the preparation of these financial statements requires our management to make estimates and judgments that affect the reported amounts of assets , liabilities , income and expenses , and related disclosure of contingent assets and liabilities . we evaluate our estimates on an ongoing basis . our estimates are based on historical experience and on various other assumptions that we believe to be reasonable . overview the following is our only product candidate in the clinical stage of development : · pedmark tm ( sodium thiosulfate ( sts ) anhydrous injection ) –has announced results of two phase 3 clinical trials for the prevention of cisplatin induced hearing loss , or ototoxicity in children including the pivotal phase 3 study siopel 6 , “ a multicentre open label randomised phase 3 trial of the efficacy of sodium thiosulfate in reducing ototoxicity in patients receiving cisplatin chemotherapy for standard risk hepatoblastoma , ” and the proof of concept phase 3 study “ a randomized phase 3 study of sodium thiosulfate for the prevention of cisplatin-induced ototoxicity in children ” . we continue to focus our resources on the development of pedmark tm . we have licensed from ohsu intellectual property rights for the use of pedmark tm as a chemoprotectant and are developing pedmark tm as a protectant against the hearing loss often caused by platinum-based anti-cancer agents in children . preclinical and clinical studies conducted by ohsu and others have indicated that pedmark tm can effectively reduce the incidence of hearing loss caused by platinum-based anti-cancer agents . we have received orphan drug designation in the united states for the use of pedmark tm in the prevention of platinum-induced ototoxicity in pediatric patients . hearing loss among children receiving platinum-based chemotherapy is frequent , permanent and often severely disabling . the incidence of hearing loss in these children depends upon the dose and duration of chemotherapy , and many of these children require lifelong hearing aids . there is currently no established preventive agent for this hearing loss and only expensive , technically difficult and sub-optimal cochlear ( inner ear ) implants have been shown to provide some benefit . in addition , adults undergoing chemotherapy for several common malignancies , including ovarian cancer , testicular cancer , and particularly head and neck cancer and brain cancer , often receive intensive platinum-based therapy and may experience severe , irreversible hearing loss , particularly in the high frequencies . in the u.s. and europe , it is estimated annually that over 10,000 children may receive platinum-based chemotherapy . the incidence of ototoxicity depends upon the dose and duration of chemotherapy , and many of these children require lifelong hearing aids . there is currently no established preventive agent for this hearing loss and only expensive , technically difficult and sub-optimal cochlear ( inner ear ) implants have been shown to provide some benefit . infants and young children that suffer ototoxicity at critical stages of development lack speech language development and literacy , and older children and adolescents lack social-emotional development and educational achievement . pedmark has been studied by cooperative groups in two phase 3 clinical studies of survival and reduction of ototoxicity , the clinical oncology group protocol accl0431 and siopel 6. both studies have been completed . the cog accl0431 protocol enrolled one of five childhood cancers typically treated with intensive cisplatin therapy for localized and disseminated disease , including newly diagnosed hepatoblastoma , germ cell tumor , osteosarcoma , neuroblastoma , and medulloblastoma . siopel 6 enrolled only hepatoblastoma patients with localized tumors . in july 2018 , the pediatric committee ( pdco ) of the european medicines agency ( ema ) accepted our pediatric investigation plan ( pip ) for sodium thiosulfate for infusion for the condition of the prevention of platinum-induced ototoxic hearing loss . an accepted pip is a prerequisite for filing a full marketing authorization application ( maa ) for a new medicinal product in europe . the indication targeted by the company 's pip is for the prevention of platinum-induced ototoxic hearing loss for standard risk hepatoblastoma ( sr-hb ) . additional tumor types within the proposed maa indication will be subject to the committee for medicinal products for human use ( chmp ) assessment at the time of the maa . no deferred clinical studies were required in the positive opinion given by pdco . the company was also advised that sodium thiosulfate for infusion is eligible for submission of an application for a pediatric use marketing authorization ( puma ) . therefore , this pip decision allows fennec to proceed with the submission of a puma in the european union ( eu ) with incentives of automatic access to the centralized procedure and up to 10 years of data and market protection . the puma is a dedicated ma for new products of medicines previously authorized and no longer under data or