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Circadian-Shaped Immune Variability Predicts Infection Outcome, Jonathan Lalsiamthara, Mariko Locke, Alejandro Aballay Jan 2026

Circadian-Shaped Immune Variability Predicts Infection Outcome, Jonathan Lalsiamthara, Mariko Locke, Alejandro Aballay

Faculty, Staff and Student Publications

Disease risk and severity are influenced by genetics, epigenetics, and environmental factors. However, immune responses vary even among genetically similar or related individuals, shaped by inherited and noninherited factors. Using Caenorhabditis elegans, we found that pathogen susceptibility can be predicted by preinfection biomarkers. Individuals with high-basal expression of irg-5, an infection response gene regulated by the p38 mitogen-activated protein kinase-1 (PMK-1) pathway, were more susceptible to Pseudomonas aeruginosa infection. A genome-wide screen identified the myeloid ecotropic viral integration site-1 (MEIS) homeobox protein UNC-62 as a regulator of irg-5 expression, acting through PMK-1 and GATA binding erythroid-like transcription factor …


Career Plans Among Graduating Us Emergency Medicine Residents, Dave W. Lu, Bo Gu, D. Mark Courtney, Bryan G. Kane, Michelle D. Lall, Michael Gottlieb, Yvette Calderon, Christopher Bennett Jan 2026

Career Plans Among Graduating Us Emergency Medicine Residents, Dave W. Lu, Bo Gu, D. Mark Courtney, Bryan G. Kane, Michelle D. Lall, Michael Gottlieb, Yvette Calderon, Christopher Bennett

Department of Emergency Medicine Faculty Papers

IMPORTANCE: The emergency medicine (EM) workforce is undergoing complex change, including a potential projected physician surplus, the volatile and evolving interests of medical students, and the continued high rates of burnout. Understanding the career intentions of graduating residents is critical to inform workforce planning.

OBJECTIVE: To examine the career plans, anticipated career durations, and key factors associated with the career decisions of graduating US EM residents.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional survey study, which sampled graduating residents from all Accreditation Council for Graduate Medical Education-accredited categorical EM programs, was conducted after the 2023 American Board of Emergency Medicine In-Training …


Unwrapping The Candy Cane: An Underrecognized Cause Of Postoperative Abdominal Pain, Priscilla Itua, Uzma Ali, Mohammad Mahdi, Osamah Salim, Sarib Sultan Jan 2026

Unwrapping The Candy Cane: An Underrecognized Cause Of Postoperative Abdominal Pain, Priscilla Itua, Uzma Ali, Mohammad Mahdi, Osamah Salim, Sarib Sultan

Gulf Coast Division GME Research Day 2026

No abstract provided.


Survival Following Extreme Metformin-Associated Lactic Acidosis In A Patient With Acute-On-Chronic Kidney Disease Managed With Crrt, Phil Khong, Danielle Sudilovsky, Logan Blackney, Ryan Spilman, Alex Enurah Jan 2026

Survival Following Extreme Metformin-Associated Lactic Acidosis In A Patient With Acute-On-Chronic Kidney Disease Managed With Crrt, Phil Khong, Danielle Sudilovsky, Logan Blackney, Ryan Spilman, Alex Enurah

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.


Hidden In The Hilum: A Rare Case Of Mediastinal Mucormycosis In A Patient With Uncontrolled Diabetes Mellitus, Neethu George, Anusha Putta, Harikaran Ragireddy Jan 2026

Hidden In The Hilum: A Rare Case Of Mediastinal Mucormycosis In A Patient With Uncontrolled Diabetes Mellitus, Neethu George, Anusha Putta, Harikaran Ragireddy

Gulf Coast Division GME Research Day 2026

No abstract provided.


Bilateral Pseudoangiomatous Stromal Hyperplasia In A Twelve-Year-Old Female: A Case Report, Alexandra Mcmillan, Taylor Sullivan, Joyce Moore, Robert M. Pride Jan 2026

Bilateral Pseudoangiomatous Stromal Hyperplasia In A Twelve-Year-Old Female: A Case Report, Alexandra Mcmillan, Taylor Sullivan, Joyce Moore, Robert M. Pride

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.


