mini is preferentially used by physicians compared with propel when treating smaller anatomies or following less extensive procedures . propel contour is designed to facilitate treatment of the frontal and maxillary sinus ostia , or openings , of the dependent sinuses in procedures performed in both the operating room and in the office setting of care . propel contour 's lower profile , hourglass shape and malleable delivery system are designed for use in the narrow and difficult to access sinus ostia . in propel contour 's pivotal 53 clinical study , the product demonstrated a 65 % relative reduction in the need for postoperative interventions in the frontal sinus ostia compared to surgery alone with standard postoperative care . sinuva , when placed during a routine physician office visit , expands into the sinus cavity and delivers an anti-inflammatory steroid directly to the site of polyp disease for 90 days . we have studied sinuva in 4 clinical trials in over 400 patients to-date . results from the pivotal resolve ii randomized clinical trial demonstrated a 74 % relative reduction in bilateral polyp grade ( a measurement of the extent of ethmoid polyp disease ) and a 30 % relative reduction in nasal obstruction and congestion for patients treated with sinuva compared to a control group treated with a sham procedure , receiving no implant . patients in both arms of the study were required to use an intranasal steroid spray daily . in addition , the study demonstrated a 61 % reduction in the proportion of patients indicated for revision surgery at day 90. to supplement clinical trials performed with sinuva to-date , in which one course of sinuva treatment was evaluated , we commenced the encore study in november 2017. encore was a 50-patient multicenter , open-label study focused on evaluation of the safety of repeat placement of sinuva in a population of chronic sinusitis patients with nasal polyps . study findings showed zero serious adverse events related to the implants during the measurement period and zero serious adverse events related to repeat placement . our propel family of products are used almost exclusively in the operating room of a hospital or ambulatory surgery center . these providers receive a facility fee for the sinus surgery procedure which is intended to pay for supplies used in this procedure , including the propel family of products . reimbursement submissions to cover the cost of sinuva may be reported to payors using the unassigned healthcare common procedure coding system , or hcpcs , code j3490 . we applied to the centers for medicare & medicaid services , or cms , for a product-specific j code for sinuva in the 2018 process but this code was not granted . we have submitted a new application seeking a product-specific j code in the 2019 process . story_separator_special_tag the preparation of these financial statements requires us to make estimates and assumptions for the reported amounts of assets , liabilities , revenue , expenses and related disclosures . our estimates are based on our historical experience and on various other factors that we believe are reasonable under the circumstances , the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources . actual results may differ from these estimates under different assumptions or conditions and any such differences may be material . while our significant accounting policies are more fully described in note 2 of our financial statements included in this annual report , we believe the following discussion addresses our most critical accounting policies , which are those that are most important to the portrayal of our financial condition and results of operations and require our most difficult , subjective and complex judgments . revenue recognition we adopted asc topic 606 , revenue from contracts with customers , on january 1 , 2018 using the cumulative effect transition method . the adoption did not have an effect on our financial condition or results of operations as of the adoption date and therefore no cumulative effect adjustment was required to reflect the transition requirements of topic 606. this standard applies to all contracts with customers , except for contracts that are within the scope of other standards . under topic 606 , we recognize revenue when our customer obtains control of promised goods in an amount that reflects the consideration which we expect to receive in exchange for those goods . to determine revenue recognition for arrangements that we determine are within the scope of topic 606 , we perform the following five steps : ( i ) identify the contract with a customer ; ( ii ) identify the performance obligations in the contract ; ( iii ) determine the transaction price ; ( iv ) allocate the transaction price to the performance obligations in the contract ; and ( v ) recognize revenue when , or as , we satisfy the performance obligations . we only apply the five-step model to contracts when it is probable that we will collect the consideration we are entitled to in exchange for the goods we transfer to the customer . at contract inception , once the contract is determined to be within the scope of topic 606 , we assess the goods promised within each contract and determine those that are performance obligations and assess whether each promised good is distinct . the contracts are typically in the form of a purchase order from the customer . we then recognize as revenue the amount of the transaction price that is allocated to the respective performance obligation when , or as , the performance obligation is satisfied . we must make assumptions regarding the future collectability of amounts receivable from customers to determine whether revenue recognition criteria have been met . the amount of variable consideration that is included in the net sales price may be constrained , and is included in the net sales price , or transaction price , only to the extent that we estimate it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period . we expense shipping and handling costs as incurred and include them in the cost of sales . in those cases where shipping