marketing protection , covering the indication and appropriate formulation for medicines developed exclusively for use in the pediatric population . in february 2020 , fennec announced that it has submitted a maa for the prevention of ototoxicity induced by cisplatin chemotherapy in patients 1 month to < 18 years of age with localized , non-metastatic , solid tumors . the company is targeting potential commercial launch of sodium thiosulfate for infusion , if approved , in the first half of 2021 . story_separator_special_tag we incurred approximately $ 0.25 million in executive search services as we continue to build a commercial team . · all of our derivative instruments were exercised or expired during fiscal 2018 . · amortization expense relates to the bridge bank loan facility as the loan origination fees were capitalized in fiscal 2019 . · interest income decreased in fiscal 2019 as compared to 2018 , due to a lower average balance in savings and money market accounts for the comparable periods . quarterly information the following table presents selected consolidated financial data for each of the last eight quarters through december 31 , 2019 , as prepared under u.s. gaap ( dollars in thousands , except per share information ) . replace_table_token_3_th quarter ended december 31 , 2019 versus 2018 replace_table_token_4_th we reported a net loss from operations of $ 3.6 million for the three months ended december 31 , 2019 , compared to a net loss from operations of $ 3.0 million for the same period in 2018. research and development expenses totaled $ 1.1 million for the three months ended december 31 , 2019 , as compared to a $ 1.7 million in the same period in 2018 as largely most cost associated with the production of registration batches was incurred in the first three quarters of 2019. general and administrative expenses increased by $ 1.1 million in the three months ended december 31 , 2019 , as compared to the same period in 2018. the increase arises from our commercialization activities for pedmark tm as we execute on our plan to be ready to bring product to market co-incidentally with fda approval , expected to occur later in 2020. there were also increases in compensation expenses in fiscal 2019 as we hired a chief commercial officer in september 2019. replace_table_token_5_th 50 replace_table_token_6_th story_separator_special_tag roman , times , serif ; margin : 0pt 0 ; text-align : left `` > critical accounting policies and estimates the preparation of financial statements in conformity with u.s. gaap requires management to make estimates that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities as of the date of the financial statements and the reported amounts of revenue and expense during the reporting period . these estimates are based on assumptions and judgments that may be affected by commercial , economic and other factors . actual results could differ from these estimates . an accounting policy is considered to be critical if it requires an accounting estimate to be made based on assumptions about matters that are highly uncertain at the time the estimate is made , and if different estimates reasonably could have been used , or changes in the accounting estimates that are reasonably likely to occur periodically , could materially impact the financial statements . the following description of critical accounting policies , judgments and estimates should be read in conjunction with our december 31 , 2019 consolidated financial statements . stock-based compensation the calculation of the fair values of our stock-based compensation plans requires estimates that require management 's judgments . under asc 718 , the fair value of each stock option is estimated on the grant date using the black-scholes option-pricing model . the valuation models require assumptions and estimates to determine expected volatility , expected life , expected dividends and expected risk-free interest rates . the expected volatility was determined using historical volatility of our stock based on the contractual life of the award . the risk-free interest rate assumption was based on the yield on zero-coupon u.s. treasury strips at the award grant date . we also used historical data to estimate forfeiture experience . in valuing options granted in the fiscal years ended december 31 , 2019 and 2018 , we used the following weighted average assumptions : replace_table_token_8_th common shares and warrants common shares are recorded as the net proceeds received on issuance after deducting all share issuance costs and the relative fair value of investor warrants . warrants are recorded at relative fair value and are deducted from the proceeds of common shares and recorded on the consolidated statements of stockholders ' equity as additional paid-in capital . derivative instruments the company applies asc topic 815-40 , `` derivatives and hedging `` ( asc 815-40 ) . one of the conclusions reached under asc 815-40 was that an equity-linked financial instrument would not be considered indexed to the entity 's own stock if the strike price is denominated