Start Up No.2184: hackers target US prescription system, TikTok screws Congress lobbying, Ozempic in your brain, and more


Researchers at the University of Surrey have found that higher pressure makes people use less water in showers. CC-licensed photo by Dean McCoy on Flickr.

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It’s Friday, so there’s another post due at the Social Warming Substack at about 0845 UK time.


A selection of 9 links for you. Don’t read in the shower. I’m @charlesarthur on Twitter. On Threads: charles_arthur. On Mastodon: https://newsie.social/@charlesarthur. Observations and links welcome.


How hackers dox doctors to order mountains of Oxycodone and Adderall • 404 Media

Joseph Cox:

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404 Media has uncovered a wide-spanning scheme in which criminals break into various panels used by doctors, nurses, pharmacists, and even wholesale narcotics providers, and then leverage that access to order controlled substances like oxycodone. Some of the hackers then appear to sell these substances for profit online. Because the hackers are using legitimate ordering tools designed for industry professionals, when a prescription request lands at a pharmacy, it can look as legitimate as any other.

In some cases hackers are phishing doctors for certain pieces of information, such as their unique DEA-assigned number, to then create drug ordering accounts in their name. The hackers are also making use of powerful bots that allow them to dox nearly anyone in America for as little as $15. Some of these bots use credit header data, which is information a person provides, such as their physical address, to the big three credit bureaus who then sell access to third-parties. I’ve previously shown how these bots are connected to violent criminals. Now, they’re being used as part of the underground drug trade, with hackers able to dox a specific doctor within a target ZIP code in around 15 minutes, one fraudster said.

The news presents not just a series of individual breaches at multiple companies in the pharmaceutical industry, but a more fundamental undermining of the trust in a digital prescription system that itself was created as a response to pill mills, doctor shopping, and other systemic abuses during the opioid crisis.

…One person on Telegram, who used the handle “Escripted,” explained how they steal doctor’s personal and professional information and then sign-up to electronic prescription portals. Instead of a tear-off from a notepad that a doctor signs and hands to a patient, electronic prescriptions are digitally sent by the doctor to a fulfilling pharmacy. The idea is that they are much harder to counterfeit, with a digital signature being more robust than simply copying a doctor’s handwritten one.

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Another banger from 404 Media. (Clearly, rootling about in Telegram is a reliable way to find story leads.)

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TikTok campaign against ban backfires • Semafor

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A House committee unanimously advanced legislation that would force ByteDance to divest the social media app TikTok, despite congressional offices being bombarded with calls from TikTokers who were urged by the platform to call their representatives to protest the bill.

“Let Congress know what TikTok means to you and tell them to vote NO,” a pop-up message on the app said, imploring users to “stop a TikTok shutdown.”

Aides from multiple congressional offices told Semafor that they were getting flooded with calls pushing back on the legislation Thursday. Some offices reported getting as many as 50 phone calls. One office received a message from a caller threatening suicide if the app was taken down, a Politico reporter posted on X.

But later Thursday afternoon, the House Energy and Commerce Committee unanimously advanced the legislation in a 50-0 vote. The bipartisan House bill introduced Tuesday would force ByteDance to sell off TikTok or face it being banned in the United States, over national security concerns associated with Chinese ownership of the app, which TikTok says is used by 170 million Americans. House majority leader Steve Scalise said the bill would come to the floor next week.

“This legislation has a predetermined outcome: a total ban of TikTok in the United States,” a TikTok spokesperson said in a statement. “The government is attempting to strip 170 million Americans of their Constitutional right to free expression. This will damage millions of businesses, deny artists an audience, and destroy the livelihoods of countless creators across the country.”

The bill was proposed by Reps. Mike Gallagher (R-Wisc.) and Raja Krishnamoorthi (D-Ill.), the top lawmakers on the House select committee on China, and quickly received support from the White House and Speaker Mike Johnson.

“Here you have an example of an adversary-controlled application lying to the American people, and interfering with the legislative process in Congress,” Gallagher said in response to the calls. “In a weird way it almost proves the point that we’ve been making here.”

