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Epiphenomenalism is the thesis that though physical events may cause mental events, those mental events never cause physical events. In this paper, I will be concerned with the claim that our thoughts, intentions, and awareness play no causal role in producing actions. Though epiphenomenalism has been defended with a priori philosophical arguments, the majority of the support that it has gained in recent years has come from advances in neuroscience. At the center of these experiments is the Libet paradigm that aims to show that our actions are initiated by unconscious brain processes prior to our awareness of the intention or decision to perform the corresponding actions. It has been widely suggested that these studies support the view that consciousness is epiphenomenal, and if Libet-style experiments support this conclusion, the results have direct implications for free will. I argue by way of a dilemma that any study that relies on reports of subjects' awareness in its methodology cannot be used to support epiphenomenalism because the experimenters would have to rule out the possibility that consciousness plays a causal role in order to do so. [ABSTRACT FROM AUTHOR]

Granulomatosis with polyangiitis is a rare autoimmune disease that affects small to medium-sized blood vessels throughout the body. Here, we present a case of an infratemporal mass that was the result of granulomatosis with polyangiitis. A 51-year-old male presented to the emergency department due to right cheek and facial pain that he had been experiencing for 2 to 3 months. An MRI revealed a mass within the right infratemporal and pterygopalatine fossae extending into the inferior right orbital fissure along the maxillary division of the trigeminal nerve (V2) and the vidian nerve causing concern for malignancy. Histology from an endoscopic biopsy demonstrated multiple arteries with luminal obliteration with non-necrotizing granulomas. The patient was started on steroids and immunosuppressive therapy, which improved his symptoms and decreased the size of the residual mass. This case illustrates the need for laboratory testing, imaging, and biopsy of the involved tissue in cases where GPA is suspected to prevent treatment delays that could lead to the destruction of vital organs. [ABSTRACT FROM AUTHOR]

Simple Summary: ANCA-associated vasculitis (AAV) is a rare disease and manifests in different organs. The exact mechanism of AAV is not fully understood, but it is speculated that it is induced by autoantibody production against proteinase-3 and myeloperoxidase. Patients diagnosed with ANCA-associated vasculitis are challenging to manage and experience several relapses during and after treatment. This systematic review represents the efficacy and safety profile of rituximab in AAV patients and provides evidence that rituximab can be considered the treatment of choice for AAV patients, especially for challenging patients with refractory releases. Background and aim: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a rare multisystem autoimmune disease developed by autoantibody production against human neutrophilic granulocytes, including proteinase-3 (PR3) and myeloperoxidase (MPO). The management of AAV patients is difficult due to the multiorgan involvement, high rate of relapse, and complications of immunosuppressive agents that make it challenging. This study aims to investigate the efficacy and safety of rituximab (RTX) therapy in patients with granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) subtypes. Method: The PubMed/Medline database was searched for any studies related to RTX therapy in ANCA-associated vasculitis (GPA and MPA subtypes), from inception to 1 August 2022, and proceeded in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: Our search resulted in 1082 initial records. After the elimination of review papers, irrelevant studies, and non-English records, 223 articles were included, and the data related to the efficacy and safety of RTX therapy were extracted. Several randomized and non-randomized studies showed that RTX is an effective treatment option for patients with AAV. Most of the studies showed the very effective effect of RTX in controlling disease in AAV patients, including pediatrics, adults, and elderlies, although RTX cannot completely prevent relapse. However, maintenance therapy helps delay the disease's relapse and causes sustained remission. Not only the licensed dose (375 mg/m2 intravenous per week for 4 weeks) could induce disease remission, but studies also showed that a single infusion of RTX could be effective. Although RTX could resolve many rare manifestations in AAV patients, there are few reports showing treatment failure. Additionally, few sudies have reported the unexpeted worsening of the disease after RTX administration. Generally, RTX is relatively safe compared to conventional therapies, but some serious adverse effects, mainly infections, cytopenia, hypogammaglobinemia, malignancy, and hypersensitivity have been reported. Conclusions: RTX is an effective and relatively safe therapeutic option for AAV. Studies on the evaluation of the safety profiles of RTX and the prevention of severe RTX-related side effects in AAV patients are required. [ABSTRACT FROM AUTHOR]

Remission failure and relapse numerate as one of the main problems in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAVs). The need for new agents that provide effective and safe induction accompanied by sustained remission seems to be urgent in clinical care. The efficacy and safety of rituximab (RTX) for AAVs therapy has been reported in various studies. RTX therapy offers several advantages to treating AAVs patients compared to other therapeutic approaches including reduction of Glucocorticoids (GCs) and conventional Immunosuppressive therapy (IST) usage during both the induction of remission and maintenance phases. This reduction can lead to a lower rate of serious complications making RTX therapy a safer option. It seems that RTX may provide improved clinical outcomes in these patients mediated via B-lymphocyte depletion, Proteinase 3-antineutrophilic cytoplasmic antibody (PR3-ANCA), and myeloperoxidase-antineutrophilic cytoplasmic antibody (MPO-ANCA) titers reduction. In this regard, some uncertainties have been reported to validate the association between such depletion and clinical improvement, as suggested by other sources of autoreactive B cells that did not target with RTX. Due to the prolonged B cell depletion, fixed intervals and adjusted dosage of RTX may be required in patients with AAVs. In this narrative review, we aimed to insight better understand regarding the efficacy of RTX for effective induction and sustained remission in patients with AAVs. It seems that discovering new biomarkers predicting relapse in AAVs patients can lead to future targeted therapy., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