and handling costs are billed to customers , we classify the amounts billed as a component of revenue . taxes collected from customers and remitted to governmental authorities are excluded from revenues . we expense any incremental costs of obtaining a contract as and when incurred as the expected amortization period of the incremental costs would have been less than one year . the propel family of products are regulated by the fda as medical devices . we recognize revenue through sales of our propel family of products to hospitals and ambulatory surgery centers located almost entirely in the united states when control of the product is transferred to the customer , typically upon shipment of goods to the customer , satisfying our only performance obligation . the fda has approved sinuva as a pharmaceutical product and it is therefore regulated as such . we sell sinuva to a limited number of specialty pharmacies and specialty distributors in the united states , or resellers . these resellers subsequently sell sinuva to health care providers . revenue from sinuva sales are recognized when control of the product is transferred to the resellers , typically upon receipt of goods by the reseller , satisfying our only performance obligation . we also recognize reseller fees , prompt pay discounts , product sales discounts , rebates , returns and other allowances as a reduction of revenue in the same period the 60 related revenue is recognized . in addition to the agreements with the resellers , we enter into arrangements with governmental agencies that result in rebates , chargebacks and discounts with respect to the purchase of sinuva . these amounts may include medicaid and tricare rebates , chargebacks related to federal supply schedule of the general services administration , distribution and pricing agreement with the department of defense and 340b of the public health service act as well as other allowances that may be offered within contracts between us and our direct or indirect customers relating to our sales of sinuva , collectively referred to as discounts and rebates. discounts and rebates are based on amounts owed or expected to be owed on the related sales . these estimates take into consideration our historical experience , the shelf life of the product , current contractual and statutory requirements , specific known market events and trends and industry data . overall , these reserves reflect our best estimates of the amount of consideration to which we are

liquidity and capital resources overview as of december 31 , 2018 , we had cash , cash equivalents and short-term investments of $ 100.8 million , compared to cash , cash equivalents and short-term investments of $ 102.3 million as of december 31 , 2017 . 57 cash flows replace_table_token_6_th net cash used in operating activities during the year ended december 31 , 2018 , net cash used in operating activities was $ 13.8 million , consisting primarily of a net loss of $ 22.9 million and an increase in net operating assets of $ 5.1 million , partially offset by non-cash charges of $ 14.2 million . the cash used in operations was due primarily to an increase in headcount and related expenses to support the ongoing commercialization of our propel family of products and the launch of sinuva in march 2018. the non-cash charges primarily consisted of stock-based compensation expense . the increase in net operating assets is primarily due to an increase in accounts receivable and inventory , partially offset by an increase in accounts payable . during the year ended december 31 , 2017 , net cash used in operating activities was $ 8.0 million , consisting primarily of a net loss of $ 16.4 million and an increase in net operating assets of $ 2.9 million , partially offset by non-cash charges of $ 11.3 million . the cash used in operations was due primarily to an increase in headcount to support the ongoing commercialization of our propel family of products and to prepare for the launch of sinuva . the non-cash charges consisted primarily of stock-based compensation expense . the increase in net operating assets is due primarily to an increase in inventory , accounts receivable and other assets , partially offset by an increase in accrued year-end bonuses and sales commissions .


 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.
     ```liquidity and capital resources overview as of december 31 , 2018 , we had cash , cash equivalents and short-term investments of $ 100.8 million , compared to cash , cash equivalents and short-term investments of $ 102.3 million as of december 31 , 2017 . 57 cash flows replace_table_token_6_th net cash used in operating activities during the year ended december 31 , 2018 , net cash used in operating activities was $ 13.8 million , consisting primarily of a net loss of $ 22.9 million and an increase in net operating assets of $ 5.1 million , partially offset by non-cash charges of $ 14.2 million . the cash used in operations was due primarily to an increase in headcount and related expenses to support the ongoing commercialization of our propel family of products and the launch of sinuva in march 2018. the non-cash charges primarily consisted of stock-based compensation expense . the increase in net operating assets is primarily due to an increase in accounts receivable and inventory , partially offset by an increase in accounts payable . during the year ended december 31 , 2017 , net cash used in operating activities was $ 8.0 million , consisting primarily of a net loss of $ 16.4 million and an increase in net operating assets of $ 2.9 million , partially offset by non-cash charges of $ 11.3 million . the cash used in operations was due primarily to an increase in headcount to support the ongoing commercialization of our propel family of products and to prepare for the launch of sinuva . the non-cash charges consisted primarily of stock-based compensation expense . the increase in net operating assets is due primarily to an increase in inventory , accounts receivable and other assets , partially offset by an increase in accrued year-end bonuses and sales commissions .