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Beyond the water flow rate: water pressure and smart timers impact shower efficiency • OSF Preprints

Ian Walker, Pablo Pereira-Doel and James Daly at the University of Surrey :

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England is projected to face a water supply shortfall of 4 billion litres daily by 2050, mostly due to population growth and increasing climate-driven droughts and flooding. The Environment Act 2021 mandates significant water usage reductions, targeting a decrease for households from the current 144 litres per person/day to 110, and a 15% reduction for businesses.

Enhancing water efficiency in showers is crucial, given their high water consumption, energy use and associated carbon emissions. Water consumption in 290 showers was covertly monitored for 39 weeks, capturing 86,421 showering events. Increased water pressure was strongly associated with reduced water use – an effect that can be amplified even further by installing smart timers to inform users of their shower duration.

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Walker, who is professor of environmental psychology (pause a moment to consider what that implies), wrote a thread about this research which has all sorts of fascinating details – such as that there are people who take showers lasting an hour or more. (Mean 6.7 minutes, median 5.7 minutes, 50% lie between 3.3 and 8.8 minutes. Time yourself next time!)

But the idea that making the shower stronger reduces water use is initially counterintuitive. Except: you know that a really high-pressure shower is pretty brutal, and doesn’t encourage lingering. (Thanks Adewale A for the link.)
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The Iditarod is embroiled in a controversy over moose guts • Outside Online

Frederick Dreier:

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What’s the weirdest rule in endurance sports? A few come to mind.

• Regulations governing the New York City Marathon explicitly forbid runners from pooping on the pavement at the starting line
• Article 7.01-G of the Ironman Triathlon rulebook prohibits nakedness in transition areas
• And don’t get me started on the wackadoo bylaws enforced by pro cycling’s governing body, the Union Cycliste International, which govern the minutiae of oh so many aspects of bike racing, from the height of an athlete’s socks to the size and shape of his or her ugly helmet.

But in all my time covering professional outdoor competitions, I’ve never come across anything like Rule 34 in the regulations governing Alaska’s Iditarod, the Tour de France of dogsledding. The law, titled “Killing of Game Animals,” is below:

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In the event that an edible big game animal, i.e., moose, caribou, buffalo, is killed in defense of life or property, the musher must gut the animal and report the incident to a race official at the next checkpoint. Following teams must help gut the animal when possible. No teams may pass until the animal has been gutted and the musher killing the animal has proceeded. Any other animal killed in defense of life or property must be reported to a race official, but need not be gutted. 

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Yes, the Iditarod requires you to disembowel the big mammals that you kill along the way. Not only that—officials will scrutinize the efficacy of your job gutting the animal in question.

At the moment, there’s a brewing controversy about the Iditarod’s Rule 34 – specifically, whether or not a star athlete gutted a moose the right way.

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AI likely to increase energy use and accelerate climate misinformation – report • The Guardian

Oliver Milman:

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Claims that artificial intelligence will help solve the climate crisis are misguided, with the technology instead likely cause rising energy use and turbocharge the spread of climate disinformation, a coalition of environmental groups has warned.

Advances in AI have been touted by big tech companies and the United Nations as a way to help ameliorate global heating, via tools that help track deforestation, identify pollution leaks and track extreme weather events. AI is already being used to predict droughts in Africa and to measure changes to melting icebergs.

Google, which has developed its own AI program called Bard (recently rebranded to Gemini) and has an AI project to make traffic lights more efficient, has been at the forefront of promoting emissions reductions through AI adoption, releasing a report last year that found AI could cut global emissions by as much as 10%, equivalent to the entire carbon pollution put out by the European Union by 2030. “AI has a really major role in addressing climate change,” said Kate Brandt, Google’s chief sustainability officer, said in December, describing the technology at an “inflection point” in making major progress in environmental goals.

However, a new report by green groups has cast doubt over whether the AI revolution will have a positive impact upon the climate crisis, warning that the technology will spur growing energy use from data centers and the proliferation of falsehoods about climate science.