This essay proposes that action unaccompanied by the usual feeling of conscious agency constitutes a “mark of ultimacy.” Characteristically religious statements of “agentless action” find support in social psychological and cognitive scientific research that calls into question the intuitive belief that conscious thought causes action. An awareness of the limits of our powers of will lies at the the core of those limit experiences that provide the context for the meaningfulness of religious language.

Wegner and colleagues have offered an explanation of the sense of agency over one's bodily actions. If the orthodox view is correct and there is a sense of agency deficit associated with delusions of alien control, then Wegner and colleagues' model ought to extend to an explanation of this deficit. Data from intentional binding studies opens up the possibility that an abnormality in representing the timing of mental events leads to a violation of the principle of priority in those suffering from delusions of alien control. However, the model ultimately fails as it is unable to accommodate action monitoring deficits associated with delusions of alien control, in particular the theory of mind deficiencies predicted by such accounts have not materialised. There are theory of mind problems associated with schizophrenia but they are not associated with delusions of alien control. Such accounts thereby fail to adequately explain delusions of alien control. [ABSTRACT FROM AUTHOR]

Neuroscience and psychology are increasingly being invoked to cast doubt on the fundamental intuition that our intentions and decisions are causally implicated in our behaviour. The initial attack was launched thirty years ago with the famous experiment of Benjamin Libet on the timing of decisions to perform simple movements. A second prong to the attack was launched in 2002 with the pubfication of social psychologist Daniel Wegner's book, The Illusion of Conscious Will. I here summarise the intense debate that has resulted and argue that the anti-conscious-will lobby have failed to make an adequate case to justify their iconoclastic claim. [ABSTRACT FROM AUTHOR]

We assume that we can act-in at least some cases-by consciously intending to do so. Wegner () appeals to empirical research carried out by Libet et al. () to challenge this assumption. I argue that his conclusion presupposes a particular view of conscious intention. But there is an alternative model available, which has been developed by various writers in the phenomenological tradition, and most recently defended by Moran (). If we adopt this alternative account of conscious intention, Wegner's argument no longer goes through, and we can retain the claim that our conscious intentions can give rise to action. [ABSTRACT FROM AUTHOR]

Wegner’s argument on the illusory nature of conscious will, as developed in The Illusion of Conscious Will () and other publications, has had major impact. Based on empirical data, he develops a theory of apparent mental causation in order to explain the occurrence of the illusion of conscious will. Part of the evidence for his argument is derived from a specific interpretation of the phenomenon of auditory verbal hallucinations as they may occur in schizophrenia. The aim of this paper is to evaluate the validity of the evidence on auditory verbal hallucinations as employed by Wegner. I conclude that auditory hallucinations do not provide solid evidence for Wegner’s theory. Moreover, the phenomena in schizophrenia provide, in fact, an argument against part of Wegner’s theory of apparent mental causation. [ABSTRACT FROM AUTHOR]

The sense of agency, that is the sense that one is the agent of one’s bodily actions, is one component of our self-consciousness. Recently, Wegner and colleagues have developed a model of the causal history of this sense. Their model takes it that the sense of agency is elicited for an action when one infers that one or other of one’s mental states caused that action. In their terms, the sense of agency is elicited by the inference to apparent mental state causation. Here, I argue that this model is inconsistent with data from developmental psychology that suggests children can identify the agent behind an action without being capable of understanding the relationship between their intentions and actions. Furthermore, I argue that this model is inconsistent with the preserved sense of agency in autism. In general, the problem is that there are cases where subjects can experience themselves as the agent behind their actions despite lacking the resources to make the inference to apparent mental state causation. [ABSTRACT FROM AUTHOR]

Abstract: Daniel Wegner argues that conscious will is an illusion. I examine the adequacy of his theory of apparent mental causation and whether, if accurate, it suggests that our experience of agency and authorship should be considered illusory. I examine various interpretations of this claim and raise problems for each interpretation. I also distinguish between the experiences of agency and authorship. [Copyright &y& Elsevier]

This article addresses two influential lines of argument for what might be termed "scientific epiphenomenalism" about conscious intentions - the thesis that neither conscious intentions nor their physical correlates are among the causes of bodily motions - and links this thesis to skepticism about free will and moral responsibility. One line of argument is based on Benjamin Libet's neuroscientific work on free will. The other is based on a mixed bag of findings presented by social psychologist Daniel Wegner. It is argued that both lines of argument are unsuccessful.