High Suspicion Of Congenital Long Qt Syndrome Diagnosis In A Polypharmacy Patient, Alexis Lopez Cruz, Grant Haden, Julianna Vecchio, Hasnan M. Ijaz, Thomas Alexander Jan 2026

High Suspicion Of Congenital Long Qt Syndrome Diagnosis In A Polypharmacy Patient, Alexis Lopez Cruz, Grant Haden, Julianna Vecchio, Hasnan M. Ijaz, Thomas Alexander

Gulf Coast Division GME Research Day 2026

No abstract provided.


Accelerating Quality Improvement In Cabg Surgery: A Real-Time Rapid-Cycle Process Improvement Tool Guided By The Publicly Available Sts Risk Calculator, John G. Byrne, Farhaan Chaugle, Waleed Asger, Aaliyah Willis, Shelby Derose, Rachel Jones, Hannan Chaugle Jan 2026

Accelerating Quality Improvement In Cabg Surgery: A Real-Time Rapid-Cycle Process Improvement Tool Guided By The Publicly Available Sts Risk Calculator, John G. Byrne, Farhaan Chaugle, Waleed Asger, Aaliyah Willis, Shelby Derose, Rachel Jones, Hannan Chaugle

Gulf Coast Division GME Research Day 2026

No abstract provided.


Differential Sensitivity Of Leukocyte Populations To Staphylococcus Aureus Biofilm, Nichole D. Brandquist, Tammy Kielian Jan 2026

Differential Sensitivity Of Leukocyte Populations To Staphylococcus Aureus Biofilm, Nichole D. Brandquist, Tammy Kielian

Journal Articles: Pathology and Microbiology

Staphylococcus aureus is a leading cause of prosthetic joint infection (PJI) typified by biofilm formation. Anti-inflammatory granulocytic myeloid-derived suppressor cells (G-MDSCs) represent the main leukocyte population in a mouse model of S. aureus PJI, followed by neutrophils (PMNs), and macrophages (Mφs), which is also seen during human PJI. Defining how each leukocyte population responds to S. aureus biofilm vs planktonic bacteria could have important implications for how S. aureus evades immune detection to facilitate biofilm persistence. This study compared the kinetics of leukocyte death and relationship to mitochondrial ROS (mtROS) production following exposure to planktonic S. aureus or biofilm. Mφs …


Twenty-First Century Data Systems: Evolving Cancer Registries To A Learning Health System, Peter P. Yu, W. Scott Campbell, Eric B. Durbin, Lawrence N. Shulman, Jeremy L. Warner Jan 2026

Twenty-First Century Data Systems: Evolving Cancer Registries To A Learning Health System, Peter P. Yu, W. Scott Campbell, Eric B. Durbin, Lawrence N. Shulman, Jeremy L. Warner

Markey Cancer Center Faculty Publications

Introduction: Oncology is a data-rich environment reflecting the increasing incidence of cancer in the US aging population, transformation of cancer into a chronic disease due to advances in treatment, and the emergence of new data categories such as genomics. Concomitantly, healthcare systems are challenged to meet regulatory and voluntary reporting of cancer data to support government, quality certification, research and strategic partnership needs.

Materials and Methods: The National Academies of Science, Engineering, and Medicine organized a workshop entitled “Enabling 21st-century applications for cancer surveillance through enhanced registries and beyond” with representation from NCI Comprehensive Cancer Centers, oncology and medical informatics …


A Case Of Primary Gastric Diffuse Large B-Cell Non-Hodgkin Lymphoma With Tumor Lysis Syndrome And The Warburg Effect, Sarah Barnhardt, Brooke Escoe, Mary Carter Jan 2026

A Case Of Primary Gastric Diffuse Large B-Cell Non-Hodgkin Lymphoma With Tumor Lysis Syndrome And The Warburg Effect, Sarah Barnhardt, Brooke Escoe, Mary Carter

South Atlantic Division GME Research Day 2025

No abstract provided.


Optic Neuritis, Children's Health School Services Jan 2026

Optic Neuritis, Children's Health School Services

School Guides

Educator guide about how to support students with optic neuritis.


