Seminological, Hormonal and Ultrasonographic Features of Male Factor Infertility Due to Genetic Causes: Results from a Large Monocentric Retrospective Study.

Objectives: Evaluate the prevalence of genetic factors in a large population of infertile subjects and define the seminological, hormonal, and ultrasonographic features for each alteration. Methods: This single-center retrospective study included male partners of infertile couples undergoing genetic investigations due to oligozoospermia or azoospermia evaluated from January 2012 to January 2022. The genetic investigations consist of karyotype, CFTR gene mutations plus variant of the IVS8-5T polymorphic trait, Y chromosome microdeletion, and Next Generation Sequencing panel to analyze genes implicated in congenital hypogonadotropic hypogonadism (CHH). Results: Overall, 15.4% (72/466) of patients received a diagnosis of genetic cause of infertility. Specifically, 23 patients (31.9%) harbor mutations in the CFTR gene, 22 (30.6%) have a 47, XXY karyotype, 14 (19.4%) patients show a Y chromosome microdeletion, 7 (9.7%) have structural chromosomal anomalies, and 6 (8.3%) have CHH. Overall, 80.6% of patients were azoospermic and 19.4% oligozoospermic (sperm concentration 3.5 ± 3.8 million/mL). Almost all patients presented hormonal alterations related to the specific genotype, while the main ultrasound alterations were testicular hypoplasia, calcifications/microcalcifications, and enlarged/hyperechoic epididymis. Conclusions: The prevalence of genetic abnormalities in males of infertile couples was 15.4% in our Center. CFTR gene disease-causing variants resulted in more frequent, with various clinical features, highlighting the complexity and heterogeneity of the presentation. Other investigations are needed to understand if conditions like ring chromosomes and other translocations are related to infertility or are incidental factors.

Motivations for Social Withdrawal, Mental Health, and Well-Being in Emerging Adulthood: A Person-Oriented Approach.

Emerging adults seek solitude because of different underlying motivational and emotional processes. The current short-term longitudinal study aimed to: (1) identify subgroups of socially withdrawn emerging adults characterized by different motivations for solitude (shyness, unsociability, social avoidance) and affect (positive, negative); and (2) compare these subgroups in terms of indices of internalizing difficulties and life-satisfaction. Participants were N = 348 university students (Mage = 21.85 years, SD = 3.84) from Italy, who completed online questionnaires at two-time points separated by three months. Results from a latent profile analysis (LPA) suggested three distinct subgroups characterized by different social withdrawal motivations (i.e., shy, unsociable, and socially avoidant), as well as a non-withdrawn subgroup (characterized by low social withdrawal motivations, low negative affect, and high positive affect). Among the results, the socially avoidant subgroup reported the highest levels of social anxiety, whereas the avoidant and shy subgroups reported the highest loneliness and lowest life satisfaction. The unsociable subgroup appeared to be the most well-adjusted subgroup of socially withdrawn emerging adults and reported similar levels of life satisfaction as the non-withdrawn subgroup. Our findings confirmed the heterogeneity of emerging adults' experiences of solitude, with different motivations for social withdrawal appearing to confer a differential risk for maladjustment.

How Food Choices Impact on Male Fertility.

PURPOSE OF REVIEW: Increasing evidence on the significance of nutrition in reproduction is emerging from both animal and human studies, suggesting an association between nutrition and male fertility. Here, we have highlighted the impact of the various food groups on reproductive hormones and on spermatogenesis, and the effects of classical and latest dietary patterns such as Mediterranean diet, Western diet, intermittent fasting, ketogenic diet, and vegan/vegetarian diet on male fertility. RECENT FINDINGS: Nutrients are the precursors of molecules involved in various body's reactions; therefore, their balance is essential to ensure the correct regulation of different systems including the endocrine system. Hormones are strongly influenced by the nutritional status of the individual, and their alteration can lead to dysfunctions or diseases like infertility. In addition, nutrients affect sperm production and spermatogenesis, controlling sexual development, and maintaining secondary sexual characteristics and behaviors. The consumption of fruit, vegetables, fish, processed meats, dairy products, sugars, alcohol, and caffeine importantly impact on male fertility. Among dietary patterns, the Mediterranean diet and the Western diet are most strongly associated with the quality of semen. Nutrients, dietary patterns, and hormonal levels have an impact on male infertility. Therefore, understanding how these factors interact with each other is important for strategies to improve male fertility.

