Potential of Reusing 3D Printed Concrete (3DPC) Fine Recycled Aggregates as a Strategy towards Decreasing Cement Content in 3DPC.

This paper explores the new potential strategy of using fine recycled aggregates (fRA) derived from waste 3D printed concrete (3DPC) as a substitute for cement in additive manufacturing. This study hypothesizes that fRA can optimize mixture design, reduce cement content, and contribute to sustainable construction practices. Experimental programs were conducted to evaluate the fresh and hardened properties, printability window, and buildability of 3DPC mixes containing fRA. Mixes with replacement rates of cement with fRA by 10 vol%, 20 vol%, 30 vol%, 40 vol%, and 50 vol% were produced. A comprehensive experimental protocol consisting of rheological studies (static and dynamic yield stress), dynamic elastic modulus determination (first 24 h of hydration), flexural and compressive strengths (2 d and 28 d), and an open porosity test was performed. The obtained results were verified by printing tests. In addition, an economic and environmental life cycle assessment (LCA) of the mixes was performed. The results indicate that up to 50 vol% cement replacement with fRA is feasible, albeit with some technical drawbacks. While fRA incorporation enhances sustainability by reducing CO2 emissions and material costs, it adversely affects the printability window, green strength, setting time, and mechanical properties, particularly in the initial curing stages. Therefore, with higher replacement rates (above 20 vol%), potential optimization efforts are needed to mitigate drawbacks such as reduced green strength and buildability. Notably, replacement rates of up to 20 vol% can be successfully used without compromising the overall material properties or altering the mixture design. The LCA analysis shows that reducing the cement content and increasing the fRA addition results in a significant reduction in mix cost (up to 24%) and a substantial decrease in equivalent CO2 emissions (up to 48%). In conclusion, this study underscores the potential of fRA as a sustainable alternative to cement in 3D printed concrete.

Is the leptin/BMI ratio a reliable biomarker for endometriosis?

Background: The aim of this study was to analyze the concentration of leptin in peritoneal fluid and plasma and to assess their role as potential biomarkers in the diagnosis of endometriosis. Materials & methods: Leptin adjusted for BMI (leptin/BMI ratio) was measured using surface plasmon resonance imaging (SPRI) biosensors. Patients with suspected endometriosis were included in the study. Plasma was collected from 70 cases, and peritoneal fluid from 67 cases. Based on the presence of endometriosis lesions detected during laparoscopy, patients were divided into a study group and a control group (patients without endometriosis). Results: Leptin/BMI ratio in plasma did not differ between women with endometriosis and the control group (0.7159 ± 0.259 vs 0.6992 ± 0.273, p= 0,7988). No significant differences were observed in peritoneal leptin/BMI ratio levels in patients with and without endometriosis (0.6206 ± 0.258 vs 0.6215 ± 0.264, p= 0,9896). Plasma and peritoneal leptin/BMI ratios were significantly lower in women with endometriosis - related primary infertility compared to women with endometriosis without primary infertility (0.640 ± 0.502 vs 0.878 ± 0.623, p < 0.05). The difference was observed in case of primary infertility, but not in terms of the secondary one. No significant differences were noted between leptin/BMI ratio in the proliferative phase and the secretory phase (0.716 ± 0.252 vs 0.697 ± 0.288, p= 0,7785). Conclusion: The results of present study do not support the relevance of leptin concentration determination as a biomarker of the endometriosis. Due to the limited number of samples in the tested group, further studies are needed to confirm its role.

The SPRi determination of cathepsin L and S in plasma and peritoneal fluid of women with endometriosis.

PURPOSE: Endometriosis is a common disease with a complex pathomechanism and atypical symptoms, often leading to delayed diagnosis. Currently, the sole method for confirming the presence of the disease is through laparoscopy and histopathological examination of collected tissue. However, this invasive procedure carries potential risk and complications, necessitating the exploration of non-surgical diagnostic methods for endometriosis. This study aims to analyze peritoneal fluid and plasma samples for the expression of cathepsin L and cathepsin S to identify potential biomarkers for non-invasive diagnostic approaches to endometriosis. MATERIAL AND METHODS: In this cross-sectional study, plasma and peritoneal fluid samples were obtained during laparoscopy from 63 patients diagnosed with chronic pelvic pain or infertility. The study group consisted of women with confirmed endometriosis. The concentrations of cathepsins L and S were determined using an SPRi biosensor. RESULTS: The study did not reveal significant differences in the concentrations of cathepsin L and cathepsin S between the control group and the study group, both in peritoneal fluid and plasma. CONCLUSIONS: Based on the results of this study, it appears that cathepsins L and S are not suitable candidates as biomarkers for endometriosis.