Mitochondrial Transfer To Granulocytic Myeloid-Derived Suppressor Cells Augments Immunosuppressive Activity, Prabhakar Arumugam, Cortney E. Heim, Rachel W. Fallet, Dhananjay Shinde, Vinai Chittezham Thomas, Rafael J. Argüello, Tammy Kielian Jan 2026

Mitochondrial Transfer To Granulocytic Myeloid-Derived Suppressor Cells Augments Immunosuppressive Activity, Prabhakar Arumugam, Cortney E. Heim, Rachel W. Fallet, Dhananjay Shinde, Vinai Chittezham Thomas, Rafael J. Argüello, Tammy Kielian

Journal Articles: Pathology and Microbiology

The anti-inflammatory properties of granulocytic myeloid-derived suppressor cells (G-MDSCs) promote Staphylococcus aureus (S. aureus) biofilm persistence. Evidence suggests that G-MDSC activity is shaped not only by S. aureus products but also by intrinsic metabolic programs. This study explores whether G-MDSC activity can be modulated by increasing mitochondrial abundance using a co-culture paradigm with macrophages as a mitochondrial donor. Macrophages transfer mitochondria directly to G-MDSCs via tunneling nanotubes, enhancing G-MDSC respiration, as reflected by increased basal, maximal, and spare respiratory capacity. Augmenting mitochondrial abundance in G-MDSCs enhances T cell-suppressive activity and reduces tumor necrosis factor (TNF) and interleukin 6 (IL-6) production. …


Embodied Aging: Older Adults’ Gendered Participation In Physical And Recreational Activity In Assisted Living, Gavin Anderson Jan 2026

Embodied Aging: Older Adults’ Gendered Participation In Physical And Recreational Activity In Assisted Living, Gavin Anderson

Self-Designed Majors Honors Papers

This study examines how older adults interpret their experiences with physical and recreational activity in assisted living, and how these interpretations influence how they engage in their everyday social and physical contexts. In the fall of 2025, eleven older adults—nine women and two men—living in an assisted living facility in a coastal city in Southeastern Connecticut participated in in-depth semi-structured interviews. The facility provides both short-term post-acute care and long-term residential care, offering structured opportunities for physical and recreational engagement.

Past research demonstrates that participation in physical and recreational activity provides substantial benefits for older adults; yet, the lived experience …


Sexually Dimorphic Effects Of Gpnmb Modulation On Vertebral Bone Mass Regulation And Intravertebral Disc Health, Hakem Altawil, Fayez Safadi Jan 2026

Sexually Dimorphic Effects Of Gpnmb Modulation On Vertebral Bone Mass Regulation And Intravertebral Disc Health, Hakem Altawil, Fayez Safadi

Williams Honors College, Honors Research Projects

Osteoporosis and vertebral degeneration are major contributors to musculoskeletal morbidity, yet the molecular mechanisms regulating vertebral bone and intervertebral disc (IVD) homeostasis remain incompletely understood. GPNMB (osteoactivin) has been identified as a regulator of bone remodeling, though its role in spine health is unclear. This study evaluated the effects of GPNMB deficiency on lumbar vertebral bone microarchitecture and IVD integrity in a sex-dependent context.

Six-month-old male and female wild-type (WT) and GPNMB knockout (KO) mice were analyzed using micro–computed tomography (µCT) of lumbar vertebrae (L4–L6) and histological assessment of the L5–L6 IVD. KO males exhibited increased bone volume fraction, bone …


Metabolic Reprogramming Following Mitochondrial Transfer Between Idh2-Mutant Chondrosarcoma Cells And A Normal B-Cell Line, Caleb Wyckoff, Christopher Osgood, Ellen Jing, Michael Stacey Jan 2026

Metabolic Reprogramming Following Mitochondrial Transfer Between Idh2-Mutant Chondrosarcoma Cells And A Normal B-Cell Line, Caleb Wyckoff, Christopher Osgood, Ellen Jing, Michael Stacey

Bioelectrics Publications

Background/Objectives: Chondrosarcoma, glioblastoma, acute myeloid leukemia, chronic lymphocytic leukemia, and cholangiocarcinoma cancers all contain mutations in the gene isocitrate dehydrogenase 2 (IDH2). The mutant IDH2 enzyme metabolizes alpha-ketoglutarate (αKG) into the potent oncometabolite D-2-hydroxyglutarate (D2HG) in the mitochondria of these cancers, leading to altered cellular metabolism. Emerging evidence suggests that mitochondrial transfer between cancer and recipient cells represents an important form of intercellular communication that may influence cellular metabolism. The presence of intercellular TNTs between IDH2-mutant chondrosarcoma cells motivated an investigation into mitochondria-associated physiological changes occurring during an intercellular exchange with immune cells. A mitochondrial transfer is a two-way …