Cystic Fibrosis and Cancer: Unraveling the Complex Role of CFTR Gene in Cancer Susceptibility.

Cystic fibrosis (CF) is a genetic disorder affecting multiple organs, primarily the lungs and digestive system. Over the years, advancements in medical care and treatments have significantly increased the life expectancy of individuals with CF. However, with this improved longevity, concerns about the potential risk of developing certain types of cancers have arisen. This narrative review aims to explore the relationship between CF, increased life expectancy, and the associated risk for cancers. We discuss the potential mechanisms underlying this risk, including chronic inflammation, immune system dysregulation, and genetic factors. Additionally, we review studies that have examined the incidence and types of cancers seen in CF patients, with a focus on gastrointestinal, breast, and respiratory malignancies. We also explore the impact of CFTR modulator therapies on cancer risk. In the gastrointestinal tract, CF patients have an elevated risk of developing colorectal cancer, pancreatic cancer, and possibly esophageal cancer. The underlying mechanisms contributing to these increased risks are not fully understood, but chronic inflammation, altered gut microbiota, and genetic factors are believed to play a role. Regular surveillance and colonoscopies are recommended for early detection and management of colorectal cancer in CF patients. Understanding the factors contributing to cancer development in CF patients is crucial for implementing appropriate surveillance strategies and improving long-term outcomes. Further research is needed to elucidate the molecular mechanisms involved and develop targeted interventions to mitigate cancer risk in individuals with CF.

Complementary feeding approach and maternal responsiveness in 8- and 12-month-old Italian infants: A longitudinal study.

In Western countries, infants are usually introduced to solids through spoon-fed puréed foods (parent-led weaning, PLW). However, an alternative approach known as "baby-led weaning" (BLW), in which infants usually participate in family meals and eat independently, is becoming increasingly popular. We investigated the relationship between the type of complementary feeding approach and maternal responsiveness to infant feeding cues in a longitudinal sample of 178 infants observed at 8 and 12 months. Mothers reported the complementary feeding method used and, from video-recorded meals, we coded the proportion of time infants self-fed and rated maternal responsiveness by means of the Responsiveness to Child Feeding Cues Scale (Hodges et al., 2013). Responsiveness to infant receptiveness and fullness cues were significantly correlated at 8 months, but not at 12 months, when unresponsiveness decreased for receptiveness but remained stable for fullness cues. Thus, as infants got older, mothers were increasingly tuned in to their receptiveness cues. However, we did not observe the same pattern for fullness cues, perhaps because mothers were concerned that their infants did not eat enough. Moreover, at both time points, mothers were more responsive to infants' receptiveness than fullness cues, possibly due to an evolutionary drive to protect infants from starvation. Finally, responsiveness to fullness, but not responsiveness to receptiveness, was positively related to the proportion of infant self-feeding, but there were no significant differences in responsiveness depending on the self-reported complementary feeding approach. Thus, a weaning style that emphasizes independent feeding, regardless of whether this is labeled as BLW, may promote more infant-centered maternal responses at the end of the meal, with potential implications for promoting infant self-regulation not only at mealtimes, but also in other domains.

Safety of biologics in severe asthmatic patients with SARS-CoV-2 infection: A prospective study.

BACKGROUND: Asthma guidelines have recommended continuing treatment with biologics during coronavirus disease 2019 (COVID-19) pandemic. However, a continuation of treatment with biologics in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been little investigated. OBJECTIVE: To assess the safety of biologics in patients with SARS-CoV-2 infection. METHODS: A pilot, monocentric, prospective study. Patients aged 6 years old and older with severe asthma on treatment with biologics and confirmed SARS-CoV-2 infection were enrolled. Patients were followed-up with periodic calls at different time points up to 3 months to detect any adverse effect and its relationship with biologic treatment according to the Naranjo Adverse Probability Scale (NAPS). The severity of SARS-CoV-2 infection and clinical outcome were also assessed. RESULTS: Overall, we included 21 patients (10 on therapy with omalizumab, 9 with dupilumab, and 2 with mepolizumab). Only a patient-reported two local adverse events. No other adverse event was reported. Twenty out of 21 patients had a mild COVID-19 course, and no adverse outcome was observed. CONCLUSION: We showed that the scheduled dose of the biologic therapy can be administered safely on time in patients with SARS-CoV-2 infection, as the treatment did not result in adverse events or outcomes.