Functional Bi2O3/Gd2O3 Silica-Coated Structures for Improvement of Early Age and Radiation Shielding Performance of Cement Pastes.

This study presents a new approach towards the production of sol-gel silica-coated Bi2O3/Gd2O3 cement additives towards the improvement of early mechanical performance and radiation attenuation. Two types of silica coatings, which varied in synthesis method and morphology, were used to coat Bi2O3/Gd2O3 structures and evaluated as a cement filler in Portland cement pastes. Isothermal calorimetry studies and early strength evaluations confirmed that both proposed coating types can overcome retarded cement hydration process, attributed to Bi2O3 presence, resulting in improved one day compressive strength by 300% and 251% (depending on coating method) when compared to paste containing pristine Bi2O3 and Gd2O3 particles. Moreover, depending on the type of chosen coating type, various rheological performances of cement pastes can be achieved. Thanks to the proposed combination of materials, both gamma-rays and slow neutron attenuation in cement pastes can be simultaneously improved. The introduction of silica coating resulted in an increment of the gamma-ray and neutron shielding thanks to the increased probability of radiation interaction. Along with the positive early age effects of the synthesized structures, the 28 day mechanical performance of cement pastes was not suppressed, and was found to be comparable to that of the control specimen. As an outcome, silica-coated structures can be successfully used in radiation-shielding cement-based composites, e.g. with demanding early age performances.

Nanoparticles Influence Lytic Phage T4-like Performance In Vitro.

Little is known about interactions of non-filamentous, complex-structured lytic phages and free, non-ordered nanoparticles. Emerging questions about their possible bio-sanitization co-applications or predictions of possible contact effects in the environment require testing. Therefore, we revealed the influence of various nanoparticles (NPs; SiO2, TiO2-SiO2, TiO2, Fe3O4, Fe3O4-SiO2 and SiO2-Fe3O4-TiO2) on a T4-like phage. In great detail, we investigated phage plaque-forming ability, phage lytic performance, phage progeny burst times and titers by the eclipse phase determinations. Additionally, it was proved that TEM micrographs and results of NP zeta potentials (ZP) were crucial to explain the obtained microbiological data. We propose that the mere presence of the nanoparticle charge is not sufficient for the phage to attach specifically to the NPs, consequently influencing the phage performance. The zeta potential values in the NPs are of the greatest influence. The threshold values were established at ZP < −35 (mV) for phage tail binding, and ZP > 35 (mV) for phage head binding. When NPs do not meet these requirements, phage−nanoparticle physical interaction becomes nonspecific. We also showed that NPs altered the phage lytic activity, regardless of the used NP concentration. Most of the tested nanoparticles positively influenced the phage lytic performance, except for SiO2 and Fe3O4-SiO2, with a ZP lower than −35 (mV), binding with the phage infective part­the tail.

The impact of environmental water on the potential application of core-shell titania-silica nanospheres as photocatalysts.

In this study, the core-shell silica nanospheres modified with titanium dioxide were tested in the photocatalytic decomposition of dyes. The presented data underlines the advantages and shortcomings in the potential application of silica-based catalysts to neutralize organic pollutants. During the photocatalytic reaction in distilled water, catalysts showed decreased efficiency due to a carbon layer deposited on its surface. This finding set an additional goal to investigate the possibility of regenerating the photocatalyst. Studies have shown that the catalyst could be successfully reused following the thermal removal of deposited carbon.Furthermore, the reactivated silica-titania catalysts exhibited comparable photocatalytic performance to the newly made nanomaterial. Surprisingly, catalyst application in the river water eventually resulted in the permanent deactivation of silica-titania nanospheres, which was caused by the interchangeable silica dissolution/precipitation process on the surface of the studied nanomaterial. In environmental water, silica dissolves and precipitates on titanium dioxide's surface, blocking the interaction between organic compounds and TiO2. The deactivation occurring in the environmental samples is irreversible. In distilled water, the decomposition of organic compounds leads to photocatalysts' deactivation by forming a carbon layer on their surface. Reactivation of the silica-based photocatalyst after distilled water is achievable by annealing at a high temperature. In light of our findings, the combination of the photocatalytic properties of TiO2and the silica template shows no prospects in the purification of polluted waste or environmental water.

