#FactCheck - "Deep fake video falsely circulated as of a Syrian prisoner who saw sunlight for the first time in 13 years”

Introduction

The use of digital information and communication technologies for healthcare access has been on the rise in recent times. Mental health care is increasingly being provided through online platforms by remote practitioners, and even by AI-powered chatbots, which use natural language processing (NLP) and machine learning (ML) processes to simulate conversations between the platform and a user. Thus, AI chatbots can provide mental health support from the comfort of the home, at any time of the day, via a mobile phone.  While this has great potential to enhance the mental health care ecosystem, such chatbots can present technical and ethical challenges as well.

Background

According to the WHO’s World Mental Health Report of 2022, every 1 in 8 people globally is estimated to be suffering from some form of mental health disorder. The need for mental health services worldwide is high but the supply of a care ecosystem is inadequate both in terms of availability and quality. In India, it is estimated that there are only 0.75 psychiatrists per 100,000 patients and only 30% of the mental health patients get help. Considering the slow thawing of social stigma regarding mental health, especially among younger demographics and support services being confined to urban Indian centres, the demand for a telehealth market is only projected to grow. This paves the way for, among other tools, AI-powered chatbots to fill the gap in providing quick, relatively inexpensive, and easy access to mental health counseling services.

Challenges

Users who seek mental health support are already vulnerable, and AI-induced oversight can exacerbate distress due to some of the following reasons: 

1. Inaccuracy: Apart from AI’s tendency to hallucinate data, chatbots may simply provide incorrect or harmful advice since they may be trained on data that is not representative of the specific physiological and psychological propensities of various demographics. 
2. Non-Contextual Learning: The efficacy of mental health counseling often relies on rapport-building between the service provider and client, relying on circumstantial and contextual factors. Machine learning models may struggle with understanding interpersonal or social cues, making their responses over-generalised. 
3. Reinforcement of Unhelpful Behaviors: In some cases, AI chatbots, if poorly designed, have the potential to reinforce unhealthy thought patterns. This is especially true for complex conditions such as OCD, treatment for which requires highly specific therapeutic interventions. 
4. False Reassurance: Relying solely on chatbots for counseling may create a partial sense of safety, thereby discouraging users from approaching professional mental health support services. This could reinforce unhelpful behaviours and exacerbate the condition. 
5. Sensitive Data Vulnerabilities: Health data is sensitive personal information. Chatbot service providers will need to clarify how health data is stored, processed, shared, and used. Without strong data protection and transparency standards, users are exposed to further risks to their well-being. 

Way Forward

1. Addressing Therapeutic Misconception: A lack of understanding of the purpose and capabilities of such chatbots, in terms of care expectations and treatments they can offer, can jeopardize user health. Platforms providing such services should be mandated to lay disclaimers about the limitations of the therapeutic relationship between the platform and its users in a manner that is easy to understand. 
2. Improved Algorithm Design: Training data for these models must undertake regular updates and audits to enhance their accuracy, incorporate contextual socio-cultural factors for profile analysis, and use feedback loops from customers and mental health professionals. 
3. Human Oversight: Models of therapy where AI chatbots are used to supplement treatment instead of replacing human intervention can be explored. Such platforms must also provide escalation mechanisms in cases where human-intervention is sought or required. 

Conclusion

It is important to recognize that so far, there is no substitute for professional mental health services. Chatbots can help users gain awareness of their mental health condition and play an educational role in this regard, nudging them in the right direction, and provide assistance to both the practitioner and the client/patient. However, relying on this option to fill gaps in mental health services is not enough. Addressing this growing —and arguably already critical— global health crisis requires dedicated public funding to ensure comprehensive mental health support for all. 

Sources 

• https://www.who.int/news/item/17-06-2022-who-highlights-urgent-need-to-transform-mental-health-and-mental-health-care 
• https://health.economictimes.indiatimes.com/news/industry/mental-healthcare-in-india-building-a-strong-ecosystem-for-a-sound-mind/105395767#:~:text=Indian%20mental%20health%20market%20is,access%20to%20better%20quality%20services. 
• https://www.frontiersin.org/journals/digital-health/articles/10.3389/fdgth.2023.1278186/full 

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Introduction

This tale, the Toothbrush Hack, straddles the ordinary and the sophisticated; an unassuming household item became the tool for committing cyber crime. Herein lies the account of how three million electronic toothbrushes turned into the unwitting infantry in a cyber skirmish—a Distributed Denial of Service (DDoS) assault that flirted with the thin line that bridges the real and the outlandish.

