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Summary of Significant accounting policies (Tables)
12 Months Ended
Dec. 31, 2023
Accounting Policies [Abstract]  
Adjustments resulting from foreign currency translations Amounts charged or credited to the Consolidated Statements of Operations for the years ended December 31, 2023, December 31, 2022 and December 31, 2021 were as follows:
Year ended
 December 31, 2023December 31, 2022December 31, 2021
(in thousands)
Amounts charged/(credited)$12,916 $(25,997)$(14,316)
Estimated useful lives of assets Depreciation of property, plant and equipment is computed using the straight line method based on the estimated useful lives of the assets as listed below: 
Estimated Useful Life
Buildings  40 years
Computer equipment and software
2 - 8 years
Office furniture and fixtures8 years
Laboratory equipment  5 years
Motor vehicles5 years
Schedule of Finite-Lived Intangible Assets
Intangible assets are amortized on a straight-line basis over their estimated useful lives, as set forth in the table below:

Estimated Useful Life
Customer relationships
16 - 23 years
Order backlog3 years
Trade names3 years
Patient database7 years
Technology assets5 years
The carrying amount of Intangible Assets for the years ended December 31, 2023 and 2022 is as follows:
December 31, 2023December 31, 2022
Cost(in thousands)
Customer relationships$4,090,393 $4,076,435 
Order backlog541,302 536,934 
Trade names & brands204,653 204,621 
Patient database170,366 170,238 
Technology assets141,257 120,984 
Total cost5,147,971 5,109,212 
Accumulated amortization(1,292,106)(830,553)
 
Net book value
$3,855,865 $4,278,659