Predictors Of Increased Length Of Stay And Cost In Readmissions For Spinal Surgical Site Infections, Matthew Giammanco, Alex Zhang, Phillip Alexeev, Ryan Snowden Jan 2026

Predictors Of Increased Length Of Stay And Cost In Readmissions For Spinal Surgical Site Infections, Matthew Giammanco, Alex Zhang, Phillip Alexeev, Ryan Snowden

SPARK Symposium Presentations

Abstract:

 

Background

Surgical site infection (SSI) following spinal surgery remains a costly and morbid complication, frequently necessitating hospital readmission and operative management. While prior studies have characterized the overall economic burden of spinal SSI, the specific drivers of cost during SSI-related readmissions are poorly defined. The primary research question of this study was to identify clinical, operative, and microbiologic factors associated with increased hospital cost, length of stay, and financial margins during readmission for operative management of spinal SSI.

 

Methods

We performed a retrospective cohort study of adult patients readmitted for surgical management of spinal SSI at a single tertiary …


Oral N-Acetylcysteine In Hepatitis C - Induced Acute Liver Injury: A Case Report, Mohammed Irfan Khan, Shuchita Jhaveri, Renu Thomas, Kevin Garnepudi, Galvin Dhaliwal, Ahmed Ouni, Shane P. Sweeney, Julian Nguyen Jan 2026

Oral N-Acetylcysteine In Hepatitis C - Induced Acute Liver Injury: A Case Report, Mohammed Irfan Khan, Shuchita Jhaveri, Renu Thomas, Kevin Garnepudi, Galvin Dhaliwal, Ahmed Ouni, Shane P. Sweeney, Julian Nguyen

Gulf Coast Division GME Research Day 2026

No abstract provided.


Dry Gangrene Following Av Fistula Ligation For Vascular Access-Induced Steal Syndrome: A Case Report, Marium Batool Abbas, Umema Ifran, Marelle Montanez Jan 2026

Dry Gangrene Following Av Fistula Ligation For Vascular Access-Induced Steal Syndrome: A Case Report, Marium Batool Abbas, Umema Ifran, Marelle Montanez

Gulf Coast Division GME Research Day 2026

No abstract provided.


Increasing Patient Safety By Improving Healthcare Team Communication Through Imobile At Hca Healthcare Trident Hospital, Jordan Read, Laura Brant, Matthew Madden Jan 2026

Increasing Patient Safety By Improving Healthcare Team Communication Through Imobile At Hca Healthcare Trident Hospital, Jordan Read, Laura Brant, Matthew Madden

South Atlantic Division GME Research Days 2026

No abstract provided.


The Great Imitator: A Subtle Case Of Syphilis In The Emergency Department Amid Rising National Incidence, Jyotirmaya Jain, Michael Flanders, Manzoor Bevinal Jan 2026

The Great Imitator: A Subtle Case Of Syphilis In The Emergency Department Amid Rising National Incidence, Jyotirmaya Jain, Michael Flanders, Manzoor Bevinal

Gulf Coast Division GME Research Day 2026

No abstract provided.


A Rare Case Of Successful Resolution Of Bifurcation Stenosis Using Double Kissing Crush Stenting Technique, Greeshma Molugu, Tony Alacron, Karthik Anand, Machaiah Madhrira Jan 2026

A Rare Case Of Successful Resolution Of Bifurcation Stenosis Using Double Kissing Crush Stenting Technique, Greeshma Molugu, Tony Alacron, Karthik Anand, Machaiah Madhrira

North Texas GME Research Forum 2026

Introduction: Bifurcation lesions are associated with greater procedural complexity and consequently are at higher risk for stent restenosis. Bifurcation lesions are still technically challenging even in the era of modern stents. High incidence of restenosis both in the main vesseI and side branch Iimits the Iong-term prognosis. We present a rare case of successful resolution of bifurcation stenosis in a patient by using the double kissing (DK) crush stenting technique.