In January, within the  Swiss borders, a story began circulating—first reported by the Aargauer Zeitung, a Swiss German-language daily newspaper. A legion of cybercriminals, with honed digital acumen, had planted malware on some three million electric toothbrushes. These devices, mere slivers of plastic and circuitry, became agents of chaos, converging their electronic requests upon the servers of an undisclosed Swiss firm, hurling that digital domain into digital blackout for several hours and wreaking an economic turmoil calculated in seven-figure sums.

The entire Incident

It was claimed that three million electric toothbrushes were allegedly used for a distributed denial-of-service (DDoS) attack, first reported by the Aargauer Zeitung, a Swiss German-language daily newspaper. The article claimed that cybercriminals installed malware on the toothbrushes and used them to access a Swiss company's website, causing the site to go offline and causing significant financial loss. However, cybersecurity experts have questioned the veracity of the story, with some describing it as "total bollocks" and others pointing out that smart electric toothbrushes are connected to smartphones and tablets via Bluetooth, making it impossible for them to launch DDoS attacks over the web. Fortinet clarified that the topic of toothbrushes being used for DDoS attacks was presented as an illustration of a given type of attack and that no IoT botnets have been observed targeting toothbrushes or similar embedded devices.

The Tech Dilemma - IOT Hack

Imagine the juxtaposition of this narrative against our common expectations of technology: 'This example, which could have been from a cyber thriller, did indeed occur,' asserted the narratives that wafted through the press and social media. The story radiated outward with urgency, painting the image of IoT devices turned to evil tools of digital unrest. It was disseminated with such velocity that face value became an accepted currency amid news cycles. And yet, skepticism took root in the fertile minds of those who dwell in the domains of cyber guardianship.

Several cyber security and IOT experts, postulated that the information from Fortinet had been contorted by the wrench of misinterpretation. They and their ilk highlighted a critical flaw: smart electric toothbrushes are bound to their smartphone or tablet counterparts by the tethers of Bluetooth, not the internet, stripping them of any innate ability to conduct DDoS or any other type of cyber attack directly.

With this unraveling of an incident fit for our cyber age, we are presented with a sobering reminder of the threat spectrum that burgeons as the tendrils of the Internet of Things (IoT) insinuate themselves into our everyday fabrics. Innocuous devices, previously deemed immune to the internet's shadow, now stand revealed as potential conduits for cyber evil. The layers of impact are profound, touching the private spheres of individuals, the underpinning frameworks of national security, and the sinews that clutch at our economic realities. The viral incident was a misinformation. 

IOT Weakness

IoT devices bear inherent weaknesses for twin reasons: the oft-overlooked element of security and the stark absence of a means to enact those security measures. Ponder this problem Is there a pathway to traverse the security settings of an electric toothbrush? Or to install antivirus measures within the cooling confines of a refrigerator? The answers point to an unsettling simplicity—you cannot.

How to Protect 

Vigilance - What then might be the protocol to safeguard our increasingly digital space? It begins with vigilance, the cornerstone of digital self-defense. Ensure the automatic updating of all IoT devices when they beckon with the promise of a new security patch. 

Self Awareness - Avoid the temptation of public USB charging stations, which, while offering electronic succor to your devices, could also stand as the Trojan horses for digital pathogens. Be attuned to signs of unusual power depletion in your gadgets, for it may well serve as the harbinger of clandestine malware. Navigate the currents of public Wi-Fi with utmost care, as they are as fertile for data interception as they are convenient for your connectivity needs.

Use of Firewall - A firewall can prove stalwart against the predators of the internet interlopers. Your smart appliances, from the banality of a kitchen toaster to the novelty of an internet-enabled toilet, if shielded by this barrier, remain untouched, and by extension, uncompromised. And let us not dismiss this notion with frivolity, for the prospect of a malware-compromised toilet or any such smart device leaves a most distasteful specter.

Limit the use of IOT -  Additionally, and this is conveyed with the gravity warranted by our current digital era, resist the seduction of IoT devices whose utility does not outweigh their inherent risks. A smart television may indeed be vital for the streaming aficionado amongst us, yet can we genuinely assert the need for a connected laundry machine, an iron, or indeed, a toothbrush? Here, prudence is a virtue; exercise it with judicious restraint.

Conclusion 

As we step forward into an era where connectivity has shifted from a mere luxury to an omnipresent standard, we must adopt vigilance and digital hygiene practices with the same fervour as those for our corporal well-being. Let the toothbrush hack not simply be a tale of caution, consigned to the annals of internet folklore, but a fable that imbues us with the recognition of our role in maintaining discipline in a realm where even the most benign objects might be mustered into service by a cyberspace adversary.

