ARTIS pheno VE10 System Operation Job Aid

SIEMENS Healthineers System Operation Job Aid ARTIS pheno VE10 Template Effective Date: 05/27/2019 | HOOD05162003010284 Job Aid Effective Date: 01/31/2020 | HOOD05162003063487 Effective Date: 01/31/2020 | HOOD05162003063487 Effective Date: XX/XX/XXXX | HILS/HOOD# Unrestricted © Siemens Healthcare GmbH, 2020 Unrestricted © Siemens Healthineers, 2020 © Siemens Healthcare GmbH, 2018 System Operation – SIEMENS Healthineers Table of Contents Switching On/Off 3 Restart System 4 Membrane keys on the Flat Detector (FD) 5 Control Modules – Overview 6 Control Modules – Table Control Module (TCM) 7 Control Modules – Collimator Control Module (CCM) 10 Control Modules – Pilot Control Module (PCM) 11 Onscreen Menu 24 Layout Gallery 25 Layout Gallery – Layout Configurator 26 2 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Switching On/Off Switching the system on Switching the system off To start the system press and hold the Power-on button on 1. Select Shut down > Shut down on the Home Screen. the CPC for approximately 0.5 seconds. or – – Please ensure that the on-site main switch is switched on Select Options > End Session... in the main menu. and the Emergency Shutdown button is inactive. 2. The End Session window is displayed. 3. Click Shutdown System... 4. Another dialog box appears, click Yes to switch the system off. Options Help End Session X Maintenance ... End Session ... Log Off ... Configuration ... Shutdown System .. Set Move Mask Restart System ... Auto Expose SIEMENS Load Test Images Restart Application .. --- Store Service Image Standby .. --- Copy To WinNIEA Service Cancel Help 3 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers System Restart When a problem with the imaging system occurs, it may be necessary to restart the imaging system (Restart application) or the entire ARTIS pheno system (Restart system). If a message ... Restart imaging system appears, you must terminate the imaging system application and then restart it. Restart application 1. On the Home screen select Shut down > Restart. or – – Options On an active task card select Options > End Session... from the Help End Session X Maintenance ... main menu. The End Session window is displayed. End Session ... Log Off ... 2. Click Restart Application... Another dialog box appears. Configuration ... Shutdown System .. 3. Click Yes. The application in the control room is terminated and Set Move Mask Restart System. Auto Expose restarted. Load Test Images Restart Application .. -- --- -- Store Service Image -- - Restart system Standby ... --- 1. Select Options > End Session... from the main menu. The End Copy To WinNIEA Service Cancel Help Session dialog box is displayed. 2. Click Restart System... Another dialog box appears. 3. Click Yes. The entire system is shut down and restarted. 4 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Membrane keys on the Flat Detector (FD) C-arm rotation (Cran/ Caud angulations) SIEMENS Healthingers C-arm orbital movement (RAO/LAO angulations) ........... - Longitudinal C-arm movement Laser positioner light on/off * FD rotation (setting portrait/landscape) T FD lifting and lowering - setting the SID * Laser is optional 5 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Control Modules – Overview Table-side controls allows you to operate the stand, patient table and imaging system. ARTES G OK ❶ ❷ ❸ ❶Table control module (TCM) ❷Pilot control module (PCM) ❸Collimator control module (CCM) 6 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Control Modules – Table Control Module (TCM) There are 2 types of Table control modules: Table Panning knob for servo- 4 Table lift up/down assisted tabletop movement: Adjust the tabletop position Block table movements STOP LED lights white when the table is not blocked. LED lights blue when the table is blocked. LED blinks blue when block all movements has been enabled. Joystick for motoric Unlock table rotation tabletop movement: Adjust LED lights white when table rotation is not active. the tabletop position < -- LED lights blue when table rotation is active. Orientation of control module STOP The blue LED indicates the selected orientation. (Indication on top of the control module, key on the underside of the control module) 7 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Control Modules – Table Control Module (TCM) Table Rotation: There are 3 options to rotate the table. a. Press the table unlocking a. Pull the grip 3 for rotating the a. Press the pedal for releasing the table rotation key ❶ on the Table table (available on both sides of lock. 4 control module. Siemens table). b. Keep pressing the pedal and rotate the patient b. Press knob/ joystick ❷ b. Keep pulling the grip and rotate table. on the Table control the patient table. c. Release the pedal and rotate the patient table module down to release c. Release the grip and rotate the back and forth slightly until you hear it engage. the breaks and rotate the table back and forth slightly until table. ❷ it engages. 3 ❶ 4 STOP 8 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Control Modules – Table Control Module (TCM) Touchscreen - Other table movements Besides the basic table movements which can be released directly on the Table control module, additional movements can be released in the Table menu on the touchscreen of the Pilot control module. Table Table Height: Adjust table height Tilt: Tilt the tabletop in Trendelenburg or reverse Trendelenburg direction Height 95 cm Transversal 8 cm Cradle: Tilt the tabletop laterally Tilt Longitudinal Transversal: Move the tabletop transversally only 4 cm Longitudinal: Move the tabletop longitudinally only Cradle 0º Define as ROI Define as ROI: Set the isocenter Couple C-Arm: Maintain relative position and angle of patient table and C-arm Transversal 8 cm Couple C-Arm Block Table: Block all table movements Longitudinal 4 cm BlockTable Block Rotation: Unlock table rotation Block Transversal: Block transversal tabletop movements, move tabletop O Define as ROI Block Rotation longitudinally only Couple C-Arm Block Transversal 9 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Control Modules – Collimator Control Module (CCM) 1 Filter joysticks: The upper joysticks control the wedge filter and the finger filters. Toggle wedge filters/finger filter (only with universal collimator) Press joystick down to remove filter. 