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Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Thousands
 6 Months Ended
Jun. 30, 2018
Jun. 30, 2017
Operating Activities:    
Net income $ 28,339 $ 58,769
Non-cash items included in net income:    
Depreciation 16,624 17,998
Amortization 18,609 23,095
Stock-based compensation 14,220 8,564
Deferred income tax benefit (9,909) (19,791)
Losses from equity method investments 1,838 18,482
Gain on acquisitions (11,484) (39,428)
Impairment of property, plant and equipment 480 4,581
Amortization of income taxes payable on inter-company transfers of property 5,166 17,770
Remeasurement of contingent consideration to fair value (5,546) 155
Other (943) 1,675
Changes in operating assets and liabilities:    
Accounts receivable, net 21,799 (15,912)
Inventories (11,285) (6,927)
Other current and non-current assets (15,786) (13,904)
Accounts payable and accrued current and non-current liabilities (3,870) (12,438)
Restructuring reserve 284 (11,129)
Net cash provided by operating activities 48,536 31,560
Investing Activities:    
Acquisitions, net of cash acquired (279,863) (14,194)
Purchases of property, plant and equipment and other (13,231) (14,923)
Proceeds from the sale of CRM business franchise 186,682 0
Proceeds from sale of cost-method investment 0 3,192
Loans to equity method investees 0 (6,834)
Proceeds from asset sales 13,222 5,170
Other 0 (145)
Net cash used in investing activities (93,190) (27,734)
Financing Activities:    
Change in short-term borrowing, net (17,971) (12,812)
Proceeds from short-term borrowing (maturities greater than 90 days) 240,000 20,000
Repayment of short-term borrowing (maturities greater than 90 days) (190,000) 0
Repayment of long-term debt obligations (12,240) (11,306)
Proceeds from exercise of stock options 2,731 2,442
Payment of deferred consideration - acquisition of Caisson Interventional, LLC (14,073) 0
Shares repurchased from employees for minimum tax withholding (7,130) (1,594)
Other 390 97
Net cash provided by (used in) financing activities 927 (3,367)
Effect of exchange rate changes on cash and cash equivalents (2,508) 2,442
Net (decrease) increase in cash and cash equivalents (46,235) 2,901
Cash and cash equivalents at beginning of period 93,615 39,789
Cash and cash equivalents at end of period $ 47,380 $ 42,690