Serveur d'exploration sur le patient édenté

Attention, ce site est en cours de développement !
Attention, site généré par des moyens informatiques à partir de corpus bruts.
Les informations ne sont donc pas validées.

Comparison of three different methods of internal sinus lifting for elevation heights of 7 mm: an ex vivo study

Identifieur interne : 000302 ( Main/Exploration ); précédent : 000301; suivant : 000303

Comparison of three different methods of internal sinus lifting for elevation heights of 7 mm: an ex vivo study

Auteurs : Aghiad Yassin Alsabbagh [Syrie] ; Mohammed Monzer Alsabbagh [Syrie] ; Batol Darjazini Nahas [Syrie] ; Salam Rajih [États-Unis]

Source :

RBID : PMC:5583135

Abstract

Background

Various techniques are available for elevating the sinus membrane. The aim of this study is to evaluate three methods of indirect sinus floor elevation regarding elevation heights of 7 mm on the outcomes of membrane perforation, length of perforation, and time required to perform the procedure.

Methods

Three different methods for indirect sinus lifting, bone added osteotome sinus floor elevation (BAOSFE), sinus floor elevation with an inflatable balloon, and crestal approach system (CAS kit) from OSSTEM, were assessed for their ability to lift the sinus without causing laceration of the Schneiderian membrane. The study was performed on 18 freshly slaughtered sheep heads (36 sinus lifts were done, 12 for each method). CBCT images of the heads were taken to assess the best location for the sinus lift. Then, the heads were bisected and the membrane was exposed from the medial aspect. After that, each method was performed. The intended elevation height was 7 mm. If the 7 mm were not reached, the maximum height of elevation was measured.

Results

The method used was significantly associated with the occurrence of perforation (p value = 0.014) where BAOSFE was associated with the largest number of perforations (58.4%, n = 7) compared to 8.3% and 8.3% for the balloon and CAS kit methods, respectively. The odds ratio for perforation occurrence from BAOSFE compared to the CAS kit was significant (OR = 0.091, p = .022). No significant odds ratio was found for the balloon method compared to CAS kit. Additionally, the method used was significantly associated with time of operation and with the length of perforation (p value < 0.001) where CAS kit required the longest time and BAOSFE caused the biggest perforations.

Conclusions

The study shows that both the balloon and the CAS kit were superior to the BAOSFE in terms of safety in elevating the sinus membrane. Further, in vivo studies have to prove these findings.


Url:
DOI: 10.1186/s40729-017-0103-5
PubMed: 28871524
PubMed Central: 5583135


Affiliations:


Links toward previous steps (curation, corpus...)