Abstractness emerges progressively over the second year of life.

words, terms not referring to here and now, are acquired slowly in infancy. They are difficult to acquire as they are more detached from sensory modalities than concrete words. Recent theories propose that, because of their complexity, other people are pivotal for abstract concepts' acquisition and use. Eight children (4 girls) and their mothers were observed longitudinally and extensively from 12 to 24 months of age. Video recordings of mother-infant free play with toys were done every two weeks in a laboratory setting with families in the USA. Children progressively use a range of words referring to abstract concepts, with a major shift from 12 to 15 months and again from 22 to 24 months, but the qualitative data testify an incremental growth of abstract concepts. We identified a progression in the acquisition of words denoting abstract concepts in relation to the overall productive vocabulary, suggesting that having more abstract terms in one's vocabulary promotes faster language acquisition.

Infant sleep and development: Concurrent and longitudinal relations during the first 8 months of life.

Sleep is an essential function of human life, underlying both biological and cultural processes. Dramatic changes in sleep occur during infancy, in terms of night awakenings, which tend to diminish over time, and day/night sleep duration, with newborns sleeping up to 16-17 h per day and gradually decreasing to 9-13 h between 6 and 11 months of age. Remarkably, research indicates that changes in infant sleep are in interaction with important acquisitions in other domains of child development. In the present study, we aimed at investigating concurrent and longitudinal relations between sleep and cognitive maturation during infancy, by collecting data on 156 infants at 4 and 8 months of age. Infants' sleep was assessed through the Brief Infant Sleep Questionnaire (BISQ; Sadeh, 2004), whereas cognitive maturation was evaluated using the Developmental Profile™ 3 (Alpern 2007). We also examined infants' language understanding through the short form of the Italian version of the MacArthur-Bates Communicative Development Inventory (MCDI-SF): Words and Gestures (Caselli, Bello, Rinaldi, Stefanini, & Pasqualetti, 2015; Fenson et al., 2000). Finally, information about infants' temperament and maternal practices potentially relevant for sleep quality, such as the use of a pacifier at nighttime, co-sleeping and exclusive breastfeeding, was detected. Results showed that night and day sleep were differently related to infants' development at 4 and 8 months of age, but there were no robust longitudinal relationships.

Online Assessment of Motor, Cognitive, and Communicative Achievements in 4-Month-Old Infants.

Remote methods for data collection allow us to quickly collect large amounts of data, offering several advantages as compared to in-lab administration. We investigated the applicability of an online assessment of motor, cognitive, and communicative development in 4-month-old infants based on several items of the Bayley Scales of Infant Development, 3rd edition (BSID-III). We chose a subset of items which were representative of the typical developmental achievements at 4 months of age and that we could administer online with the help of the infant's caregiver using materials which were easily available at home. Results showed that, in a sample of infants tested live (N = 18), the raw scores of the BSID-III were significantly correlated with the raw scores of a subset of items corresponding to those administered to a sample of infants tested online (N = 53). Moreover, for the "online" participants, the raw scores of the online assessment did not significantly differ from the corresponding scores of the "live" participants. These findings suggest that the online assessment was to some extent comparable to the live administration of the same items, thus representing a viable opportunity to remotely evaluate infant development when in-person assessment is not possible.

Monoclonal Antibodies in Treating Food Allergy: A New Therapeutic Horizon.

Food allergy (FA) is a pathological immune response, potentially deadly, induced by exposure to an innocuous and specific food allergen. To date, there is no specific treatment for FAs; thus, dietary avoidance and symptomatic medications represent the standard treatment for managing them. Recently, several therapeutic strategies for FAs, such as sublingual and epicutaneous immunotherapy and monoclonal antibodies, have shown long-term safety and benefits in clinical practice. This review summarizes the current evidence on changes in treating FA, focusing on monoclonal antibodies, which have recently provided encouraging data as therapeutic weapons modifying the disease course.

Cytological and molecular aspects of the ageing sperm.

