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Summary Clinicians and patients must make treatment decisions at a series of key decision points throughout disease progression. A dynamic treatment regime is a set of sequential decision rules that return treatment decisions based on accumulating patient information, like that commonly found in electronic medical record (EMR) data. When applied to a patient population, an optimal treatment regime leads to the most favorable outcome on average. Identifying optimal treatment regimes that maximize residual life is especially desirable for patients with life-threatening diseases such as sepsis, a complex medical condition that involves severe infections with organ dysfunction. We introduce the residual life value estimator (ReLiVE), an estimator for the expected value of cumulative restricted residual life under a fixed treatment regime. Building on ReLiVE, we present a method for estimating an optimal treatment regime that maximizes expected cumulative restricted residual life. Our proposed method, ReLiVE-Q, conducts estimation via the backward induction algorithm Q-learning. We illustrate the utility of ReLiVE-Q in simulation studies, and we apply ReLiVE-Q to estimate an optimal treatment regime for septic patients in the intensive care unit using EMR data from the Multiparameter Intelligent Monitoring Intensive Care database. Ultimately, we demonstrate that ReLiVE-Q leverages accumulating patient information to estimate personalized treatment regimes that optimize a clinically meaningful function of residual life. 

Abstract We present a detailed analysis of AT 2020nov, a tidal disruption event (TDE) in the center of its host galaxy, located at a redshift ofz= 0.083. AT 2020nov exhibits unique features, including double-peaked Balmer emission lines, a broad UV/optical flare, and a peak log luminosity in the extreme-ultraviolet (EUV) estimated at $\sim 45.66_{-0.33}^{+0.10}\mathrm{erg}{\mathrm{s}}^{-1}$. A late-time X-ray flare was also observed, reaching an absorbed luminosity of 1.67 × 10⁴³erg s⁻¹approximately 300 days after the UV/optical peak. Multiwavelength coverage, spanning optical, UV, X-ray, and mid-infrared (MIR) bands, reveals a complex spectral energy distribution (SED) that includes MIR flaring indicative of dust echoes, suggesting a dust covering fraction consistent with typical TDEs. Spectral modeling indicates the presence of an extended, quiescent disk around the central supermassive black hole with a radius of $\sim 5.06_{-0.77}^{+0.59}\times 10^4{R}_{\mathrm{g}}$. The multicomponent SED model, which includes a significant EUV component, suggests that the primary emission from the TDE is reprocessed by this extended disk, producing the observed optical and MIR features. The lack of strong active galactic nuclei signatures in the host galaxy, combined with the quiescent disk structure, highlights AT 2020nov as a rare example of a TDE occurring in a galaxy with a dormant but extended preexisting accretion structure. 

Abstract Tidal disruption events (TDEs) that are spatially offset from the nuclei of their host galaxies offer a new probe of massive black hole (MBH) wanderers, binaries, triples, and recoiling MBHs. Here we present AT2024tvd, the first off-nuclear TDE identified through optical sky surveys. High-resolution imaging with the Hubble Space Telescope shows that AT2024tvd is 0 $\stackrel{\text{″}}{.}$914 ± 0 $\stackrel{\text{″}}{.}$010 offset from the apparent center of its host galaxy, corresponding to a projected distance of 0.808 ± 0.009 kpc atz= 0.045. Chandra and Very Large Array observations support the same conclusion for the TDE’s X-ray and radio emission. AT2024tvd exhibits typical properties of nuclear TDEs, including a persistent hot UV/optical component that peaks atL_bb ∼ 6 × 10⁴³erg s⁻¹, broad hydrogen lines in its optical spectra, and delayed brightening of luminous (L_X,peak ∼ 3 × 10⁴³erg s⁻¹), highly variable soft X-ray emission. The MBH mass of AT2024tvd is 10^6±1M_⊙, at least 10 times lower than its host galaxy’s central black hole mass (≳10⁸M_⊙). The MBH in AT2024tvd has two possible origins: a wandering MBH from the lower-mass galaxy in a minor merger during the dynamical friction phase or a recoiling MBH ejected by triple interactions. Combining AT2024tvd with two previously known off-nuclear TDEs discovered in X-rays (3XMM J2150 and EP240222a), which likely involve intermediate-mass black holes in satellite galaxies, we find that the parent galaxies of all three events are very massive (∼10^10.9M_⊙). This result aligns with expectations from cosmological simulations that the number of offset MBHs scales linearly with the host halo mass. 

