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There is a broad consensus that accretion onto supermassive black holes and consequent jet formation power the observed emission from active galactic nuclei (AGNs). However, there has been less agreement about how jets form in accretion flows, their possible relationship to black hole spin, and how they interact with the surrounding medium. There have also been theoretical concerns about instabilities in standard accretion disk models and lingering discrepancies with observational constraints. Despite seemingly successful applications to X-ray binaries, the standard accretion disk model faces a growing list of observational constraints that challenge its application to AGNs. Theoretical exploration of these questions has become increasingly reliant on numerical simulations owing to the dynamic nature of these flows and the complex interplay between hydrodynamics, magnetic fields, radiation transfer, and curved spacetime. We conclude the following:
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