The mechanisms driving immune dysregulation in long COVID disease remain elusive. Here we integrated single-cell multiome data, immunological profiling and functional assays to investigate immune alterations across multiple cohorts. A transcriptional state in circulating monocytes (LC-Mo) was enriched in individuals with mild–moderate acute infection and accompanied by persistent elevations of plasma CCL2, CXCL11 and TNF. LC-Mo showed TGFβ and WNT–β-catenin signaling and correlated with fatigue severity. Protein markers of LC-Mo were increased in individuals with pronounced fatigue or dyspnea, and those with severe respiratory symptoms showed higher LC-Mo expression. Epigenetically, LC-Mo exhibited AP-1- and NF-κB1-driven profibrotic programs. LC-Mo-like macrophages in bronchoalveolar lavage samples from individuals with severe respiratory symptoms displayed a profibrotic profile, and individuals with a high LC-Mo transcriptional state showed impaired interferon responses after stimulation. Collectively, our findings define a pathogenic monocyte transcriptional state linking systemic immune dysfunction to persistent long COVID disease, providing mechanistic insights and potential therapeutic targets.

Background: Since diet is generally recognized as an important factor directly modulating the gut microbiome, it is also considered a potential environmental triggering factor for the pathogenesis and onset of inflammatory bowel disease (IBD). While the habitual and sex-related dietary behavior of the general population has been the subject of extensive study and reporting, data on IBD patients’ dietary behavior and especially its sex-related differences are underrepresented. However, as diet is an important factor in the course of IBD, we hypothesized that men and women with IBD have a different dietary profile than the general population. Methods: We performed a cohort analysis of a monocentric, cross-sectional study and compared the sex-related dietary behavior of 82 IBD patients (n = 40 women) to a sex- and age-matched cohort of the general German population [n = 328 (n = 160 women)]. Further on, disease-related quality of life and fecal calprotectin were correlated to the IBD patients’ dietary behavior. Results: While sex-related dietary behavior was frequently of statistical difference in the general population within the IBD cohort, only minor numerical differences were observed between the sexes, which were rarely statistically significant. However, correlation analyses of disease-related quality of life (IBDQ) and diet revealed significant differences in male IBD patients but not in female IBD patients (p = 0.007; r = 0.409 for energy intake (kJ/d); p = 0.003, r = 0.449 for adherence to Mediterranean diet). Conclusion: The dietary behavior of IBD patients showed more similarity between the sexes than the general German population. Distinct sex-related trends and differences in correlation with disease parameters demonstrated a significant difference for an adaptive dietary behavior, especially in IBD men.

Background/Objectives: Inflammatory bowel disease (IBD) affects gastrointestinal function and may alter fecal and flatulence odor (intestinal odor) due to changes in inflammation, the gut microbiome, and metabolism. Investigating the relationship between dietary habits and intestinal odor in IBD is critical given the relationship between diet, gut health, and microbiome diversity. Methods: We performed a cohort analysis of a monocentric, cross-sectional study at a tertiary referral center and compared the perception of fecal and flatulence odor in 233 IBD patients (n = 117 women) with that of 96 healthy controls (HCs) (n = 67 women). In addition to a short screening questionnaire on highly processed foods (sQ-HPF), dietary behavior (Food Frequency Questionnaire (FFQ)), clinical (HBI, PMS) and biochemical (CRP, fecal calprotectin) parameters of disease activity, and adherence to a Mediterranean diet were assessed. Results: A notable predisposition towards elevated levels of intestinal malodor was identified in the IBD cohort when compared to the HC group. The analysis of dietary behavior in conjunction with intestinal malodor revealed more pronounced associations in the HC collective than in the IBD collective. The data further indicated that, in comparison to those in remission, IBD individuals with an active disease status exhibited a higher prevalence of intestinal malodor. In an adjusted logistic regression analysis of the influence of disease- and diet-specific factors on flatulence and fecal malodor in IBD, male sex was identified as a significant risk factor. Conclusions: This study highlights the significance of dietary factors in the management of IBD symptoms, with a particular focus on flatulence and fecal odor. Individuals with IBD demonstrated a higher propensity for intestinal malodor compared to HC, with active disease status further amplifying this prevalence. Dietary behavior showed stronger associations with malodor in the HC group than in IBD individuals, suggesting distinct interaction patterns between diet and gut health in these populations.

Background: Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), consists of chronic gastrointestinal inflammation, with nutrition playing a significant role in its development. IBD patients often face dietary challenges affecting their quality of life (QoL), yet research on food-related QoL (FR-QoL) and sex-specific differences is limited. It was hypothesized that dietary patterns and choices impact food-related quality of life in IBD and that these effects vary by sex. The objective of this analysis was, therefore, to evaluate the impact of diet on food-related quality of life for men and women with IBD, respectively. Methods: A monocentric, cross-sectional study at a tertiary referral center analyzed the food-related quality of life in 117 women and 116 men with IBD, with a particular focus on dietary choices and patterns. To achieve this, multiple assessment tools, including the German version of the IBD-specific Questionnaire for Food-Related Quality of Life (FR-QoL-29-German) and a validated Food Frequency Questionnaire (FFQ) for dietary behavior, were used. Clinical indices (Harvey–Bradshaw Index (HBI); Partial Mayo Score (PMS)) and biochemical markers (C-reactive protein; fecal calprotectin) were evaluated. Results: The FR-QoL-29-German sum score differed significantly between the sexes (p = 0.034; g = −0.3), with men showing a higher mean score. Distinct dietary patterns showed little correlation with FR-QoL for both sexes, except for a significant inverse correlation between FR-QoL and sQ-HPF scores for men (p = 0.021; r = −0.214) but not for women (p = 0.897; r = −0.012). In a logistic regression analysis that was adjusted for confounding, the impact of IBD-specific and diet-related factors on FR-QoL was assessed, and disease entity was identified as a significant influencing factor for men but not for women. In women, older age and lower body weight were associated with higher FR-QoL. Conclusions: The findings of this study indicate that dietary choices and patterns do not exhibit uniform associations with IBD-related quality of life. In addition, sex differences have been identified as a substantial factor in IBD food-related quality of life.