in a currency other than the issuer 's functional currency . the conclusion reached under asc 815-40 clarified the accounting treatment for these and certain other financial instruments . asc 815-40 specifies that a contract will not be treated as a derivative if it meets the following conditions : ( a ) indexed to our own stock ; and ( b ) classified in stockholders ' equity in our statement of financial position . our options issued to consultants and denominated in canadian dollars were not considered to be indexed to our own stock because the exercise price is denominated in canadian dollars and our functional currency is united states dollars . therefore , these options were treated as derivative financial instruments and recorded at their fair value as a liability . all other outstanding convertible instruments are considered to be indexed to our stock , because their exercise price is denominated in the same currency as our functional currency , and are included in stockholders ' equity . 52 during the year ended december 31 , 2018 , there were exercises of options to purchase 19 shares of our common shares , which were classified as derivative instruments . this resulted in gross proceeds of $ 26 and a non-cash gain on the extinguishment of the remaining derivative liability of $ 167. the fair value of these options was estimated using the black-scholes option-pricing model and is summarized below . replace_table_token_9_th outstanding share information our outstanding

liquidity and capital resources · there was a $ 9.1 million decrease in cash and cash equivalents between december 31 , 2019 and december 31 , 2018. during the period ended december 31 , 2019 , cash for operations was used mainly in regulatory and manufacturing activities and our general and administrative expenses . · the increase in other current assets between december 31 , 2019 and december 31 , 2018 primarily relates to an increase in the prepaid amount for director and officer insurance premiums and prepaid conference expenses . · current liabilities at december 31 , 2019 increased from december 31 , 2018 primarily due to an increase in accounts payable associated with our commercialization and manufacturing activities for the production of pedmark tm and related regulatory expenses at year-end 2019 . · working capital decreased between december 31 , 2019 and december 31 , 2018 by $ 9.7 million . the decrease was a result of cash used in operations offset by $ 0.3 million interest income and the capitalization of $ 0.3 million loan origination expenses . cash outflows related to the regulatory and commercial development of pedmark tm and general and administrative expenses . we expect increased cash outflows as we prepare regulatory submission and commercial preparation to launch pedmark tm . replace_table_token_7_th the net cash flow used in operating activities for the year ended december 31 , 2019 was approximately $ 9.1 million as compared to $ 7.8 million in 2018. this increase relates to the regulatory and commercial development of pedmark tm . we continue to pursue various strategic alternatives including collaborations with other pharmaceutical and biotechnology companies . our projections of further capital requirements are subject to substantial uncertainty .


 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 · there was a $ 9.1 million decrease in cash and cash equivalents between december 31 , 2019 and december 31 , 2018. during the period ended december 31 , 2019 , cash for operations was used mainly in regulatory and manufacturing activities and our general and administrative expenses . · the increase in other current assets between december 31 , 2019 and december 31 , 2018 primarily relates to an increase in the prepaid amount for director and officer insurance premiums and prepaid conference expenses . · current liabilities at december 31 , 2019 increased from december 31 , 2018 primarily due to an increase in accounts payable associated with our commercialization and manufacturing activities for the production of pedmark tm and related regulatory expenses at year-end 2019 . · working capital decreased between december 31 , 2019 and december 31 , 2018 by $ 9.7 million . the decrease was a result of cash used in operations offset by $ 0.3 million interest income and the capitalization of $ 0.3 million loan origination expenses . cash outflows related to the regulatory and commercial development of pedmark tm and general and administrative expenses . we expect increased cash outflows as we prepare regulatory submission and commercial preparation to launch pedmark tm . replace_table_token_7_th the net cash flow used in operating activities for the year ended december 31 , 2019 was approximately $ 9.1 million as compared to $ 7.8 million in 2018. this increase relates to the regulatory and commercial development of pedmark tm . we continue to pursue various strategic alternatives including collaborations with other pharmaceutical and biotechnology companies . our projections of further capital requirements are subject to substantial uncertainty .
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 Suspicious Activity Report : the preparation of these financial statements requires our management to make estimates and judgments that affect the reported amounts of assets , liabilities , income and expenses , and related disclosure of contingent assets and liabilities . we evaluate our estimates on an ongoing basis . our estimates are based on historical experience and on various other assumptions that we believe to be reasonable . overview the following is our only product candidate in the clinical stage of development : · pedmark tm ( sodium thiosulfate ( sts ) anhydrous injection ) –has announced results of two phase 3 clinical trials for the prevention of cisplatin induced hearing loss , or ototoxicity in children including the pivotal phase 3 study siopel 6 , “ a multicentre open label randomised phase 3 trial of the efficacy of sodium thiosulfate in reducing ototoxicity in patients receiving cisplatin chemotherapy for standard risk hepatoblastoma , ” and the proof of concept phase 3 study “ a randomized phase 3 study of sodium thiosulfate for the prevention of cisplatin-induced ototoxicity in children ” . we continue to focus our resources on the development of pedmark tm . we have licensed from ohsu intellectual property rights for the use of pedmark tm as a chemoprotectant and are developing pedmark tm as a protectant against the hearing loss often caused by platinum-based anti-cancer agents in children . preclinical and clinical studies conducted by ohsu and others have indicated that pedmark tm can effectively reduce the incidence of hearing loss caused by platinum-based anti-cancer agents . we have received orphan drug designation in the united states for the use of pedmark tm in the prevention of platinum-induced ototoxicity in pediatric patients . hearing loss among children receiving platinum-based chemotherapy is frequent , permanent and often severely disabling . the incidence of hearing loss in these children depends upon the dose and duration of chemotherapy , and many of these children require lifelong hearing aids . there is currently no established preventive agent for this hearing loss and only expensive , technically difficult and sub-optimal cochlear ( inner ear ) implants have been shown to provide some benefit . in addition , adults undergoing chemotherapy for several common malignancies , including ovarian cancer , testicular cancer , and particularly head and neck cancer and brain cancer , often receive intensive platinum-based therapy and may experience severe , irreversible hearing loss , particularly in the high frequencies . in the u.s. and europe , it is estimated annually that over 10,000 children may receive platinum-based chemotherapy . the incidence of ototoxicity depends upon the dose and duration of chemotherapy , and many of these children require lifelong hearing aids . there is currently no established preventive agent for this hearing loss and only expensive , technically difficult and sub-optimal cochlear ( inner ear ) implants have been shown to provide some benefit . infants and young children that suffer ototoxicity at critical stages of development lack speech language development and literacy , and older children and adolescents lack social-emotional development and educational achievement . pedmark has been studied by cooperative groups in two phase 3 clinical studies of survival and reduction of ototoxicity , the clinical oncology group protocol accl0431 and siopel 6. both studies have been completed . the cog accl0431 protocol enrolled one of five childhood cancers typically treated with intensive cisplatin therapy for localized and disseminated disease , including newly diagnosed hepatoblastoma , germ cell tumor , osteosarcoma , neuroblastoma , and medulloblastoma . siopel 6 enrolled only hepatoblastoma patients with localized tumors . in july 2018 , the pediatric committee ( pdco ) of the european medicines agency ( ema ) accepted our pediatric investigation plan ( pip ) for sodium thiosulfate for infusion for the condition of the prevention of platinum-induced ototoxic hearing loss . an accepted pip is a prerequisite for filing a full marketing authorization application ( maa ) for a new medicinal product in europe . the indication targeted by the company 's pip is for the prevention of platinum-induced ototoxic hearing loss for standard risk hepatoblastoma ( sr-hb ) . additional tumor types within the proposed maa indication will be subject to the committee for medicinal products for human use ( chmp ) assessment at the time of the maa . no deferred clinical studies were required in the positive opinion given by pdco . the company was also advised that sodium thiosulfate for infusion is eligible for submission of an application for a pediatric use marketing authorization ( puma ) . therefore , this pip decision allows fennec to proceed with the submission of a puma in the european union ( eu ) with incentives of automatic access to the centralized procedure and up to 10 years of data and market protection . the puma is a dedicated ma for new products of medicines previously authorized and no longer under data or marketing protection , covering the indication and appropriate formulation for medicines developed exclusively for use in the pediatric population . in february 2020 , fennec announced that it has submitted a maa for the prevention of ototoxicity induced by cisplatin chemotherapy in patients 1 month to < 18 years of age with localized , non-metastatic , solid tumors . the company is targeting potential commercial launch of sodium thiosulfate for infusion , if approved , in the first half of 2021 . story_separator_special_tag we incurred approximately $ 0.25 million in executive search services as we continue to build a commercial team . · all of our derivative instruments were exercised or expired during