Case Description: A 52-year-old male patient with a past medical history of hypertension presented to the hospital for elective left heart catheterization as a part of an evaluation for a …


A Rare Interaction: Ssri Induced Rhabdomyolysis, Sakina Haider, Syeda Alisha Johar Jan 2026

A Rare Interaction: Ssri Induced Rhabdomyolysis, Sakina Haider, Syeda Alisha Johar

Gulf Coast Division GME Research Day 2026

No abstract provided.


A Greasy Imposter: A Case Of Profound Hypertriglyceridemia Mimicking Diabetic Ketoacidosis And Severe Hyponatremia, Shania Chishti, Elaheh Boroujeni, Mohammad Hussan Shafiq, Jonathan Xian Jan 2026

A Greasy Imposter: A Case Of Profound Hypertriglyceridemia Mimicking Diabetic Ketoacidosis And Severe Hyponatremia, Shania Chishti, Elaheh Boroujeni, Mohammad Hussan Shafiq, Jonathan Xian

Gulf Coast Division GME Research Day 2026

No abstract provided.


Trustworthy Multimodal Ai For Medical Imaging: Enhancing Diagnosis, Reasoning, And Human-Agent Interaction In Extended Reality, Jai Prakash Veerla Jan 2026

Trustworthy Multimodal Ai For Medical Imaging: Enhancing Diagnosis, Reasoning, And Human-Agent Interaction In Extended Reality, Jai Prakash Veerla

Computer Science and Engineering Dissertations

The transition from traditional microscopy to digital pathology has digitized diagnostic data, yet clinical workflows remain constrained by two-dimensional screens and passive, opaque analysis tools that fail to capture the spatial complexity of biological systems. While Foundation Models now promise to reason across histology and genomics, a critical disconnect persists between the richness of this data and the limited cognitive bandwidth of clinicians, who currently lack the immersive interfaces and trustworthy agents necessary to utilize it effectively. This dissertation presents a unified framework for "Embodied Agentic AI," establishing a pipeline that augments physician capabilities through immersive visualization, robust security, and …


Intra-Amniotic Infection (Iai) Prevention, Shelbie Clement, Deanna Conley Jan 2026

Intra-Amniotic Infection (Iai) Prevention, Shelbie Clement, Deanna Conley

Articles, Abstracts, and Reports

No abstract provided.


Thoracolumbar Fractures: Historical Systems And Advancements With The Ao Spine Classification, Barry Ting Sheen Kweh, Alex R. Vaccaro, Gregory D. Schroeder, Jose A. Canseco, Maximilian Reinhold, Mohamed M. Aly, Sebastian Bigdon, Mohammad El-Skarkawi, Richard J. Bransford, Andrei Fernandes Joaquim, Harvinder Singh Chhabra, Emiliano Vialle, Rishi M. Kanna, Charlotte Dandurand, Cumhur Öner, Jin Wee Tee Jan 2026

Thoracolumbar Fractures: Historical Systems And Advancements With The Ao Spine Classification, Barry Ting Sheen Kweh, Alex R. Vaccaro, Gregory D. Schroeder, Jose A. Canseco, Maximilian Reinhold, Mohamed M. Aly, Sebastian Bigdon, Mohammad El-Skarkawi, Richard J. Bransford, Andrei Fernandes Joaquim, Harvinder Singh Chhabra, Emiliano Vialle, Rishi M. Kanna, Charlotte Dandurand, Cumhur Öner, Jin Wee Tee

Rothman Institute Papers

Study Design: Systematic Review. Objective: To describe the historical classifications of thoracolumbar injuries and their evolution into the AO Spine Thoracolumbar Injury Classification System. Methods: A systematic review of MEDLINE, EMBASE and Cochrane Databases was performed in keeping with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Results: 445 articles were crystallized to 14 included studies. Simple categorization systems offered by Bohler or Watson-Jones merely identify fracture morphology. Holdsworth and Denis conveyed a sense of the stability of injuries by noting columns of stability, but still failed to take into consideration important factors such as neurological status or …


Bridging The Knowledge-Practice Gap In Breast Cancer Awareness: A Nationwide Online Cross-Sectional Kap Study Among Adult Females In Nigeria, Madinat Hassan, Taofeek Tope Adegboyega, Bilkisu Usman Farouk, Sunday Zeal Bala, Rachael Olufunmilayo Oduyemi, Kazeem Owolabi, Munir Sani, Miracle Uwa Livinus, Hannatu Usman Ayuba, Sadiq Hassan, Ifeyinwa Maureen Okeke, Abednego Shekari, Murtala Jibril Jan 2026

