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City of Amsterdam Voluntary Local Review 2022

Intellectual capital of the European Union 2008

In 2004 the report Intellectual capital of the European Union was published (Andriessen and Stam, 2004). This report provided insight in the value of the intellectual capital of the 15 countries of the European Union, in relationship to the goals set by the European Council in March 2000. Since this report, the EU grew from 15 to 27 countries and the Lisbon goals were reformulated in 2005. The aim of this paper is to repeat the measurement of the intellectual capital (IC) of the enlarged European Union (EU) in relationship to the new Lisbon goals. In order to become the most competitive and dynamic knowledge-based economy, the EU decided to focus on “delivering stronger, lasting growth and creating more and better jobs” (CEC, 2005d, p.7). In this paper we translate this overall goal in 38 indicators. As the data was not available for all the new member states, we decided to limit our paper to the so-called EU-19. Based on our measurements we conclude that the EU-19 is still behind Japan and far behind the USA, however the EU is catching up as both Japan and the USA have considerably lower growth figures than the EU-19. From an IC perspective, the EU is geographically divided. The Nordic countries are still the best performing countries. The southern European countries and the new member states stay behind. However, as the new member states invest more in their IC, it might be expected that their positions will improve in the future. The aim of our paper was to measure the progress of the Lisbon Agenda for growth and jobs. Based on our measurements we conclude that the EU-19 is successful in terms of creating more and better jobs, but not successful in terms of delivering stronger, lasting growth.

The plight of London-based startups

With Brexit looming, start-ups in the London ecosystem may ask themselves whether they are still in the right place for their business. Are they considering a move to the continent due to the ambiguous Brexit developments? This research analyzes the probability of international start-ups based in the London region relocating to another European entrepreneurial ecosystem. We use location decision theory and secondary data from the European Digital City Index to rank the most attractive eco-systems for the possible relocation of London-based start-ups. In addition, we interview London start-up founders asking how likely they are to leave and where they envision continuing their entrepreneurial endeavors. This study examines whether London will lose its top rank as the most attractive entrepreneurial ecosystem in Europe. We ask which of the competing ecosystems of Europe stands to gain from London’s possible loss. Our quantitative analyses show that Amsterdam is the most likely hub to benefit from any exodus. The qualitative analyses conveyed a mixture of concern and ambivalence as only three of the startups considered relocating their headquarters to another ecosystem. Six of the startups have either opened an office in another European ecosystem or are in the process of doing so. This allows them to watch and wait as they want to remain. The attractiveness of the London region, the social capital investments by team and partners, and the lack of finances to leave are the main reasons for not considering relocation of their headquarters currently.

Lactate is associated with mortality in very old intensive care patients suffering from COVID-19

Purpose: Lactate is an established prognosticator in critical care. However, there still is insufficient evidence about its role in predicting outcome in COVID-19. This is of particular concern in older patients who have been mostly affected during the initial surge in 2020. Methods: This prospective international observation study (The COVIP study) recruited patients aged 70 years or older (ClinicalTrials.gov ID: NCT04321265) admitted to an intensive care unit (ICU) with COVID-19 disease from March 2020 to February 2021. In addition to serial lactate values (arterial blood gas analysis), we recorded several parameters, including SOFA score, ICU procedures, limitation of care, ICU- and 3-month mortality. A lactate concentration ≥ 2.0 mmol/L on the day of ICU admission (baseline) was defined as abnormal. The primary outcome was ICU-mortality. The secondary outcomes 30-day and 3-month mortality. Results: In total, data from 2860 patients were analyzed. In most patients (68%), serum lactate was lower than 2 mmol/L. Elevated baseline serum lactate was associated with significantly higher ICU- and 3-month mortality (53% vs. 43%, and 71% vs. 57%, respectively, p < 0.001). In the multivariable analysis, the maximum lactate concentration on day 1 was independently associated with ICU mortality (aOR 1.06 95% CI 1.02–1.11; p = 0.007), 30-day mortality (aOR 1.07 95% CI 1.02–1.13; p = 0.005) and 3-month mortality (aOR 1.15 95% CI 1.08–1.24; p < 0.001) after adjustment for age, gender, SOFA score, and frailty. In 826 patients with baseline lactate ≥ 2 mmol/L sufficient data to calculate the difference between maximal levels on days 1 and 2 (∆ serum lactate) were available. A decreasing lactate concentration over time was inversely associated with ICU mortality after multivariate adjustment for SOFA score, age, Clinical Frailty Scale, and gender (aOR 0.60 95% CI 0.42–0.85; p = 0.004). Conclusion: In critically ill old intensive care patients suffering from COVID-19, lactate and its kinetics are valuable tools for outcome prediction. Trial registration number: NCT04321265.