fiscal 2018 . · amortization expense relates to the bridge bank loan facility as the loan origination fees were capitalized in fiscal 2019 . · interest income decreased in fiscal 2019 as compared to 2018 , due to a lower average balance in savings and money market accounts for the comparable periods . quarterly information the following table presents selected consolidated financial data for each of the last eight quarters through december 31 , 2019 , as prepared under u.s. gaap ( dollars in thousands , except per share information ) . replace_table_token_3_th quarter ended december 31 , 2019 versus 2018 replace_table_token_4_th we reported a net loss from operations of $ 3.6 million for the three months ended december 31 , 2019 , compared to a net loss from operations of $ 3.0 million for the same period in 2018. research and development expenses totaled $ 1.1 million for the three months ended december 31 , 2019 , as compared to a $ 1.7 million in the same period in 2018 as largely most cost associated with the production of registration batches was incurred in the first three quarters of 2019. general and administrative expenses increased by $ 1.1 million in the three months ended december 31 , 2019 , as compared to the same period in 2018. the increase arises from our commercialization activities for pedmark tm as we execute on our plan to be ready to bring product to market co-incidentally with fda approval , expected to occur later in 2020. there were also increases in compensation expenses in fiscal 2019 as we hired a chief commercial officer in september 2019. replace_table_token_5_th 50 replace_table_token_6_th story_separator_special_tag roman , times , serif ; margin : 0pt 0 ; text-align : left `` > critical accounting policies and estimates the preparation of financial statements in conformity with u.s. gaap requires management to make estimates that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities as of the date of the financial statements and the reported amounts of revenue and expense during the reporting period . these estimates are based on assumptions and judgments that may be affected by commercial , economic and other factors . actual results could differ from these estimates . an accounting policy is considered to be critical if it requires an accounting estimate to be made based on assumptions about matters that are highly uncertain at the time the estimate is made , and if different estimates reasonably could have been used , or changes in the accounting estimates that are reasonably likely to occur periodically , could materially impact the financial statements . the following description of critical accounting policies , judgments and estimates should be read in conjunction with our december 31 , 2019 consolidated financial statements . stock-based compensation the calculation of the fair values of our stock-based compensation plans requires estimates that require management 's judgments . under asc 718 , the fair value of each stock option is estimated on the grant date using the black-scholes option-pricing model . the valuation models require assumptions and estimates to determine expected volatility , expected life , expected dividends and expected risk-free interest rates . the expected volatility was determined using historical volatility of our stock based on the contractual life of the award . the risk-free interest rate assumption was based on the yield on zero-coupon u.s. treasury strips at the award grant date . we also used historical data to estimate forfeiture experience . in valuing options granted in the fiscal years ended december 31 , 2019 and 2018 , we used the following weighted average assumptions : replace_table_token_8_th common shares and warrants common shares are recorded as the net proceeds received on issuance after deducting all share issuance costs and the relative fair value of investor warrants . warrants are recorded at relative fair value and are deducted from the proceeds of common shares and recorded on the consolidated statements of stockholders ' equity as additional paid-in capital . derivative instruments the company applies asc topic 815-40 , `` derivatives and hedging `` ( asc 815-40 ) . one of the conclusions reached under asc 815-40 was that an equity-linked financial instrument would not be considered indexed to the entity 's own stock if the strike price is denominated in a currency other than the issuer 's functional currency . the conclusion reached under asc 815-40 clarified the accounting treatment for these and certain other financial instruments . asc 815-40 specifies that a contract will not be treated as a derivative if it meets the following conditions : ( a ) indexed to our own stock ; and ( b ) classified in stockholders ' equity in our statement of financial position . our options issued to consultants and denominated in canadian dollars were not considered to be indexed to our own stock because the exercise price is denominated in canadian dollars and our functional currency is united states dollars . therefore , these options were treated as derivative financial instruments and recorded at their fair value as a liability . all other outstanding convertible instruments are considered to be indexed to our stock , because their exercise price is denominated in the same currency as our functional currency , and are included in stockholders ' equity . 52 during the year ended december 31 , 2018 , there were exercises of options to purchase 19 shares of our common shares , which were classified as derivative instruments . this resulted in gross proceeds of $ 26 and a non-cash gain on the extinguishment of the remaining derivative liability of $ 167. the fair value of these options was estimated using the black-scholes option-pricing model and is summarized below . replace_table_token_9_th outstanding share information our outstanding