Abstract We present the tidal disruption event (TDE) AT2022lri, hosted in a nearby (≈144 Mpc) quiescent galaxy with a low-mass massive black hole (10⁴M_⊙<M_BH< 10⁶M_⊙). AT2022lri belongs to the TDE-H+He subtype. More than 1 Ms of X-ray data were collected with NICER, Swift, and XMM-Newton from 187 to 672 days after peak. The X-ray luminosity gradually declined from 1.5 × 10⁴⁴erg s⁻¹to 1.5 × 10⁴³erg s⁻¹and remains much above the UV and optical luminosity, consistent with a super-Eddington accretion flow viewed face-on. Sporadic strong X-ray dips atop a long-term decline are observed, with a variability timescale of ≈0.5 hr–1 days and amplitude of ≈2–8. When fitted with simple continuum models, the X-ray spectrum is dominated by a thermal disk component with inner temperature going from ∼146 to ∼86 eV. However, there are residual features that peak around 1 keV, which, in some cases, cannot be reproduced by a single broad emission line. We analyzed a subset of time-resolved spectra with two physically motivated models describing a scenario either where ionized absorbers contribute extra absorption and emission lines or where disk reflection plays an important role. Both models provide good and statistically comparable fits, show that the X-ray dips are correlated with drops in the inner disk temperature, and require the existence of subrelativistic (0.1–0.3c) ionized outflows. We propose that the disk temperature fluctuation stems from episodic drops of the mass accretion rate triggered by magnetic instabilities or/and wobbling of the inner accretion disk along the black hole’s spin axis. 

ABSTRACT We present numerical simulation results for the propagation of Alfvén waves in the charge starvation regime. This is the regime where the plasma density is below the critical value required to supply the current for the wave. We analyse a conservative scenario where Alfvén waves pick up charges from the region where the charge density exceeds the critical value and advect them along at a high Lorentz factor. The system consisting of the Alfvén wave and charges being carried with it, which we call charge-carrying Alfvén wave (CC-AW), moves through a medium with small, but non-zero, plasma density. We find that the interaction between CC-AW and the stationary medium has a two-stream like instability which leads to the emergence of a strong electric field along the direction of the unperturbed magnetic field. The growth rate of this instability is of the order of the plasma frequency of the medium encountered by the CC-AW. Our numerical code follows the system for hundreds of wave periods. The numerical calculations suggest that the final strength of the electric field is of the order of a few per cent of the AW amplitude. Little radiation is produced by the sinusoidally oscillating currents associated with the instability during the linear growth phase. However, in the non-linear phase, the fluctuating current density produces strong EM radiation near the plasma frequency and limits the growth of the instability. 

ABSTRACT FRB 20220912A is a repeating Fast Radio Burst (FRB) that was discovered in Fall 2022 and remained highly active for several months. We report the detection of 35 FRBs from 541 h of follow-up observations of this source using the recently refurbished Allen Telescope Array, covering 1344 MHz of bandwidth primarily centred at 1572 MHz. All 35 FRBs were detected in the lower half of the band with non-detections in the upper half and covered fluences from 4–431 Jy-ms (median = 48.27 Jy-ms). We find consistency with previous repeater studies for a range of spectrotemporal features including: bursts with downward frequency drifting over time; a positive correlation between bandwidth and centre frequency; and a decrease in sub-burst duration over time. We report an apparent decrease in the centre frequency of observed bursts over the two months of the observing campaign (corresponding to a drop of 6.21 ± 0.76 MHz per d). We predict a cut-off fluence for FRB 20220912A of Fmax ≲ 104 Jy-ms, for this source to be consistent with the all-sky rate, and find that FRB 20220912A significantly contributed to the all-sky FRB rate at a level of a few per cent for fluences of ∼100 Jy-ms. Finally, we investigate characteristic time-scales and sub-burst periodicities and find (a) a median inter-subburst time-scale of 5.82 ± 1.16 ms in the multi-component bursts and (b) no evidence of strict periodicity even in the most evenly spaced multi-component burst in the sample. Our results demonstrate the importance of wideband observations of FRBs, and provide an important set of observational parameters against which to compare FRB progenitor and emission mechanism models.