“We seem to be hearing all the time that AI can save the planet, but we shouldn’t be believing this hype,” said Michael Khoo, climate disinformation program director at Friends of the Earth, which is part of the Climate Action against Disinformation coalition that put out the report.

“It’s not like AI is ridding us of the internal combustion engine. People will be outraged to see how much more energy is being consumed by AI in the coming years, as well as how it will flood the zone with disinformation about climate change.”

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There’s so much handwaving about AI saving energy down the years. It was going to be deployed in 2017 by the electricity grid in the UK to optimise things. Did anything come of that?
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Ozempic is in fact a brain drug • The Atlantic

Sarah Zhang:

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When scientists first created the class of drugs that includes Ozempic, they told a tidy story about how the medications would work: The gut releases a hormone called GLP-1 that signals you’re full, so a drug that mimics GLP-1 could do the exact same thing, helping people eat less and lose weight.

The rest, as they say, is history. The GLP-1 revolution birthed begat semaglutide, which became Ozempic and Wegovy, and tirzepatide, which became Mounjaro and Zepbound—blockbuster drugs that are rapidly changing the face of obesity medicine. The drugs work as intended: as powerful modulators of appetite. But at the same time that they have become massive successes, the original science that underpinned their development has fallen apart. The fact that they worked was “serendipity,” Randy Seeley, an obesity researcher at the University of Michigan, told me. (Seeley has also consulted for and received research funding from companies that make GLP-1 drugs.)

Now scientists are beginning to understand why. In recent years, studies have shown that GLP-1 from the gut breaks down quickly and has little effect on our appetites. But the hormone and its receptors are naturally present in many parts of the brain too. These brain receptors are likely the reason the GLP-1 drugs can curb the desire to eat—but also, anecdotally, curb other desires as well. The weight-loss drugs are ultimately drugs for the brain.

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Fascinating. (Subediting note: “birth” is not a transitive verb; it’s a noun. “Created” works, and “begat” as substituted by me above if you want to sprinkle a little light Biblical feel.)
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How Google blew up its open culture and compromised its product • Big Technology

David Kiferbaum:

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In my seven years at Google, one of the most shocking moments came after I questioned our fixation with the word “guys.”

It was 2017, and Google had been facing gender pay gap allegations when I attended an unconscious bias training. Rather than directly discuss the issue, the instructors were obsessed with word choice, focusing on replacing “guys.”

“You should be aware that the term ‘guys’ is gendered and could be alienating for some Googlers, so instead you should be referring to groups of people you work with as ‘team’ or ‘folks’,” one session leader said.

When I challenged the instructor, raising skepticism that this language change would address the real issue, I got shouted down.

“How dare you!” a colleague said from the other side of the room. Other participants, and the instructor, began to scold me. I nearly got shouted out of the session.

Google used to be a place to ask questions. “You must make it safe to ask the tough questions and to tell the truth at all times, even when the truth hurts,” wrote Eric Schmidt and Jonathan Rosenberg in their 2014 book How Google Works. “When you learn of something going off the rails, and the news is delivered in a timely, forthright fashion, this means — in its own, screwed-up way — that the process is working.” 

Inside Google today, the process is not working. Previously accessible Google executives have disappeared, once acceptable questions can’t be asked, and a dispassionate arrogance has taken hold. Unsurprisingly, the company’s deficient culture is showing up in the product, most vividly in its recent Gemini debacle. As a user and shareholder, I’m concerned.

…Lacking the forums for public questioning — and feeling their precarious job security — Google employees no longer feel fully able to speak up within the company.

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Very much what we suspected, but interesting to hear it from the horse’s mouth.
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IDC forecasts global PC shipments to grow 2.0% in 2024, led by the arrival of AI PCs and the start of a commercial refresh cycle • IDC

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As the global economy nears recovery, so will the PC market with global shipments forecast to reach 265.4 million units in 2024, up 2.0% from the prior year according to the International Data Corporation (IDC) Worldwide Quarterly Personal Computing Device Tracker. While vendors focused on clearing inventory in 2023, IDC expects 2024 to be an expansion year with the introduction of AI PCs, which will ultimately drive the market forward to 292.2m units in 2028 and a compound annual growth rate (CAGR) of 2.4% over the 2024–2028 forecast period.