Despite efforts toward gender equality, disparities persist in medical careers and leadership. This study examines gender representation in gastroenterology at the German Visceral Medicine Congress from 2013 to 2024, focusing on changes over time. Programs from 1,333 sessions were analyzed for gender ratios of speakers and chairs, including plenary, ab-stract, and industry sessions, plus congress presidents and awardees. Trends were assessed via linear regression and Cochran-Armitage tests. Trend analysis revealed a significant increase in female speakers (r²=0.599, p=0.005) and chairpersons (r²=0.747, p<0.001). Female speaker proportions rose significantly in plenary (r²=0.600, p=0.005), abstract (r²=0.445, p=0.025), and industry sessions (r²=0.641, p=0.003), but did not reach parity. Female chairs showed stronger upward trends: plenary (r²=0.807, p<0.001), abstract (r²=0.490, p=0.016), industry (r²=0.729, p<0.001). Congress presidencies remained all male, and 75–93% of awards went to men. Female representation, especially in chair roles, has improved since the 2019 parity resolution but remains insufficient in key areas. Ongoing gender-sensitive planning and support are needed to foster a more inclusive academic environment. Trotz Bemühungen um Geschlechtergerechtigkeit bestehen weiterhin Disparitäten in medizinischen Karrieren und Führungspositionen. Diese Studie untersucht die Geschlechterrepräsentation in der Gastroenterologie beim Deutschen Viszeralmedizin-Kongress von 2013 bis 2024 mit Fokus auf zeitliche Veränderungen. Die Programme von 1333 Sitzungen wurden hinsichtlich der Geschlechterverteilung von Vortragenden und Sitzungsleitern analysiert, darunter Plenar-, Abstract- und Industriesitzungen sowie Kongresspräsident:innen und Preisträger:innen. Trends wurden mittels linearer Regression und Cochran-Armitage-Test bewertet. Es zeigte sich ein signifikanter Anstieg weiblicher Referentinnen (r²=0.599, p=0.005) und Sitzungsleiterinnen (r²=0.747, p<0.001). Der Anteil weiblicher Referentinnen stieg signifikant in Plenar- (r²=0.600, p=0.005), Abstract- (r²=0.445, p=0.025) und Industriesitzungen (r²=0.641, p=0.003), erreichte jedoch keine Parität. Weibliche Sitzungsleiterinnen zeigten stärkere Zuwächse: Plenar- (r²=0.807, p<0.001), Abstract- (r²=0.490, p=0.016) und Industriesitzungen (r²=0.729, p<0.001). Kongresspräsidentschaften blieben vollends männlich dominiert, ebenso erhielten 75–93% der Preise Männer. Die weibliche Repräsentation, insbesondere bei Sitzungsleitungen, hat sich seit der Paritätsresolution 2019 verbessert, bleibt jedoch in zentralen Bereichen unzureichend. Fortgesetzte geschlechtersensible Planung und institutionelle Unterstützung sind erforderlich, um eine inklusivere akademische Umgebung zu fördern. ^* Shared first authorship. Received: 30 June 2025 Accepted after revision: 12 September 2025 Article published online: 07 October 2025 © 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Ultra-processed foods (UPF) and highly processed foods (HPF) are linked to non-communicable diseases and their consumption is rising globally. Currently no validated German tool to assess HPF consumption exists. This study aimed to translate and culturally adapt the validated Screening Questionnaire of Highly Processed Food Consumption (sQ-HPF) into German and evaluate its validity and reliability.In this monocentric, cross-sectional study participants completed sociodemographic questionnaires, a food frequency questionnaire (FFQ), the German version of the sQ-HPF, anthropometric data and 25-(OH)-Vitamin D3 levels were measured. The sQ-HPF has been translated into German with the forward-backward method, and its reliability and validity was assessed using Pearson correlation coefficients, intraclass correlation coefficients, and Cronbachʼs α.N=91 participants completed the questionnaires with n=58 participants completing the follow up questionnaires after an average of six weeks. The sQ-HPF sum scores significantly correlated with sex (p=0.004), waist circumference (p=0.015), 25-(OH)-Vitamin D3 (p=0.008), daily energy intake (kJ) (p<0.001), and the percentage of HPF and UPFD (g/d) as measured by FFQ (HPF p<0.001; UPFD p<0.001). Cronbachʼs α of the German version of the sQ-HPF was 0.723 and showed good test-retest reliability (ICC=0.786 [95% CI: 0.64–0.87]). A Bland-Altman plot showed good general agreement between the percentage of HPF (g/d) measured by FFQ and the percentage of HPF (g/d) measured by sQ-HPF.The German version of the sQ-HPF is a valid and reliable tool for assessing highly processed food consumption in German-speaking individuals.