STUDY QUESTION: Is ageing associated with a decline in semen quality and molecular changes to human sperm? SUMMARY ANSWER: Semen quality declines with advancing age and characteristic molecular changes take place during the ageing process, including increased sperm DNA damage, altered sperm protamination and altered seminal plasma miRNA profile. WHAT IS KNOWN ALREADY: During ageing, the reproductive system is exposed to physiological changes and potentially damaging factors that may impair testicular function. Reactive oxygen species (ROS) can induce errors during DNA replication, transcription or post-transcriptional events (fragmentation, chromatin condensation abnormalities and protamine expression defects). STUDY DESIGN, SIZE, DURATION: Semen parameters from 2626 healthy men aged 20-81 years were evaluated retrospectively from those attending our University Laboratory between 2011 and 2016 for andrological screening or as part of an andrological work-up. Subjects were divided into six groups by age (20-32, 33-37, 38-40, 41-44, 45-50, 51-81 years). From these subjects, semen samples from 40 elderly men (50-81 years) and 40 young men (20-40 years) (control group), all non-smokers of normal weight, were selected for the evaluation of sperm chromatin integrity, PRM1, PRM2, TNP1 and TNP2 gene expression, and microRNA expression profile in seminal plasma. PARTICIPANTS/MATERIALS, SETTING, METHODS: Semen was analysed according to WHO 2010. Sperm DNA fragmentation (SDF) was evaluated using TUNEL assay; sperm PRM1, PRM2, TNP1 and TNP2 gene expression was evaluated by quantitative RT-PCR amplification; miRNA expression profiles were analysed by TaqMan Array Cards and validated by RT-PCR amplification. MAIN RESULTS AND THE ROLE OF CHANCE: Cytological analysis - Semen volume, progressive motility and number of progressively motile sperm were significantly lower in elderly than in younger subjects (sextiles 51-81 versus 20-32 years; P < 0.001), while the percentage of abnormal forms in these subjects was significantly higher than in the 20-32 age group (P = 0.002). Binomial logistic regression models revealed an association between age and semen parameters: age 51-81 was associated with changes in total sperm number (OR 2.47; 95% CI 1.52-4.02; P < 0.001), progressive motility (OR 3.63; 95% CI 2.49-5.30; P < 0.001), and abnormal forms (OR 3.89; 95% CI 2.71-7.26; P < 0.001). Obesity was associated with reduced progressive motility (OR 1.58; 95% CI 1.14-2.19; P = 0.006) and an increase in abnormal forms (OR 1.87; 95% CI 1.02-3.57; P = 0.021). In contrast, smoking did not contribute significantly to changes in semen parameters. Molecular analysis - Elderly men showed a significantly higher percentage of SDF (23.1 ± 8.7 versus 9.8 ± 2.6%; P < 0.001) and a significantly lower expression of PRM1 (mean fold change 2.2; P = 0.016) and PRM2 (mean fold change 4.6; P < 0.001), compared to younger controls. Furthermore, miR-146a showed a 3-fold lower expression (P < 0.001), miR-371 a 14-fold lower expression (P < 0.001), and miR-122 a 5-fold lower expression (P = 0.01) in the elderly men. LIMITATIONS, REASONS FOR CAUTION: While typical chronic age-related conditions (cardiovascular, respiratory diseases) were excluded, the presence of subclinical underlying diseases cannot be excluded in the elderly population. Subjects referred to our clinic might not be fully representative of the general population. Although a careful medical history and physical examination excluded most andrological conditions that might affect spermatogenesis, we cannot exclude the presence of possible asymptomatic or idiopathic conditions. Furthermore, TUNEL, in common with other SDF detection methods (with the exception of the alkaline comet assay), does not distinguish between single and double strand breaks. WIDER IMPLICATIONS OF THE FINDINGS: The role of obesity suggests that conditions related to lifestyle factors may further worsen age-related sperm parameter impairment. Increased SDF and altered protamine expression suggest the genomic fragility of sperm in advanced age. Changes in the miRNA expression pattern with age could contribute to the identification of a characteristic molecular signature of the ageing process, a potential new biomarker for male reproductive function during the physiological ageing process. STUDY FUNDING/COMPETING INTEREST(S): This work was supported by a grant from the Italian Ministry of Education and Research (MIUR-PRIN 2015- 2015XSNA83-002) and 'Sapienza' University of Rome Faculty of Medicine. The authors have no conflicts of interest. TRIAL REGISTRATION NUMBER: N/A.

Wnt3a/ß-Catenin Signaling Conditions Differentiation of Partially Exhausted T-effector Cells in Human Cancers.

