How doctors in Belgium reconstruct noses amid rising cocaine use
More people in Belgium are arriving at clinics with serious lesions in their noses amid rising cocaine consumption, doctors say.
The ear nose and throat (ENT) clinic of Liège's University Hospital Centre (CHU) often sees patients with nasal obstruction.
Cocaine can cause blood vessels to narrow in the nose which can damage tissue.
This can lead to perforations in the mucose membrane and the cartilage.
“There is damage to both the mucus membrane and cartilage so to the nasal septum, which is affected, as well as the internal structures,” said Dr Sophie Tombu, a doctor at the ENT clinic at Liège Hospital Centre (CHU).
“When the perforation of the septum is wider, this leads to a collapse of the nasal pyramid and this will be visible from the outside,” Tombu added.
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Often people 'in their forties'
The patients these doctors see are relatively young, often in their forties.
“Sometimes a little older. They’re not [younger] patients [aged] 25. They are more likely to be in their forties,” Dr Philippe Lefèbvre, head of the ENT Department at CHU Liège, told Belgian broadcaster RTBF.
“That’s where we find them, with fairly privileged socioeconomic and professional backgrounds. They may be managers or teachers or people who work in banking or something like that," Lefèbvre added.
When the nasal septum is damaged, the nose may need to be reconstructed, a procedure called a rib graft rhinoplasty which involves taking a piece of cartilage from the patient's rib.
“We will then model it to reconstruct the nasal pyramid and reconstruct the function of the nose,” Tombu said.
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While this can help patients breathe normally again, doctors say not many patients with cocaine use can undergo operations like this.
This is because the patient needs to have stopped cocaine consumption for at least six months for the mucous membrane to heal before the operation.
"Even if we have a lot of patients in consultation with this type of pathology, the number of operations is limited because stopping cocaine is complicated,” said Tombu.
A report published recently by the Belgian health authority suggests cocaine use has increased over the past five years in Belgium, while heroin use has decreased.
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policymakers chasing a shiny object when basic investment in infrastructure is needed," Robert Noland, distinguished professor at the Bloustein School of Planning and Public Policy at Rutgers University, said in comments emailed to The Associated Press.
"It costs too much to build," he added.
Lamme said skeptics should come and take a look for themselves.
"We built the European Hyperloop Center and from what we have built, we know that we can be competitive with high-speed rail," he said.
"And then we have not even included all the cost optimisations that we can do in the coming decade to reduce that even further".
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The test center's tube is made up of 34 separate sections mostly 2.5 m in diameter. A vacuum pump in a steel container next to the tube sucks out the air to reduce the internal pressure. That reduces drag and allows capsules to travel at such high speeds.
A test capsule built by Dutch hyperloop pioneer Hardt Hyperloop will take part next month in the first tests at the center that is funded by private investment as well as contributions from the provincial government, the Dutch national government, and European Commission.
'Highway of tubes'
A unique feature of the Veendam tube is that it has a switch - where it splits into two separate tubes, a piece of infrastructure that will be critical to real-life applications.
"Lane switching is very important for hyperloop, because it allows vehicles to travel from any origin to any destination," said Marinus van der Meijs, Hardt's technology and engineering director.
"So, it really creates a network effect where you sort of have a highway of tubes and vehicles can take an on and offramp or they can take a lane switch to go to a different part of Europe or to a different destination".
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While testing continues in Veendam, hyperloop developers hope that destinations for their technology are forthcoming.
"Really the main challenge is finding government commitments to build routes and, on the other hand, finding new funding to realise the necessary test facility and technology demonstration that you need to do to make this happen," Lamme said.
can cause copyright issues and ethical questions around if the data is biased.
“These [the weights] are new things, and it's a very new time in history where we have a new artefact that is still the production of human ingenuity and intelligence and creativity,” he said.
“But at the same time is also the elaboration of semi-random calculation that is done by large computers”.
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‘Truth-seeking’
Musk previously said in a post on his social media platform X that his open source AI is “by far the most transparent & truth-seeking", and sued OpenAI for abandoning its original mission to benefit humanity by partnering with Microsoft. Yet, Musk’s Grok does not disclose what data the weight was trained on.
In fact, there is little incentive for companies to do so because the moment you announce what you build your data on is the moment you open yourself up to copyright lawsuits.
We are the stewards, maintainers of the definition, but we don't really have any strong powers to enforce it. Stefano Maffulli OSI
“Until we have a little bit of clarity on that legal front, I think we're still going to be witnessing these sorts of issues,” Maffulli said.
Another reason so-called open source AI companies may not want to be fully transparent is to preserve trade secrets.
The OSI has, therefore, a difficult task on its hands when it comes to defining open source AI. The organisation began its quest two years ago after OpenAI’s ChatGPT catapulted onto the scene in November 2022.
The biggest hurdle, he said, when it comes to defining open source AI is understanding the dependency between the data in the training sets, and the model weights, Maffulli said.
How to define open source AI
The OSI started by assembling a group of initial experts from organisations such as the Mozilla Foundation and Wikipedia, but also with civil society groups, universities, and Big Tech companies such as Microsft and Meta.
The working groups then assessed three generative AI models - Meta’s Llama, Illusion AI, and Bloom as well as a non-generative AI model that uses machine learning.
The working groups voted on the minimum requirements for an AI system to be open source.
Maffulli said that the working groups “all said that at the very least, there is to be a minimum requirement of data transparency”.
The OSI is now refining this draft definition, which it expects to release to the public over the summer.
But it does not mean that after the definition is finalised the OSI will come after Musk or other self-proclaimed open source AI companies.
“We are the stewards, maintainers of the definition, but we don't really have any strong powers to enforce it,” Maffulli said.
He added that judges and courts around the world are starting to recognise that the open source definition is important, especially when it comes to mergers but also regulation.
Countries around the world are finalising how they will regulate AI and open source software has been an issue of contention.
“The open source definition serves as a barrier to identify false advertising,” said Maffulli.
“If a company says it's open source, it must carry the values that the open source definition carries. Otherwise, it's just confusing”.