References 

• https://www.bleepingcomputer.com/news/security/no-3-million-electric-toothbrushes-were-not-used-in-a-ddos-attack/ 
• https://www.zdnet.com/home-and-office/smart-home/3-million-smart-toothbrushes-were-not-used-in-a-ddos-attack-but-they-could-have-been/
• https://www.securityweek.com/3-million-toothbrushes-abused-for-ddos-attacks-real-or-not/

https://www.cxodigitalpulse.com/hackers-use-electric-toothbrushes-in-massive-cyber-attack-results-in-huge-financial-loss/

In 2023, PIB reported that up to 22% of young women in India are affected by Polycystic Ovarian Syndrome (PCOS). However, access to reliable information regarding the condition and its treatment remains a challenge. A study by the PGIMER Chandigarh conducted in 2021 revealed that approximately 37% of affected women rely on the internet as their primary source of information for PCOS. However, it can be difficult to distinguish credible medical advice from misleading or inaccurate information online since the internet and social media are rife with misinformation. The uptake of misinformation can significantly delay the diagnosis and treatment of medical conditions, jeopardizing health outcomes for all.

The PCOS Misinformation Ecosystem Online

PCOS is one of the most common disorders diagnosed in the female endocrine system, characterized by the swelling of ovaries and the formation of small cysts on their outer edges. This may lead to irregular menstruation, weight gain, hirsutism, possible infertility, poor mental health, and other symptoms. However, there is limited research on its causes, leaving most medical practitioners in India ill-equipped to manage the issue effectively and pushing women to seek alternate remedies from various sources.

This creates space for the proliferation of rumours, unverified cures and superstitions,  on social media, For example, content on YouTube, Facebook, and Instagram may promote “miracle cures” like detox teas or restrictive diets, or viral myths claiming PCOS can be “cured” through extreme weight loss or herbal remedies. Such misinformation not only creates false hope for women but also delays treatment, or may worsen symptoms.

 How Tech Platforms Amplify Misinformation 

1. Engagement vs. Accuracy: Social media algorithms are designed to reward viral content, even if it’s misleading or incendiary since it generates advertisement revenue. Further, non-medical health influencers often dominate health conversations online and offer advice with promises of curing the condition.
2. Lack of Verification: Although platforms like YouTube try to provide verified health-related videos through content shelves, and label unverified content, the sheer volume of content online means that a significant chunk of content escapes the net of content moderation. 
3. Cultural Context: In India, discussions around women’s health, especially reproductive health, are stigmatized, making social media the go-to source for private, albeit unreliable, information. 

Way Forward

a. Regulating Health Content on Tech Platforms: Social media is a significant source of health information to millions who may otherwise lack access to affordable healthcare. Rather than rolling back content moderation practices as seen recently, platforms must dedicate more resources to identify and debunk misinformation, particularly health misinformation. 

b. Public Awareness Campaigns: Governments and NGOs should run nationwide campaigns in digital literacy to educate on women’s health issues in vernacular languages and utilize online platforms for culturally sensitive messaging to reach rural and semi-urban populations. This is vital for countering the stigma and lack of awareness which enables misinformation to proliferate. 

c. Empowering Healthcare Communication: Several studies suggest a widespread dissatisfaction among women in many parts of the world regarding the information and care they receive for PCOS.  This is what drives them to social media for answers. Training PCOS specialists and healthcare workers to provide accurate details and counter misinformation during patient consultations can improve the communication gaps between healthcare professionals and patients. 

d. Strengthening the Research for PCOS: The allocation of funding for research in PCOS is vital, especially in the face of its growing prevalence amongst Indian women. Academic and healthcare institutions must collaborate to produce culturally relevant, evidence-based interventions for PCOS. Information regarding this must be made available online since the internet is most often a primary source of information. An improvement in the research will inform improved communication, which will help reduce the trust deficit between women and healthcare professionals when it comes to women’s health concerns.

Conclusion 

In India, the PCOS misinformation ecosystem is shaped by a mix of local and global factors such as health communication failures, cultural stigma, and tech platform design prioritizing engagement over accuracy. With millions of women turning to the internet for guidance regarding their conditions, they are increasingly vulnerable to unverified claims and pseudoscientific remedies which can lead to delayed diagnoses, ineffective treatments, and worsened health outcomes. The rising number of PCOS cases in the country warrants the bridging of health research and communications gaps so that women can be empowered with accurate, actionable information to make the best decisions regarding their health and well-being. 

Sources

• https://pib.gov.in/PressReleasePage.aspx?PRID=1893279#:~:text=It%20is%20the%20most%20prevailing%20female%20endocrine,neuroendocrine%20system%2C%20sedentary%20lifestyle%2C%20diet%2C%20and%20obesity. 
• https://www.thinkglobalhealth.org/article/india-unprepared-pcos-crisis?utm_source=chatgpt.com 
• https://www.bbc.com/news/articles/ckgz2p0999yo ‍
• https://pmc.ncbi.nlm.nih.gov/articles/PMC9092874/