In this study, we investigated the role of the Wnt/ß-catenin signaling pathway in antitumor immune responses. We report that the concentration of secreted Wnt3a was significantly higher in conditioned medium from tumor or nontumor tissues obtained from all hepatocellular carcinoma or colorectal cancer patients tested, than in serum of healthy donors or patients. In addition, both Wnt3a and ß-catenin were overexpressed by tumor-infiltrating and nontumor-infiltrating CD4+ or CD8+ T cells. The majority of these T cells expressed a dysfunctional effector memory Eomes+T-bet-phenotype that we defined as partially exhausted, because they performed effector functions (in terms of interferon-γ and tumor necrosis factor-α production, as well as CD107a mobilization) despite their PD-1 expression. Wnt3a/ß-catenin signaling in T naïve cells in vitro recapitulated the T-cell setting in vivo Indeed, the differentiation of cultured T naïve cells was arrested, producing cells that resembled the EomeshighT-betlowß-cateninhigh T cells with moderate effector functions that infiltrated tumor and nontumor areas. Wnt3a blockade improved the capacity of T naïve cells to differentiate into effector cells in vitro However, Wnt3a blockade did not affect the function and phenotype of differentiated, partially exhausted, tumor-infiltrating T cells ex vivo Taken together, our data suggest that Wnt3a blockade halts the capacity of Wnt/ß-catenin signaling to inhibit the differentiation of T naïve cells, but it does not restore the dysfunction of differentiated T cells, in the tumor setting. Cancer Immunol Res; 6(8); 941-52. ©2018 AACR.

Mediterranean diet adherence and body composition among Southern Italian adolescents.

INTRODUCTION: Adherence to the traditional Mediterranean diet has been associated with health benefits in young populations. The aim of this study was to evaluate the association between adherence to the Mediterranean diet and cardio-metabolic parameters in adolescents living in Sicily, Southern Italy. METHODS: A cross-sectional study was conducted during two school years (2012-2013 and 2013-2014) on 1643 adolescents of 11-16 years attending 15 secondary schools. Socio-demographic, dietary, lifestyle, and anthropometric data were collected. The KIDMED score was used to evaluate the adherence to the Mediterranean diet. Linear and logistic regression models were used to test the association between the variable of interest and the outcomes. RESULTS: A higher percentage of boys compared with girls was overweight (30.8% vs. 25.4%) and obese (28.7% vs. 18.5%) and only 9.1% had high adherence to the Mediterranean diet. Vegetable intake was negatively associated with being overweight/obese whereas higher intake of sweets, sugar-sweetened beverages, and fast foods was associated with overweight and obesity. A good adherence to the Mediterranean diet resulted in 30% decreased odds of being overweight or obese (odd ratio 0.70, 95% confidence interval: 0.56-0.87) in both boys and girls. An inverse correlation was found between KIDMED score and BMI, waist circumference and fat mass. No relation with blood pressure was found. CONCLUSIONS: Mediterranean dietary pattern resulted significantly associated with weight status in adolescents. These results underline the importance of providing lifestyle and dietary habits education to prevent overweight and obesity in adolescent.

The moderating role of internalising negative emotionality in the relation of self-regulation to social adjustment in Italian preschool-aged children.

The purpose of this study was to examine the moderating role of internalising negative emotionality (i.e., anxious, concerned, and embarrassed displays) in the association between children's self-regulation and social adjustment. Seventy-four Italian children (44 girls, 30 boys; M age = 35.05 months, SD = 3.57) were assessed using two self-regulation tasks. Internalising negative emotionality was assessed through observations of children's emotion expressions during the tasks. Teachers evaluated children's social competence and internalising and externalising problems. Results demonstrated that among children who exhibited internalising negative emotionality, self-regulation was positively associated with social competence and negatively related to externalising problems. Our results suggest that self-regulation may play a crucial role for social adjustment when children show emotions such as anxiety and embarrassment during challenging situations.

False belief understanding and "cool" inhibitory control in 3-and 4-years-old Italian children.

During preschool years, major developments occur in both executive function and theory of mind (ToM), and several studies have demonstrated a correlation between these processes. Research on the development of inhibitory control (IC) has distinguished between more cognitive, "cool" aspects of self-control, measured by conflict tasks, that require inhibiting an habitual response to generate an arbitrary one, and "hot," affective aspects, such as affective decision making, measured by delay tasks, that require inhibition of a prepotent response. The aim of this study was to investigate the relations between 3- and 4-year-olds' performance on a task measuring false belief understanding, the most widely used index of ToM in preschoolers, and three tasks measuring cognitive versus affective aspects of IC. To this end, we tested 101 Italian preschool children in four tasks: (a) the Unexpected Content False Belief task, (b) the Conflict task (a simplified version of the Day-Night Stroop task), (c) the Delay task, and (d) the Delay Choice task. Children's receptive vocabulary was assessed by the Peabody Picture Vocabulary test. Children's performance in the False Belief task was significantly related only to performance in the Conflict task, controlling for vocabulary and age. Importantly, children's performance in the Conflict task did not significantly correlate with their performance in the Delay task or in the Delay Choice task, suggesting that these tasks measure different components of IC. The dissociation between the Conflict and the Delay tasks may indicate that monitoring and regulating a cool process (as flexible categorization) may involve different abilities than monitoring and regulating a hot process (not touching an available and highly attractive stimulus or choosing between a smaller immediate option and a larger delayed one). Moreover, our findings support the view that "cool" aspects of IC and ToM are interrelated, extending to an Italian sample of children previous findings on an association between self-control and ToM.