Growth is expected to slowly ramp up over the year along with the availability of AI PCs, which will coincide with the beginning of a commercial refresh cycle in 2025. “Commercial buyers, both enterprise and educational, are on the cusp of a refresh cycle that begins later this year and reaches its peak in 2025,” said Jitesh Ubrani, research manager with IDC’s Worldwide Mobile and Consumer Device Trackers. “Many of these buyers are expected to be among the first in terms of AI PC adoption. The presence of on-device AI capabilities is not likely to lead to an increase in the PC installed base, but it will certainly lead to a growth in average selling prices.”

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Have to love IDC forecasting this to four significant figures: 292.2 million, not 292. To be honest, though, I wouldn’t put that much weight on this. Wayyy back in 2012 I looked at how IDC’s forecasts for PC sales had changed in the light of tablets. The forecast for 2016’s sales: over 500m. Actual sales in 2016: 270m. This stuff is not very good guesswork.
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Roku disables TVs and streaming devices until users consent to new terms • TechCrunch

Devin Coldewey:

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Roku users around the country turned on their TVs this week to find an unpleasant surprise: The company required them to consent to new dispute resolution terms in order to access their device. The devices are unusable until the user agrees.

Users (at least, this user) received an email the day before saying that “we have made changes to our Dispute Resolution Terms, which describe how you can resolve disputes with Roku. We encourage you to read the updated Dispute Resolution Terms. By continuing to use our products or services, you are agreeing to these updated terms.”

The terms, of course, include a forced arbitration agreement that prevents the user from suing or taking part in lawsuits against Roku. It’s common these days as a way of limiting liability, and users often have little or no recourse. They only find out later, when the company does something heinous and consequences are negligible. Tech companies love this one dirty trick to save millions! (Full disclosure, our parent company requires arbitration as part of its dispute resolution policy as well.)

But what is actually new on perusal of the terms is a whole “Informal Dispute Resolution” section. This requires anyone with legal complaints to take them to Roku lawyers first, who will conduct a “Meet-and-Confer” call and then “make a fair, fact-based offer of resolution” that will no doubt be generous and thoughtful. So they’ve added a pre-arbitration arbiter to further distance legal threats from materializing. The change was actually made last fall (though no notification appears to have been sent out) but only came into effect recently, and now, some weeks later, users are being informed by this questionable method.

I try to opt out of these when I can, and after reading the terms (to which, of course, by “continuing to use” my TV, I had already agreed), I found that you could only do so by mailing a written notice to their lawyers — something I fully intended to do today. Actually, since arbitration was apparently already required, this update provides an opportunity to opt out of something I didn’t know I was already subject to.

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Of course disconnecting your Roku TV from the internet will mean that you can’t look at any content through the Roku part.
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• Why do social networks drive us a little mad?
• Why does angry content seem to dominate what we see?
• How much of a role do algorithms play in affecting what we see and do online?
• What can we do about it?
• Did Facebook have any inkling of what was coming in Myanmar in 2016?

Read Social Warming, my latest book, and find answers – and more.


Errata, corrigenda and ai no corrida: none notified

1 thought on “Start Up No.2184: hackers target US prescription system, TikTok screws Congress lobbying, Ozempic in your brain, and more

  1. A large amount of “horse’s mouth” information about these problems with Google’s culture (at least alleged problems) can be found in various legal filings. It’s by no means a secret. It just doesn’t get to the mass media pundit levels, because it’s too niche for the right-wing outrage machine, too meager for the I’m-a-liberal-BUT types, and not going to be touched by anyone further left. However, it’s very well-known in certain subgroups. It’s possible the Gemini debacle will be a turning point in wider willingness engage with the issues. But since the structural incentives haven’t changed, I’m inclined to think there won’t be much of a change in the overall discussion.

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