Revenue Performance - ICON reported second quarter 2023 revenue of 2,020.3million,representingayear−over−yearincreaseof4.43,998.8 million, reflecting a year-over-year increase of 4.2%[10] - The company revised its full-year 2023 revenue guidance to a range of 8,070−8,210 million, indicating a growth of 4.3% to 6.1% year-over-year[4] Profitability Metrics - Adjusted EBITDA for the second quarter was 414.2million,accountingfor20.5256.9 million, leading to an adjusted diluted earnings per share of 3.11,anincreaseof8.7813,369 thousand, up from 694,910thousandinthesameperiodof2022,reflectinganincreaseof17.0496,742 thousand, compared to 463,746thousandinthesameperiodof2022,anincreaseof7.16.01, up from 5.62inthesameperiodof2022,anincreaseof6.9203.9 million, with capital expenditures of 32.1million[9]−CashflowsfromoperatingactivitiesforthesixmonthsendedJune30,2023,were379,381 thousand, compared to 408,966thousandforthesameperiodin2022,indicatingadecreaseof7.268,653 thousand for the six months ended June 30, 2023, compared to 48,639thousandinthesameperiodof2022,anincreaseof41.2270,176 thousand, down from 614,918thousandattheendofthesameperiodin2022,adecreaseof56.12,419 million in the second quarter, resulting in a book-to-bill ratio of 1.20[6] - The closing backlog increased to 21.7billion,up2.24.0 billion, with a net debt to adjusted EBITDA ratio of 2.5x[5] - The effective tax rate for the second quarter was 15.2%, with an updated estimate for the full-year 2023 effective tax rate at 15.5%[8] Shareholder Information - The diluted weighted average number of Ordinary Shares outstanding for the six months ended June 30, 2023, was 82,617,391, compared to 82,462,842 for the same period in 2022[28] Acquisitions - The company completed the acquisition of a 51% majority voting share capital of Oncacare Limited, resulting in an acquisition-related gain of 6,160thousand[33]OverallIncome−NetincomeforthesixmonthsendedJune30,2023,was232,252 thousand, a slight increase from 227,704thousandinthesameperiodof2022,representingagrowthof2.417,107,660 thousand, a decrease from $17,185,278 thousand as of the previous period[23]