Do displacement activities help preschool children to inhibit a forbidden action?

Displacement activities are commonly recognized as behavioral patterns, mostly including self-directed actions (e.g., scratching, self-touching), that often occur in situations involving conflicting motivational tendencies. In ethology, several researchers have suggested that displacement activities could facilitate individuals in dealing with the stress experienced in a frustrating context. In child developmental research, some authors have assessed whether distraction strategies could help children to inhibit a dominant response during delay of gratification tasks. However, little is known about the displacement activities that young children may produce in such situations. This study was aimed at investigating whether displacement activities had an effect on preschool children's ability to postpone an immediate gratification (i.e., interacting with an attractive toy, a musical box), thereby functioning as regulators of their emotional state. To this end, we administered 143 2- to 4-year-olds with a delay maintenance task and related their performance with displacement activities they produced during the task and with actions with an external object. Children's latency to touch the musical box was positively related to their rate of displacement activities. However, the rate of displacement activities increased progressively as long as the children were able to inhibit the interaction with the musical box. In addition, the rate of displacement activities during the first 1 min of test did not predict the ability of children to inhibit the interaction with the box. These results suggest that displacement activities represented a functionless by-product of motivational conflict rather than a strategy that children used to inhibit their response to an attractive stimulus.

Waiting by mistake: symbolic representation of rewards modulates intertemporal choice in capuchin monkeys, preschool children and adult humans.

In the Delay choice task subjects choose between a smaller immediate option and a larger delayed option. This paradigm, also known as intertemporal choice task, is frequently used to assess delay tolerance, interpreting a preference for the larger delayed option as willingness to wait. However, in the Delay choice task subjects face a dilemma between two preferred responses: "go for more" (i.e., selecting the larger, but delayed, option) vs. "go for sooner" (i.e., selecting the immediate, but smaller, option). When the options consist of visible food amounts, at least some of the choices of the larger delayed option might be due to a failure to inhibit a prepotent response towards the larger option rather than to a sustained delay tolerance. To disentangle this issue, we tested 10 capuchin monkeys, 101 preschool children, and 88 adult humans in a Delay choice task with food, low-symbolic tokens (objects that can be exchanged with food and have a one-to-one correspondence with food items), and high-symbolic tokens (objects that can be exchanged with food and have a one-to-many correspondence with food items). This allows evaluating how different methods of representing rewards modulate the relative contribution of the "go for more" and "go for sooner" responses. Consistently with the idea that choices for the delayed option are sometimes due to a failure at inhibiting the prepotent response for the larger quantity, we expected high-symbolic tokens to decrease the salience of the larger option, thus reducing "go for more" responses. In fact, previous findings have shown that inhibiting prepotent responses for quantity is easier when the problem is framed in a symbolic context. Overall, opting for the larger delayed option in the visible-food version of the Delay choice task seems to partially result from an impulsive preference for quantity, rather than from a sustained delay tolerance. In capuchins and children high-symbolic stimuli decreased the individual's preference for the larger reward by distancing from its appetitive features. Conversely, the sophisticated symbolic skills of adult humans prevented the distancing effect of high-symbolic stimuli in this population, although this result may be due to methodological differences between adult humans and the other two populations under study. Our data extend the knowledge concerning the influence of symbols on both human and non-human primate behavior and add a new element to the interpretation of the Delay choice task. Since high-symbolic stimuli decrease the individual's preference for the larger reward by eliminating those choices due to prepotent responses towards the larger quantity, they allow to better discriminate responses based on genuine delay aversion. Thus, these findings invite greater caution in interpreting the results obtained with the visible-food version of the Delay choice task, which may overestimate delay tolerance.