Bridging The Knowledge-Practice Gap In Breast Cancer Awareness: A Nationwide Online Cross-Sectional Kap Study Among Adult Females In Nigeria, Madinat Hassan, Taofeek Tope Adegboyega, Bilkisu Usman Farouk, Sunday Zeal Bala, Rachael Olufunmilayo Oduyemi, Kazeem Owolabi, Munir Sani, Miracle Uwa Livinus, Hannatu Usman Ayuba, Sadiq Hassan, Ifeyinwa Maureen Okeke, Abednego Shekari, Murtala Jibril

Chemistry & Biochemistry Faculty Publications

Background and Aims

Breast cancer (BCa) is a major cause of cancer morbidity and mortality among women in Nigeria, with late presentation contributing to poor outcomes. This study assessed knowledge, attitudes, and willingness to perform breast self-examination (BSE) among adult females in Nigeria and examined associated factors.

Methods

We conducted a descriptive cross-sectional online survey between February 16 and April 30, 2024. A structured, pretested questionnaire was disseminated through digital platforms, yielding 711 consenting adult female respondents from all six geopolitical zones. Knowledge, attitude, and willingness-to-perform-BSE measures were analyzed using descriptive statistics, linear regression, and binary logistic regression. Associations were …


Training Set Augmentation And Biology-Aware Harmonization Improve Radiomic Models For Lung Cancer Prediction In Indeterminate Nodules, Claire Huchthausen, Menglin Shi, Gabriel De Sousa, James Larner, Einsley Janowski, Jonathan Colen, Krishni Wijesooriya Jan 2026

Training Set Augmentation And Biology-Aware Harmonization Improve Radiomic Models For Lung Cancer Prediction In Indeterminate Nodules, Claire Huchthausen, Menglin Shi, Gabriel De Sousa, James Larner, Einsley Janowski, Jonathan Colen, Krishni Wijesooriya

Data Science Faculty Publications

CT radiomics-based machine learning has potential to predict lung cancer in pulmonary nodules (PNs) earlier than standard-of-care methods. Low malignancy rates in early-development PNs and variable image acquisition hinder development of radiomic models for diagnosing these PNs. To address these challenges, we augmented training using later-development PNs and harmonized for acquisition effects. We examine early-development benign and malignant PNs (n = 106) below the sensitivity of standard-of-care diagnosis. Classifiers predicting malignancy performed near chance when trained on ComBat-harmonized radiomic features from only early-development PNs. We then augmented training with later-development benign and malignant PNs (n = 225). We evaluated whether …


Real-Space Imaging Of The Electron-Pair Density Hole In Molecular Auger-Meitner Decay, Mats Simmermacher, Nathan Goff, Andres Moreno Carrascosa, Elke Fasshauer, Thomas Northey, Lingyu Ma, Haiwang Yong, Brian Stankus, Asami Odate, Xuan Xu, Wenping Du, Kyle Acheson, Joseph C. Cooper, Daniel Ratner, Mengning Liang, Ruaridh Forbes, Michael P. Minitti, Adam Kirrander, Peter M. Weber Jan 2026

Real-Space Imaging Of The Electron-Pair Density Hole In Molecular Auger-Meitner Decay, Mats Simmermacher, Nathan Goff, Andres Moreno Carrascosa, Elke Fasshauer, Thomas Northey, Lingyu Ma, Haiwang Yong, Brian Stankus, Asami Odate, Xuan Xu, Wenping Du, Kyle Acheson, Joseph C. Cooper, Daniel Ratner, Mengning Liang, Ruaridh Forbes, Michael P. Minitti, Adam Kirrander, Peter M. Weber

Physics Faculty Publications

Electrons in matter can rearrange extremely quickly under external perturbations, underpinning subsequent structural and chemical transformations. Coulomb interactions between neighbouring electrons often shape this response, giving rise to correlated motion and strongly affecting the distribution of electrons in the system. Here we show that non-resonant hard X-ray scattering can directly access changes in the radial electron-pair density during the rapid rearrangement of core and valence electrons. We do this by studying sulfur hexafluoride molecules undergoing Auger–Meitner decay. We exploit a second-order interaction between the X-ray photons and the molecules to trigger and probe the decay dynamics with a single pulse, …