Le document en format XML

<record>
<TEI>
<teiHeader>
<fileDesc>
<titleStmt>
<title xml:lang="en">Comparison of three different methods of internal sinus lifting for elevation heights of 7 mm: an ex vivo study</title>
<author>
<name sortKey="Yassin Alsabbagh, Aghiad" sort="Yassin Alsabbagh, Aghiad" uniqKey="Yassin Alsabbagh A" first="Aghiad" last="Yassin Alsabbagh">Aghiad Yassin Alsabbagh</name>
<affiliation wicri:level="1">
<nlm:aff id="Aff1">
<institution-wrap>
<institution-id institution-id-type="ISNI">0000 0001 2353 3326</institution-id>
<institution-id institution-id-type="GRID">grid.8192.2</institution-id>
<institution>Department of Periodontology,</institution>
<institution>Damascus University Dental School,</institution>
</institution-wrap>
Damascus, Syrian Arab Republic</nlm:aff>
<country xml:lang="fr">Syrie</country>
<wicri:regionArea>Damascus</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Alsabbagh, Mohammed Monzer" sort="Alsabbagh, Mohammed Monzer" uniqKey="Alsabbagh M" first="Mohammed Monzer" last="Alsabbagh">Mohammed Monzer Alsabbagh</name>
<affiliation wicri:level="1">
<nlm:aff id="Aff1">
<institution-wrap>
<institution-id institution-id-type="ISNI">0000 0001 2353 3326</institution-id>
<institution-id institution-id-type="GRID">grid.8192.2</institution-id>
<institution>Department of Periodontology,</institution>
<institution>Damascus University Dental School,</institution>
</institution-wrap>
Damascus, Syrian Arab Republic</nlm:aff>
<country xml:lang="fr">Syrie</country>
<wicri:regionArea>Damascus</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Darjazini Nahas, Batol" sort="Darjazini Nahas, Batol" uniqKey="Darjazini Nahas B" first="Batol" last="Darjazini Nahas">Batol Darjazini Nahas</name>
<affiliation wicri:level="1">
<nlm:aff id="Aff2">
<institution-wrap>
<institution-id institution-id-type="ISNI">0000 0001 2353 3326</institution-id>
<institution-id institution-id-type="GRID">grid.8192.2</institution-id>
<institution>Department of Orthodontics,</institution>
<institution>Damascus University Dental School,</institution>
</institution-wrap>
Damascus, Syrian Arab Republic</nlm:aff>
<country xml:lang="fr">Syrie</country>
<wicri:regionArea>Damascus</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Rajih, Salam" sort="Rajih, Salam" uniqKey="Rajih S" first="Salam" last="Rajih">Salam Rajih</name>
<affiliation wicri:level="1">
<nlm:aff id="Aff3">
<institution-wrap>
<institution-id institution-id-type="ISNI">0000 0001 2248 3398</institution-id>
<institution-id institution-id-type="GRID">grid.264727.2</institution-id>
<institution>Temple university,</institution>
</institution-wrap>
Philadelphia, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Philadelphia</wicri:regionArea>
</affiliation>
</author>
</titleStmt>
<publicationStmt>
<idno type="wicri:source">PMC</idno>
<idno type="pmid">28871524</idno>
<idno type="pmc">5583135</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5583135</idno>
<idno type="RBID">PMC:5583135</idno>
<idno type="doi">10.1186/s40729-017-0103-5</idno>
<date when="2017">2017</date>
<idno type="wicri:Area/Pmc/Corpus">000D05</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000D05</idno>
<idno type="wicri:Area/Pmc/Curation">000D05</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000D05</idno>
<idno type="wicri:Area/Pmc/Checkpoint">000278</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000278</idno>
<idno type="wicri:Area/Ncbi/Merge">007164</idno>
<idno type="wicri:Area/Ncbi/Curation">007164</idno>
<idno type="wicri:Area/Ncbi/Checkpoint">007164</idno>
<idno type="wicri:Area/Main/Merge">000302</idno>
<idno type="wicri:Area/Main/Curation">000302</idno>
<idno type="wicri:Area/Main/Exploration">000302</idno>
</publicationStmt>
<sourceDesc>
<biblStruct>
<analytic>
<title xml:lang="en" level="a" type="main">Comparison of three different methods of internal sinus lifting for elevation heights of 7 mm: an ex vivo study</title>
<author>
<name sortKey="Yassin Alsabbagh, Aghiad" sort="Yassin Alsabbagh, Aghiad" uniqKey="Yassin Alsabbagh A" first="Aghiad" last="Yassin Alsabbagh">Aghiad Yassin Alsabbagh</name>
<affiliation wicri:level="1">
<nlm:aff id="Aff1">
<institution-wrap>
<institution-id institution-id-type="ISNI">0000 0001 2353 3326</institution-id>
<institution-id institution-id-type="GRID">grid.8192.2</institution-id>
<institution>Department of Periodontology,</institution>
<institution>Damascus University Dental School,</institution>
</institution-wrap>
Damascus, Syrian Arab Republic</nlm:aff>
<country xml:lang="fr">Syrie</country>
<wicri:regionArea>Damascus</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Alsabbagh, Mohammed Monzer" sort="Alsabbagh, Mohammed Monzer" uniqKey="Alsabbagh M" first="Mohammed Monzer" last="Alsabbagh">Mohammed Monzer Alsabbagh</name>
<affiliation wicri:level="1">
<nlm:aff id="Aff1">
<institution-wrap>
<institution-id institution-id-type="ISNI">0000 0001 2353 3326</institution-id>
<institution-id institution-id-type="GRID">grid.8192.2</institution-id>
<institution>Department of Periodontology,</institution>
<institution>Damascus University Dental School,</institution>
</institution-wrap>
Damascus, Syrian Arab Republic</nlm:aff>
<country xml:lang="fr">Syrie</country>
<wicri:regionArea>Damascus</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Darjazini Nahas, Batol" sort="Darjazini Nahas, Batol" uniqKey="Darjazini Nahas B" first="Batol" last="Darjazini Nahas">Batol Darjazini Nahas</name>
<affiliation wicri:level="1">
<nlm:aff id="Aff2">
<institution-wrap>
<institution-id institution-id-type="ISNI">0000 0001 2353 3326</institution-id>
<institution-id institution-id-type="GRID">grid.8192.2</institution-id>
<institution>Department of Orthodontics,</institution>
<institution>Damascus University Dental School,</institution>
</institution-wrap>
Damascus, Syrian Arab Republic</nlm:aff>
<country xml:lang="fr">Syrie</country>
<wicri:regionArea>Damascus</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Rajih, Salam" sort="Rajih, Salam" uniqKey="Rajih S" first="Salam" last="Rajih">Salam Rajih</name>
<affiliation wicri:level="1">
<nlm:aff id="Aff3">
<institution-wrap>
<institution-id institution-id-type="ISNI">0000 0001 2248 3398</institution-id>
<institution-id institution-id-type="GRID">grid.264727.2</institution-id>
<institution>Temple university,</institution>
</institution-wrap>
Philadelphia, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Philadelphia</wicri:regionArea>
</affiliation>
</author>
</analytic>
<series>
<title level="j">International Journal of Implant Dentistry</title>
<idno type="eISSN">2198-4034</idno>
<imprint>
<date when="2017">2017</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc>
<textClass></textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<sec>
<title>Background</title>
<p id="Par1">Various techniques are available for elevating the sinus membrane. The aim of this study is to evaluate three methods of indirect sinus floor elevation regarding elevation heights of 7 mm on the outcomes of membrane perforation, length of perforation, and time required to perform the procedure
<bold>.</bold>
</p>
</sec>
<sec>
<title>Methods</title>
<p id="Par2">Three different methods for indirect sinus lifting, bone added osteotome sinus floor elevation (BAOSFE), sinus floor elevation with an inflatable balloon, and crestal approach system (CAS kit) from OSSTEM, were assessed for their ability to lift the sinus without causing laceration of the Schneiderian membrane. The study was performed on 18 freshly slaughtered sheep heads (36 sinus lifts were done, 12 for each method). CBCT images of the heads were taken to assess the best location for the sinus lift. Then, the heads were bisected and the membrane was exposed from the medial aspect. After that, each method was performed. The intended elevation height was 7 mm. If the 7 mm were not reached, the maximum height of elevation was measured.</p>
</sec>
<sec>
<title>Results</title>
<p id="Par3">The method used was significantly associated with the occurrence of perforation (
<italic>p</italic>
value = 0.014) where BAOSFE was associated with the largest number of perforations (58.4%,
<italic>n</italic>
 = 7) compared to 8.3% and 8.3% for the balloon and CAS kit methods, respectively. The odds ratio for perforation occurrence from BAOSFE compared to the CAS kit was significant (OR = 0.091,
<italic>p</italic>
 = .022). No significant odds ratio was found for the balloon method compared to CAS kit. Additionally, the method used was significantly associated with time of operation and with the length of perforation (
<italic>p</italic>
value < 0.001) where CAS kit required the longest time and BAOSFE caused the biggest perforations.</p>
</sec>
<sec>
<title>Conclusions</title>
<p id="Par4">The study shows that both the balloon and the CAS kit were superior to the BAOSFE in terms of safety in elevating the sinus membrane. Further, in vivo studies have to prove these findings.</p>
</sec>
</div>
</front>
<back>
<div1 type="bibliography">
<listBibl>
<biblStruct>
<analytic>
<author>
<name sortKey="Seong, Wj" uniqKey="Seong W">WJ Seong</name>
</author>
<author>
<name sortKey="Barczak, M" uniqKey="Barczak M">M Barczak</name>
</author>
<author>
<name sortKey="Jung, J" uniqKey="Jung J">J Jung</name>
</author>
<author>
<name sortKey="Basu, S" uniqKey="Basu S">S Basu</name>
</author>
<author>
<name sortKey="Olin, Ps" uniqKey="Olin P">PS Olin</name>
</author>
<author>
<name sortKey="Conrad, Hj" uniqKey="Conrad H">HJ Conrad</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Cawood, Ji" uniqKey="Cawood J">JI Cawood</name>
</author>
<author>
<name sortKey="Howell, Ra" uniqKey="Howell R">RA Howell</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Tan, Wc" uniqKey="Tan W">WC Tan</name>
</author>
<author>
<name sortKey="Lang, Np" uniqKey="Lang N">NP Lang</name>
</author>
<author>
<name sortKey="Zwahlen, M" uniqKey="Zwahlen M">M Zwahlen</name>
</author>
<author>
<name sortKey="Pjetursson, Be" uniqKey="Pjetursson B">BE Pjetursson</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Cho, Sc" uniqKey="Cho S">SC Cho</name>
</author>
<author>
<name sortKey="Wallace, Ss" uniqKey="Wallace S">SS Wallace</name>
</author>
<author>
<name sortKey="Froum, Sj" uniqKey="Froum S">SJ Froum</name>
</author>
<author>
<name sortKey="Tarnow, Dp" uniqKey="Tarnow D">DP Tarnow</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Kim, Yk" uniqKey="Kim Y">YK Kim</name>
</author>
<author>
<name sortKey="Cho, Ys" uniqKey="Cho Y">YS Cho</name>
</author>
<author>
<name sortKey="Yun, Py" uniqKey="Yun P">PY Yun</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Soltan, M" uniqKey="Soltan M">M Soltan</name>
</author>
<author>
<name sortKey="Smiler, Dg" uniqKey="Smiler D">DG Smiler</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Stelzle, F" uniqKey="Stelzle F">F Stelzle</name>
</author>
<author>
<name sortKey="Benner, Ku" uniqKey="Benner K">KU Benner</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Lopez Nino, J" uniqKey="Lopez Nino J">J Lopez-Nino</name>
</author>
<author>
<name sortKey="Garcia Caballero, L" uniqKey="Garcia Caballero L">L Garcia-Caballero</name>
</author>
<author>
<name sortKey="Gonzalez Mosquera, A" uniqKey="Gonzalez Mosquera A">A Gonzalez-Mosquera</name>
</author>
<author>
<name sortKey="Seoane Romero, J" uniqKey="Seoane Romero J">J Seoane-Romero</name>
</author>
<author>
<name sortKey="Varela Centelles, P" uniqKey="Varela Centelles P">P Varela-Centelles</name>
</author>
<author>
<name sortKey="Seoane, J" uniqKey="Seoane J">J Seoane</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Benavides, E" uniqKey="Benavides E">E Benavides</name>
</author>
<author>
<name sortKey="Rios, Hf" uniqKey="Rios H">HF Rios</name>
</author>
<author>
<name sortKey="Ganz, Sd" uniqKey="Ganz S">SD Ganz</name>
</author>
<author>
<name sortKey="An, C H" uniqKey="An C">C-H An</name>
</author>
<author>
<name sortKey="Resnik, R" uniqKey="Resnik R">R Resnik</name>
</author>
<author>
<name sortKey="Reardon, Gt" uniqKey="Reardon G">GT Reardon</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Hu, X" uniqKey="Hu X">X Hu</name>
</author>
<author>
<name sortKey="Lin, Y" uniqKey="Lin Y">Y Lin</name>
</author>
<author>
<name sortKey="Metzmacher, Ar" uniqKey="Metzmacher A">AR Metzmacher</name>
</author>
<author>
<name sortKey="Zhang, Y" uniqKey="Zhang Y">Y Zhang</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Zitzmann, Nu" uniqKey="Zitzmann N">NU Zitzmann</name>
</author>
<author>
<name sortKey="Scharer, P" uniqKey="Scharer P">P Scharer</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Schwartz Arad, D" uniqKey="Schwartz Arad D">D Schwartz-Arad</name>
</author>
<author>
<name sortKey="Herzberg, R" uniqKey="Herzberg R">R Herzberg</name>
</author>
<author>
<name sortKey="Dolev, E" uniqKey="Dolev E">E Dolev</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Emmerich, D" uniqKey="Emmerich D">D Emmerich</name>
</author>
<author>
<name sortKey="Att, W" uniqKey="Att W">W Att</name>
</author>
<author>
<name sortKey="Stappert, C" uniqKey="Stappert C">C Stappert</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Engelke, W" uniqKey="Engelke W">W Engelke</name>
</author>
<author>
<name sortKey="Deckwer, I" uniqKey="Deckwer I">I Deckwer</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Pommer, B" uniqKey="Pommer B">B Pommer</name>
</author>
<author>
<name sortKey="Watzek, G" uniqKey="Watzek G">G Watzek</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Sotirakis, Eg" uniqKey="Sotirakis E">EG Sotirakis</name>
</author>
<author>
<name sortKey="Gonshor, A" uniqKey="Gonshor A">A Gonshor</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Jesch, P" uniqKey="Jesch P">P Jesch</name>
</author>
<author>
<name sortKey="Bruckmoser, E" uniqKey="Bruckmoser E">E Bruckmoser</name>
</author>
<author>
<name sortKey="Bayerle, A" uniqKey="Bayerle A">A Bayerle</name>
</author>
<author>
<name sortKey="Eder, K" uniqKey="Eder K">K Eder</name>
</author>
<author>
<name sortKey="Bayerle Eder, M" uniqKey="Bayerle Eder M">M Bayerle-Eder</name>
</author>
<author>
<name sortKey="Watzinger, F" uniqKey="Watzinger F">F Watzinger</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Bae, Oy" uniqKey="Bae O">OY Bae</name>
</author>
<author>
<name sortKey="Kim, Ys" uniqKey="Kim Y">YS Kim</name>
</author>
<author>
<name sortKey="Shin, Sy" uniqKey="Shin S">SY Shin</name>
</author>
<author>
<name sortKey="Kim, Wk" uniqKey="Kim W">WK Kim</name>
</author>
<author>
<name sortKey="Lee, Yk" uniqKey="Lee Y">YK Lee</name>
</author>
<author>
<name sortKey="Kim, Sh" uniqKey="Kim S">SH Kim</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Ahn, Sh" uniqKey="Ahn S">SH Ahn</name>
</author>
<author>
<name sortKey="Park, Ej" uniqKey="Park E">EJ Park</name>
</author>
<author>
<name sortKey="Kim, Es" uniqKey="Kim E">ES Kim</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Toffler, M" uniqKey="Toffler M">M Toffler</name>
</author>
<author>
<name sortKey="Toscano, N" uniqKey="Toscano N">N Toscano</name>
</author>
<author>
<name sortKey="Holtzclaw, D" uniqKey="Holtzclaw D">D Holtzclaw</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
</TEI>
<affiliations>
<list>
<country>
<li>Syrie</li>
<li>États-Unis</li>
</country>
</list>
<tree>
<country name="Syrie">
<noRegion>
<name sortKey="Yassin Alsabbagh, Aghiad" sort="Yassin Alsabbagh, Aghiad" uniqKey="Yassin Alsabbagh A" first="Aghiad" last="Yassin Alsabbagh">Aghiad Yassin Alsabbagh</name>
</noRegion>
<name sortKey="Alsabbagh, Mohammed Monzer" sort="Alsabbagh, Mohammed Monzer" uniqKey="Alsabbagh M" first="Mohammed Monzer" last="Alsabbagh">Mohammed Monzer Alsabbagh</name>
<name sortKey="Darjazini Nahas, Batol" sort="Darjazini Nahas, Batol" uniqKey="Darjazini Nahas B" first="Batol" last="Darjazini Nahas">Batol Darjazini Nahas</name>
</country>
<country name="États-Unis">
<noRegion>
<name sortKey="Rajih, Salam" sort="Rajih, Salam" uniqKey="Rajih S" first="Salam" last="Rajih">Salam Rajih</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

Pour manipuler ce document sous Unix (Dilib)

EXPLOR_STEP=$WICRI_ROOT/Wicri/Santé/explor/EdenteV2/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000302 | SxmlIndent | more

Ou

HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000302 | SxmlIndent | more

Pour mettre un lien sur cette page dans le réseau Wicri

{{Explor lien
   |wiki=    Wicri/Santé
   |area=    EdenteV2
   |flux=    Main
   |étape=   Exploration
   |type=    RBID
   |clé=     PMC:5583135
   |texte=   Comparison of three different methods of internal sinus lifting for elevation heights of 7 mm: an ex vivo study
}}

Pour générer des pages wiki

HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i   -Sk "pubmed:28871524" \
       | HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd   \
       | NlmPubMed2Wicri -a EdenteV2 

Wicri

This area was generated with Dilib version V0.6.32.
Data generation: Thu Nov 30 15:26:48 2017. Site generation: Tue Mar 8 16:36:20 2022