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 Suspicious Activity Report : we undertake no obligation to revise or update any forward-looking statements to reflect any event or circumstance that arises after the date of this report , or to conform such statements to actual results or changes in our expectations . overview we are a commercial drug delivery company committed to improving the quality of life for patients with ear , nose and throat conditions . our fda approved products are steroid releasing implants designed to treat adult patients suffering from chronic sinusitis , who are managed by ent physicians . these products include our propel ® family of products ( propel ® , propel ® mini and propel ® contour ) and the sinuva ® ( mometasone furoate ) sinus implant . the propel family of products are used in conjunction with sinus surgery primarily in hospitals and ambulatory surgery centers and sinuva is designed to be used in the physician 's office setting of care to treat adult patients who have had ethmoid sinus surgery yet suffer from recurrent sinus obstruction due to polyps . the propel family of products are devices approved under a premarket approval , or pma and sinuva is a drug that was approved under a new drug application , or nda . our propel family of steroid releasing implants are clinically proven to improve outcomes for chronic sinusitis patients following sinus surgery . propel implants mechanically prop open the sinuses and release mometasone furoate , an advanced corticosteroid with anti-inflammatory properties , directly into the sinus lining , and then dissolve . propel 's safety and effectiveness is supported by level 1-a clinical evidence from multiple clinical trials , which demonstrates that propel implants reduce inflammation and scarring after surgery , thereby reducing the need for postoperative oral steroids and repeat surgical interventions . more than 280,000 patients have been treated with propel products to-date . propel clinical outcomes have been reported in a meta-analysis of prospective , multicenter , randomized , controlled , double-blind clinical studies to improve surgical outcomes , demonstrating a 35 % relative reduction in the need for postoperative interventions compared to surgery alone . a physician may treat a patient with propel by inserting it into the ethmoid sinuses . propel is a self-expanding implant designed to conform to and hold open the surgically enlarged sinus while gradually releasing an anti-inflammatory steroid over a period of approximately 30 days and is absorbed into the body over a period of approximately six weeks . propel mini has also been shown by our clinical studies to reduce the need for postoperative interventions , including a 38 % relative reduction in the need for postoperative interventions in the frontal sinus , compared to surgery alone with standard postoperative care . propel mini is a smaller version of propel and is approved for use in both the ethmoid and frontal sinuses . propel mini is preferentially used by physicians compared with propel when treating smaller anatomies or following less extensive procedures . propel contour is designed to facilitate treatment of the frontal and maxillary sinus ostia , or openings , of the dependent sinuses in procedures performed in both the operating room and in the office setting of care . propel contour 's lower profile , hourglass shape and malleable delivery system are designed for use in the narrow and difficult to access sinus ostia . in propel contour 's pivotal 53 clinical study , the product demonstrated a 65 % relative reduction in the need for postoperative interventions in the frontal sinus ostia compared to surgery alone with standard postoperative care . sinuva , when placed during a routine physician office visit , expands into the sinus cavity and delivers an anti-inflammatory steroid directly to the site of polyp disease for 90 days . we have studied sinuva in 4 clinical trials in over 400 patients to-date . results from the pivotal resolve ii randomized clinical trial demonstrated a 74 % relative reduction in bilateral polyp grade ( a measurement of the extent of ethmoid polyp disease ) and a 30 % relative reduction in nasal obstruction and congestion for patients treated with sinuva compared to a control group treated with a sham procedure , receiving no implant . patients in both arms of the study were required to use an intranasal steroid spray daily . in addition , the study demonstrated a 61 % reduction in the proportion of patients indicated for revision surgery at day 90. to supplement clinical trials performed with sinuva to-date , in which one course of sinuva treatment was evaluated , we commenced the encore study in november 2017. encore was a 50-patient multicenter , open-label study focused on evaluation of the safety of repeat placement of sinuva in a population of chronic sinusitis patients with nasal polyps . study findings showed zero serious adverse events related to the implants during the measurement period and zero serious adverse events related to repeat placement . our propel family of products are used almost exclusively in the operating room of a hospital or ambulatory surgery center . these providers receive a facility fee for the sinus surgery procedure which is intended to pay for supplies used in this procedure , including the propel family of products . reimbursement submissions to cover the cost of sinuva may be reported to payors using the unassigned healthcare common procedure coding system , or hcpcs , code j3490 . we applied to the centers for medicare & medicaid services , or cms , for a product-specific j code for sinuva in the 2018 process but this code was not granted . we have submitted a new application seeking a product-specific j code in the 2019 process . story_separator_special_tag the preparation of these financial statements requires us to make estimates and assumptions for the reported amounts of assets , liabilities , revenue , expenses and related disclosures . our estimates are based on our historical experience and on various other factors that we believe are reasonable under the circumstances , the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources . actual results may differ from these estimates under different assumptions or conditions and any such differences may be material . while our significant accounting policies are more fully described in note 2 of our financial statements included in this annual report , we believe the following discussion addresses our most critical accounting policies , which are those that are most important to the portrayal of our financial condition and results of operations and require our most difficult , subjective and complex judgments . revenue recognition we adopted asc topic 606 , revenue from contracts with customers , on january 1 , 2018 using the cumulative effect transition method . the adoption did not have an effect on our financial condition or results of operations as of the adoption date and therefore no cumulative effect adjustment was required to reflect the transition requirements of topic 606. this standard applies to all contracts with customers , except for contracts that are within the scope of other standards . under topic 606 , we recognize revenue when our customer obtains control of promised goods in an amount that reflects the consideration which we expect to receive in exchange for those goods . to determine revenue recognition for arrangements that we determine are within the scope of topic 606 , we perform the following five steps : ( i ) identify the contract with a customer ; ( ii ) identify the performance obligations in the contract ; ( iii ) determine the transaction price ; ( iv ) allocate the transaction price to the performance obligations in the contract ; and ( v ) recognize revenue when , or as , we satisfy the performance obligations . we only apply the five-step model to contracts when it is probable that we will collect the consideration we are entitled to in exchange for the goods we transfer to the customer . at contract inception , once the contract is determined to be within the scope of topic 606 , we assess the goods promised within each contract and determine those that are performance obligations and assess whether each promised good is distinct . the contracts are typically in the form of a purchase order from the customer . we then recognize as revenue the amount of the transaction price that is allocated to the respective performance obligation when , or as , the performance obligation is satisfied . we must make assumptions regarding the future collectability of amounts receivable from customers to determine whether revenue recognition criteria have been met . the amount of variable consideration that is included in the net sales price may be constrained , and is included in the net sales price , or transaction price , only to the extent that we estimate it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period . we expense shipping and handling costs as incurred and include them in the cost of sales . in those cases where shipping and handling costs are billed to customers , we classify the amounts billed as a component of revenue . taxes collected from customers and remitted to governmental authorities are excluded from revenues . we expense any incremental costs of obtaining a contract as and when incurred as the expected amortization period of the incremental costs would have been less than one year . the propel family of products are regulated by the fda as medical devices . we recognize revenue through sales of our propel family of products to hospitals and ambulatory surgery centers located almost entirely in the united states when control of the product is transferred to the customer , typically upon shipment of goods to the customer , satisfying our only performance obligation . the fda has approved sinuva as a pharmaceutical product and it is therefore regulated as such . we sell sinuva to a limited number of specialty pharmacies and specialty distributors in the united states , or resellers . these resellers subsequently sell sinuva to health care providers . revenue from sinuva sales are recognized when control of the product is transferred to the resellers , typically upon receipt of goods by the reseller , satisfying our only performance obligation . we also recognize reseller fees , prompt pay discounts , product sales discounts , rebates , returns and other allowances as a reduction of revenue in the same period the 60 related revenue is recognized . in addition to the agreements with the resellers , we enter into arrangements with governmental agencies that result in rebates , chargebacks and discounts with respect to the purchase of sinuva . these amounts may include medicaid and tricare rebates , chargebacks related to federal supply schedule of the general services administration , distribution and pricing agreement with the department of defense and 340b of the public health service act as well as other allowances that may be offered within contracts between us and our direct or indirect customers relating to our sales of sinuva , collectively referred to as discounts and rebates. discounts and rebates are based on amounts owed or expected to be owed on the related sales . these estimates take into consideration our historical experience , the shelf life of the product , current contractual and statutory requirements , specific known market events and trends and industry data . overall , these reserves reflect our best estimates of the amount of consideration to which we are