Early-Age Mechanical Properties of 3D-Printed Mortar with Spent Garnet.

This study determines the effect of spent garnet as a replacement for natural sand in 3D-printed mortar at early ages. Five mixes with different spent garnet amounts were prepared (0%, 25%, 50%, 75% and 100% by volume). The ratio of binder to aggregate remained unchanged. In all mixes the water/binder ratio was assumed as a constant value of 0.375. Tests were performed to confirm the printability of the mix (a path quality test using a gantry robot with an extruder). Determinations of key buildability properties of the mix (green strength and Young's Modulus) during uniaxial compressive strength at 15 min, 30 min and 45 min after adding water were conducted. A hydraulic press and the GOM ARAMIS precision image analysis system were used to conduct the study. The results showed that an increase in spent garnet content caused a decrease in green strength and Young's Modulus (up to 69.91% and 80.37%, respectively). It was found that to maintain proper buildability, the recommended maximum replacement rate of natural sand with garnet is 50%. This research contributes new knowledge in terms of using recycled waste in the 3D printing technology of cementitious materials.

The Response of Pseudomonas aeruginosa PAO1 to UV-activated Titanium Dioxide/Silica Nanotubes.

Pseudomonas aeruginosa is a bacterium of high clinical and biotechnological importance thanks to its high adaptability to environmental conditions. The increasing incidence of antibiotic-resistant strains has created a need for alternative methods to increase the chance of recovery in infected patients. Various nanomaterials have the potential to be used for this purpose. Therefore, we aimed to study the physiological response of P. aeruginosa PAO1 to titanium dioxide/silica nanotubes. The results suggest that UV light-irradiated nanomaterial triggers strong agglomeration in the studied bacteria that was confirmed by microscopy, spectrophotometry, and flow cytometry. The effect was diminished when the nanomaterial was applied without initial irradiation, with UV light indicating that the creation of reactive oxygen species could play a role in this phenomenon. The nanocomposite also affected biofilm formation ability. Even though the biomass of biofilms was comparable, the viability of cells in biofilms was upregulated in 48-hour biofilms. Furthermore, from six selected genes, the mexA coding efflux pump was upregulated, which could be associated with an interaction with TiO2. The results show that titanium dioxide/silica nanotubes may alter the physiological and metabolic functions of P. aeruginosa PAO1.

Potential Use of Silica Nanoparticles for the Microbial Stabilisation of Wine: An In Vitro Study Using Oenococcus oeni as a Model.

The emerging trend towards the reduction of SO2 in winemaking has created a need to look for alternative methods to ensure the protection of wine against the growth of undesired species of microorganisms and to safely remove wine microorganisms. This study describes the possible application of silica nanospheres as a wine stabilisation agent, with Oenococcus oeni (DSM7008) as a model strain. The experiment was conducted firstly on model solutions of phosphate-buffered saline and 1% glucose. Their neutralising effect was tested under stirring with the addition of SiO2 (0.1, 0.25, and 0.5 mg/mL). Overall, the highest concentration of nanospheres under continuous stirring resulted in the greatest decrease in cell counts. Transmission electron microscope (TEM) and scanning electron microscopy (SEM) analyses showed extensive damage to the bacterial cells after stirring with silica nanomaterials. Then, the neutralising effect of 0.5 mg/mL SiO2 was tested in young red wine under stirring, where cell counts were reduced by over 50%. The obtained results suggest that silica nanospheres can serve as an alternative way to reduce or substitute the use of sulphur dioxide in the microbial stabilisation of wine. In addition, further aspects of following investigations should focus on the protection against enzymatic and chemical oxidation of wine.

Carbonized Lanthanum-Based Metal-Organic Framework with Parallel Arranged Channels for Azo-Dye Adsorption.

In this contribution, the synthesis of the metal-organic framework (MOF) based on lanthanum that exhibits trigonal prism shape is presented. The length of a single side of this structure ranges from 2 to 10 µm. The carbonized lanthanum-based organic framework (CMOF-La) maintained the original shape. However, the lanthanum oxide was reshaped in the form of rods during the carbonization. It resulted in the creation of parallel arranged channels. The unique structure of the carbonized structure motivated us to reveal its adsorption performance. Therefore, the adsorption kinetics of acid red 18 onto a carbonized metal-organic framework were conducted. Various physicochemical parameters such as initial dye concentration and pH of dye solution were investigated in an adsorption process. The adsorption was found to decrease with an increase in initial dye concentration. In addition, the increase in adsorption capacity was noticed when the solution was changed to basic. Optimal conditions were obtained at a low pH. Kinetic adsorption data were analyzed using the pseudo-first-order kinetic model, the pseudo-second-order kinetic model and the intraparticle diffusion model. The adsorption kinetics were well fitted using a pseudo-second-order kinetic model. It was found that the adsorption of anionic dye onto CMOF-La occurs by hydrophobic interactions between carbonized metal-organic framework and acid red 18.

Can adipokine visfatin be a novel marker of pregnancy-related disorders in women with obesity?

Overweight and obesity have become a dangerous disease requiring multiple interventions, treatment and preventions. In women of reproductive age, obesity is one of the most common medical conditions. Among others, obese state is characterized by low-grade systemic inflammation and enhanced oxidative stress. Increased maternal body mass index might amplify inflammation and reactive oxygen species production, which is associated with unfavourable clinical outcomes that affect both mother and child. Intrauterine growth retardation, preeclampsia, or gestational diabetes mellitus are examples of the hampered maternal and foetoplacental unit interactions. Visfatin is the obesity-related adipokine produced mainly by the visceral adipose tissue. Visfatin affects glucose homeostasis, as well as the regulation of genes related to oxidative stress and inflammatory response. Here, we review visfatin interactions in pregnancy-related disorders linked to obesity. We highlight the possible predictive and prognostic value of visfatin in diagnostic strategies on gravidas with obesity.

Cost-effectiveness of a bacterial-binding dressing to prevent surgical site infection following caesarean section.

OBJECTIVE: A randomised controlled trial (RCT) recruited women undergoing caesarean section (CS) in Poland. The aim of the trial was to assess the efficacy of a dialkylcarbamoyl chloride (DACC)-impregnated surgical dressing (bacterial-binding dressings) compared with standard of care (SoC) in preventing surgical site infection (SSI). The aim of the present analysis was to evaluate the cost-effectiveness of the bacterial-binding dressings in the context of the UK National Health Service (NHS). METHOD: The clinical trial randomised patients to a bacterial-binding dressing (n=272) or a standard surgical dressing (n=271). The study recorded the presence of SSI and associated resource use up to 14 days postoperatively. To generalise results to the NHS, UK unit costs were applied to resource use recorded in the trial. An alternative approach applied a single UK-specific episode cost per SSI. RESULTS: There were 543 women recruited to the trial. SSI rates were 5/272 (1.8%) and 14/271 (5.2%) for bacterial-binding dressings and SoC, respectively (p=0.04). Patients in the bacterial-binding dressing group had six fewer outpatient visits and 33 fewer hospital bed-days. The mean length of SSI-attributable hospitalisation was 2.36 days. Applying UK unit costs at 2017 prices to resource use recorded in the trial, costs of SSI prophylaxis and treatment were £48.97 and £24.69 per patient in the SoC and bacterial-binding dressing groups respectively, a difference of £24.27 (49.6%) per patient. The alternative costing approach produced a cost saving of £119 (57.6%) per patient with the bacterial-binding dressing. CONCLUSION: Use of bacterial-binding dressings following CS has the potential to reduce the incidence of SSI and costs to the NHS.

Graphitic Carbon Nitride and Titanium Dioxide Modified with 1 D and 2 D Carbon Structures for Photocatalysis.

Enhancing the photocatalytic performance of graphitic carbon nitride (g-C3 N4 , GCN) and titanium dioxide (TiO2 ) has played a key role in the energy and environmental protection research community. Therefore, it is necessary to explore the synergy of both materials with carbon nanostructures for photocatalysis. Among the variety of carbon materials, graphene flakes and nanotubes, as nanoadditives to improve electron charge transfer and the optical absorption behavior in the visible-light region, have been widely explored. Thus, flake-like (2 D) and tubular (1 D) carbon structures in composition with GCN and/or TiO2 are reviewed, as are their photocatalytic response. Current trends clearly indicate that this type of molecular hybrids can be efficiently exploited in this field. This Minireview covers state-of-the-art research over the period of 2015 to 2018.

Analysis of correlations between the placental expression of glucose transporters GLUT-1, GLUT-4 and GLUT-9 and selected maternal and fetal parameters in pregnancies complicated by diabetes mellitus.

PURPOSE: The aim of the study was to analyze the correlations between the expression of glucose transporters GLUT-1, GLUT-4, and GLUT-9 in human term placenta and selected maternal and fetal parameters in pregnancies complicated by diabetes mellitus (DM). MATERIALS AND METHODS: Placental samples were obtained from healthy control (n = 25) and diabetic pregnancies, including diet-controlled gestational diabetes mellitus (GDMG1) (n = 16), insulin-controlled gestational diabetes mellitus (GDMG2) (n = 6), and pregestational DM (PGDM) (n = 6). Computer-assisted quantitative morphometry of stained placental sections was performed to determine the expression of selected glucose transporter proteins. For the purposes of correlation analysis, the following parameters were selected: type of diabetes, gestational age, maternal prepregnancy body mass index (BMI), gestational weight gain, third trimester glycated hemoglobin concentration, placental weight, fetal birth weight (FBW) as well as ultrasonographic indicators of fetal adiposity, including subscapular (SSFM), abdominal (AFM), and midthigh (MTFM) fat mass measurements. RESULTS: In the PGDM group, the analysis demonstrated positive correlations between the placental expression of GLUT-1, GLUT-4, and GLUT-9 and FBW, AFM, and SSFM measurements (p < .05). Similarly in the GDMG2 patients positive correlations between GLUT-4 expression, FBW and SSFM were observed (p < .05). In the multivariate regression analysis, only the type of diabetes and FBW were significantly associated with GLUTs expression (p < .001). In addition, maternal prepregnancy BMI significantly contributed to GLUT-1 expression (p < .001). CONCLUSIONS: The study results revealed that placental expression of GLUT-1, GLUT-4, and GLUT-9 may be involved in the intensification of the fetal growth in pregnancies complicated by GDM/PGDM.

MOF-5 derived carbon as material for CO2 absorption.

In our study we prepared MOF-5 derived carbon to reveal the thermodynamics of CO2 absorption processes in great detail. Porous carbon material was prepared from a metal-organic framework (MOF-5) via carbonization at 1000 °C. The obtained structure consists only of carbon and exhibits a BET specific surface area, total pore volume and micropore volume of 1884 m2 g-1, 1.84 cm3 g-1 and 0.59 cm3 g-1, respectively. Structural analysis allowed the assumption that this material is an ideal candidate for efficient CO2 absorption. The CO2 uptake was 2.43 mmol g-1 at 25 °C and 1 bar. Additionally, the absorption over a wide range of temperatures (25, 40, 60, 80 and 100 °C) and pressures (in range of 0-40 bar) was investigated. It is shown that the CO2 absorption isotherm fits a multitemperature Sips model. The calculated Sips equation parameters allows the isosteric heat of adsorption to be obtained. The isosteric heat of adsorption for CO2 decreased substantially with an increase in surface coverage by gas molecules. This indicates a negligible intermolecular interaction between CO2 molecules. A decrease in the isosteric heat of adsorption with surface coverage is a result of the disappearance of favourable adsorption sites.

Correction: MOF-5 derived carbon as material for CO2 adsorption.

[This corrects the article DOI: 10.1039/C9RA01786K.].

Poly(vinylidene fluoride) and Carbon Derivative Structures from Eco-Friendly MOF-5 for Supercapacitor Electrode Preparation with Improved Electrochemical Performance.

Electrodes from carbonized Zn4O(1,4-benzodicarboxylic acid) (MOF-5) structures were prepared successfully via evaporating the solvent with a poly(vinylidene fluoride) (PVDF) binder. The solvent used for a nanocomposite cast was easily removed. Such an elegant method for preparing electrodes provides a facile, cost-effective, and void/cracking-free nanocomposite distribution on the current collector. The highly porous nanoparticles containing pure carbon attach well to the PVDF membrane which results in an increased active surface area of the electrode to 847 m²/g. The electrochemical analysis shows that the best weight ratio of CMOF-5 to PVDF equals 85:15, 80:20, and 75:25, respectively. The specific capacitance of these samples is 218 F/g, 210 F/g, and 180 F/g, correspondingly. An additional advantage of the electrode prepared from the carbonized MOF-5 is the possibility to synthesis MOF structures from recovered substrates used in its synthesis (distilled N,N-Dimethylformamide DMF and terephthalic acid recovered from polyethylene terephthalate waste). We will demonstrate this in this contribution as well. Furthermore, the carbonized MOF-5 can be recovered from the spent electrode and reused again in the electrochemical device.

Presurgical diagnostic difficulties in an asymptomatic patient with primary transitional cell carcinoma of the oviduct: case report.

Primary transitional cell carcinoma of the fallopian tube is a very rare condition. We present a case of a 70-year-old asymptomatic Caucasian patient with an irregular solid right adnexal mass of 67 × 35 × 59 mm which was discovered during routine ultrasound pelvic examination. There was no acoustic shadow and the patient did not feel pain during examination. No evidence of metastases or ascites was found by ultrasound. There was moderate vascularization of the mass. The mass was considered malignant according to the subjective assessment of the examiner. Serum level of CA125 was elevated to 519 U/ml. The results of logistic regression model LR2 according to the International Ovarian Tumor Analysis (IOTA) group was 64.4%, suggesting the malignant nature of the mass. The IOTA-ADNEX model showed 97% probability of malignancy, probably (85.5%) stage II-IV ovarian cancer. The risk of malignancy being borderline, stage I and metastatic was 0.6%, 3.9% and 7%, respectively. Omitting CA125 in the IOTA-ADNEX model slightly decreased the probability of malignancy to 81.3%, still most likely (54.2%) stage II-IV ovarian cancer. The results of risk of malignancy indices RMI I-IV were 1557, 2076, 1557 and 2076, respectively, reflecting the malignant nature of the mass. The final diagnosis was transitional cell carcinoma of the fallopian tube, stage IIIc according to FIGO.

A Comparison of Hydrogen Storage in Pt, Pd and Pt/Pd Alloys Loaded Disordered Mesoporous Hollow Carbon Spheres.

Comprehensive study to evaluate the ability of hydrogen uptake by disordered mesoporous hollow carbon spheres doped witch metal such as Pt, Pd or Pt/Pd was conducted. They were synthesized facilely using sonication and then calcination process under vacuum at the temperature of 550 °C. The effect on hydrogen sorption at neat-ambient conditions (40 °C, up to 45 bar) was thoroughly analyzed. The results clearly revealed that metal functionalization has a significant impact on the hydrogen storage capacity as the mechanism of gas uptake depends on two factors: metal type and certain size of particles. Thus, functionalized spheres adsorb hydrogen by physisorption forming metal hydrides or metal hydrides combined with hydrogen spillover effect. As a result, a sample with narrower distribution of nanoparticles and smaller specific size exhibited enhanced hydrogen uptake.

Does the Risk of Ovarian Malignancy Algorithm Provide Better Diagnostic Performance Than HE4 and CA125 in the Presurgical Differentiation of Adnexal Tumors in Polish Women?

AIM: This study compared the diagnostic performance of the Risk of Ovarian Malignancy Algorithm (ROMA) and HE4 and CA125 for the presurgical differentiation of adnexal tumors. MATERIAL AND METHODS: This prospective study included 302 patients admitted for surgical treatment due to adnexal tumors. The ROMA was calculated depending on CA125, HE4, and menopausal status. RESULTS: Fifty patients were diagnosed with malignant disease. In the differentiation of malignant from nonmalignant adnexal tumors, the area under curve (AUC) was higher for ROMA and HE4 than that for CA125 in both the premenopausal and postmenopausal subgroups. In the differentiation of stage I FIGO malignancies and epithelial ovarian cancer from nonmalignant pathologies, the AUC of HE4 and ROMA was higher than that of CA125. The ROMA performed significantly better than CA125 in the differentiation of all malignancies and differentiation of stage I FIGO malignancies from nonmalignant pathologies (p = 0.043 and p = 0.025, resp.). There were no significant differences between the ROMA and the tumor markers for any other variants. CONCLUSIONS: The ROMA is more useful than CA125 for the differentiation of malignant (including stage I FIGO) from nonmalignant adnexal tumors. It is also as useful as HE4 and CA125 for the differentiation of epithelial ovarian cancer from nonmalignant adnexal tumors.