Trolling in asynchronous computer-mediated communication: From user discussions to academic definitions

Whilst computer-mediated communication (CMC) can benefit users by providing quick and easy communication between those separated by time and space, it can also provide varying degrees of anonymity that may encourage a sense of impunity and freedom from being held accountable for inappropriate online behaviour. As such, CMC is a fertile ground for studying impoliteness, whether it occurs in response to perceived threat (flaming), or as an end in its own right (trolling). Currently, first and secondorder definitions of terms such as im/politeness (Brown and Levinson 1987; Bousfield 2008; Culpeper 2008; Terkourafi 2008), in-civility (Lakoff 2005), rudeness (Beebe 1995, Kienpointner 1997, 2008), and etiquette (Coulmas 1992), are subject to much discussion and debate, yet the CMC phenomenon of trolling is not adequately captured by any of these terms. Following Bousfield (in press), Culpeper (2010) and others, this paper suggests that a definition of trolling should be informed first and foremost by user discussions. Taking examples from a 172-million-word, asynchronous CMC corpus, four interrelated conditions of aggression, deception, disruption, and success are discussed. Finally, a working definition of trolling is presented

Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden