ROME (AP) — Pope Francis on Saturday installed 21 new cardinals, many of whom are key figures in his reform agenda: A Dominican preacher who acted as the spiritual father for Francis' recent gathering of bishops, a Neapolitan “street priest” like himself, and a Peruvian bishop who has strongly backed his crackdown on abuse.

Francis’ 10th consistory to create new princes of the church is also the biggest infusion of voting-age cardinals in his 11-year pontificate, further cementing his imprint on the group of men who will one day elect his successor. With Saturday's additions, Francis will have created 110 of the 140 cardinals under 80, thus eligible to vote in a conclave.

Francis appeared at the ceremony in the St. Peter’s Basilica with a significant bruise on his chin, but presided over the ritual without apparent problems.

A Vatican spokesman said later Saturday that the bruise was caused by a contusion Friday morning, when Francis hit his nightstand with his chin. The pontiff, who turns 88 later this month, appeared slightly fatigued on Saturday but carried on as normal with the scheduled ceremony.

Francis has suffered several health problems in recent years and now uses a wheelchair due to knee and back pain. In 2017, while on a trip to Colombia, Francis sported a black eye after he hit his head on a support bar when his popemobile stopped suddenly.

His consistory brings the number of voting-age cardinals well over the 120-man limit set by St. John Paul II. But 13 existing cardinals will turn 80 next year, bringing the numbers back down.

This consistory is notable too because the 21 men being elevated aren’t the same ones Francis named Oct. 6 when he announced an unusual December consistory.

One of Francis’ original picks, Indonesian Bishop Paskalis Bruno Syukur, the bishop of Bogor, asked not to be made a cardinal “because of his desire to grow more in his life as a priest,” the Vatican said. Francis quickly substituted him with the Naples archbishop, Domenico Battaglia, known for his pastoral work in the slums and rough parts of Naples.

Which country gets the most new cardinals?

Battaglia is one of five Italians getting the red hat, keeping the once-dominant Italian presence in the College of Cardinals strong. Turin is getting a cardinal in its archbishop, Roberto Repole, as is Rome: Baldassare Reina, who on the same day Francis announced he was becoming a cardinal also learned that Francis had promoted him to be his top administrator for the diocese of Rome.

Francis, who is technically bishop of Rome, has been conducting a years-long reorganization of the Rome diocese and its pontifical universities. Reina – who is also grand chancellor of the pre-eminent Pontifical Lateran University – will be expected to execute the reform.

Another Italian is the oldest cardinal: Angelo Acerbi, a 99-year-old retired Vatican diplomat. He is the only one among the 21 new cardinals to be older than 80 and thus ineligible to vote in a conclave. Francis' picks on Saturday also include the youngest cardinal: the 44-year-old head of the Ukrainian Greek Catholic Church in Melbourne, Australia, Mykola Bychok.

“I think that there is a special sign which was made by the Pope to nominate me as the youngest cardinal in the world,” Bychok said. “Ukraine has been fighting for three years, officially and maybe unofficially from 2014, after the occupation of the Crimean Peninsula and two regions, Donetsk and Lugansk. … Maybe my weak voice will help to stop this war not only in Ukraine, but as well in other countries around the world.”

Yet another Italian is one of two Vatican priests who do jobs in the Holy See that don’t usually carry the red hat: Fabio Baggio is undersecretary in the Vatican development office. Francis also decided to make a cardinal out of George Jacob Koovakad, the priest who organizes the pope’s foreign travels.

Other picks have high-profile roles in Francis’ reforms.

The archbishop of Lima, Peru, Carlos Gustavo Castillo Mattasoglio, made headlines recently because of an extraordinary essay he penned for El Pais newspaper in which he called for the suppression of an influential Peruvian Catholic movement, the Sodalitium Christianae Vitae, which also has a presence in the U.S.

Castillo called the group a “failed experiment” of the church in Latin America, one of several conservative, right-wing movements that cropped up in the 1970s and 1980s as a counterweight to the more left-leaning liberation theology.

“My hypothesis is that the Sodalitium obeys a political project,” Castillo wrote. “It is the resurrection of fascism in Latin America, artfully using the church by means of sectarian methods.”

Francis has recently expelled the Sodalitium's founder and several top members following a Vatican investigation.

What are the geographic breakdowns?

Castillo is one of five new Latin American cardinals named by history’s first Latin American pope. They include the archbishop of Santiago del Estero, Argentina, Vicente Bokalic Iglic; the archbishop of Porto Alegre, Brazil, Jaime Spengler; the archbishop of Santiago, Chile, Fernando Natalio Chomali Garib and the archbishop of Guayaquil, Ecuador, Luis Gerardo Cabrera Herrera.

Francis has long sought to broaden the geographic diversity of the College of Cardinals to show the universality of the church, particularly where it is growing. Asia got two new cardinals: Tarcisio Isao Kikuchi, the archbishop of Tokyo; and Pablo Virgilio Sinogco David, the bishop of Kalookan, Philippines. Africa also got two new cardinals: the archbishop of Abidjan, Ivory Coast, Ignace Bessi Dogbo, and the bishop of Algiers, Algeria, Jean-Paul Vesco.

“There hasn’t been an African pope, but it’s a possibility in the church," Dogbo said in an interview on the eve of his installation. "And I think that this eventuality — which is not necessarily a demand — if this eventuality were to arise, the universal church would have to be ready to take it on.”

Francis also tapped the archbishop of Tehran, Iran, Dominique Joseph Mathieu, the bishop of Belgrade, Serbia, Ladislav Nemet, while the lone North American cardinal named is the archbishop of Toronto, Frank Leo.

The Lithuanian-born cardinal-elect, Rolandas Makrickas, has a special job in this pontificate: As the archpriest of the St. Mary Major basilica, he hosts Francis every time the pope returns from a foreign trip, since the pope likes to pray before an icon of the Madonna in the church. Additionally, Makrickas oversaw a recent financial reform of the basilica and would have been involved in identifying the future final resting place for Francis, since the Argentine pope has said he will be buried there.

The pope's preacher

Perhaps the most familiar new cardinal to anyone who has been following Francis’ reform agenda is the Dominican Timothy Radcliff, the spiritual father of the just-concluded synod, or gathering of bishops. The years-long process aimed to make the church more inclusive and responsive to the needs of rank-and-file Catholics, especially women.

A British theologian, the white-robed Radcliffe often provided clarifying, if not humorous interventions during the weeks-long debate and retreats. At one point he set off a mini-firestorm by suggesting that external financial pressures influenced African bishops to reject Francis' permission to allow blessings for gay couples. He later said he just meant that the African Catholic Church is under pressure from other well-financed faiths.

As the synod was winding down, he offered some valuable perspective.

“Often we can have no idea as to how God’s providence is at work in our lives. We do what we believe to be right and the rest is in the hands of the Lord,” he told the gathering. “This is just one synod. There will be others. We do not have to do everything, just try to take the next step.”

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Associated Press writer Giada Zampano in Rome contributed to this report.

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