2 Collimator joystick: The lower joystick controls the rectangular diaphragm. Press joystick down to open collimator leaves completely and remove filter diaphragms. 3 (3) Reset collimator Reset collimator leaves and filter diaphragms. 10 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Control Modules – Pilot Control Module (PCM) 2 1 4 ❶Stand/C-arm joystick 1 ❷Stand/C-arm joystick 2 ❸Jog wheel w ❹Touchscreen ❺Emergency STOP button ❻Keys on top and on the front of the Pilot control module 6 5 11 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Control Modules – Pilot Control Module (PCM) General functions ❷ ❶Block radiation: LED ❹Store • When the LED lights blue, radiation is blocked. • When the LED lights white, ❺Open Onscreen menu radiation can be released. ❷Orientation of console ❻Open layout selection module ❹ OK = ❺ ? ❸Short press: Call-up help ❼ X ❼Exit function Press and hold: Collision override ❶ ❻ ❸ 12 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Control Modules – Pilot Control Module (PCM) Stand/C-arm functions ❶ ❹ ❽ ❾ ❺ ❷ ❶Angulate C-arm ❼Drive to Home position ❷Move C-arm horizontally ❽Drive to CPR position ❸ ❼ ❸Swivel C-arm clockwise ❾Synchronize C-arm movement with table movement C+ ❻ ❹Swivel C-arm counterclockwise ❿Block all Stand/C-arm and table OK movements: = Ct ❺Lift C-arm up + • When the LED lights blue the movements are blocked. ❿ ❻Lower C-arm down • When the LED lights white D+ the movements are not blocked. 13 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Control Modules – Pilot Control Module (PCM) Imaging system functions ❶Open scene directory ❹Increase dose during fluoroscopy X ❷Open reference image ❺Decrease dose during fluoroscopy directory ❺ ❻Zoom-in image ❸ ❹ REF ❸Store reference image OK Q ❼Zoom-out image D+ ❷ ❶ ❼ ❻ 14 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Control Modules – Pilot Control Module (PCM) Jog wheel Jog wheel is an input device which combines several functions: Ct • It can be deflected like a joystick, for example for positioning the cursor on the screen. (x) • It can be turned, for example for scrolling reference images. • It includes the OK button, for confirming an action. Depending on your selection/action, possible different corresponding jog wheel functions are indicated OK in the Info area on the display in the examination room. Jog wheel functions in the Info area: Image +/- OK Deflect the jog wheel left/right to change images. Press OK to confirm an action. Scene +/- Deflect the jog wheel up/down to change scenes. Press OK to Play/Pause. Play / Ref Image +/- - Turn the jog wheel clockwise/counterclockwise to Pause change ref. images. 15 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Control Modules – Pilot Control Module (PCM) Touchscreen – Favorites Editing mode/Favorites Artis Editing Mode 1. Open the submenu to edit. 2. To start editing: Press and hold on the touchscreen. Patient Transfer • To rearrange items: Examination Display Left Side Drag and drop the required item to the desired position. Right Side • To add an item to the Favorites: C-Arm Position Table Touch the star next to the desired item. Head Side • To remove an item from the Favorites: * Left, Table 15º Touch the star next to the desired item. Detector RDMP & Overlay Left, Table 30º Favorites Right, Table 15º 16 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Control Modules – Pilot Control Module (PCM) Touchscreen – C-arm position Special programmed positions can be selected in the C-Arm Position menu Artis System Positions on the touchscreen of the Pilot control module. • System Positions: A set of basic positions of the stand and table. The System Positions positions of the Stand/C-arm and table will be restored in absolute Examination Display Anatom. Positions room coordinates (except collimator and filter). • Anatomical Positions: A number of positions that you require for Direct Positions examination. All imaging relevant components (including collimator and C-Arm Position Table filters) will be positioned in the same relation to the patient. Current Positions • Direct Positions: You can assign the three most frequently used system 3D App. Positions positions to the 1, 2, 3. Detector RDMP & Overlay Automap 3D • Current Positions: You can select positions in which reference images were acquired (Automap), or positions for 3D views, as well as home positions. Favorites ( LAO 4%, CAUD 10; • 3D App. Positions: You can select positions, that are specially required for 3D applications. 17 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Control Modules – Pilot Control Module (PCM) Touchscreen – C-arm position Moving to a programmed position System Positions System Positions Cancel Auto Drive X 1. Touch C-Arm Position and the required position menu. The respective System Positions Save Current Position Patient Transfer submenu opens. Anatom. Positions Transfer Position 2. Touch the required position. Direct Positions Left Side Hold to Drive 3. The following message is displayed: Automatic run: Activate stand Current Positions Head Side += Left Side movement. 3D App. Positions Parking Position Right Side 4. Touch and hold Hold to Drive. C Automap 3D RAO 0º, CRAN 0º Head Side -or- LAO 4;, CAUD 110 RAO 5º, CRAN 0º Left, Table 15º Press the Stand/C-arm joystick down and deflect it away from you until the target position has been reached. or – – If hands free movement is configured: Press the configured hands free pedal on the footswitch. 5. The system performs the required movements. The following message is displayed: Automatic run: Position reached. 18 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Control Modules – Pilot Control Module (PCM) Touchscreen – C-arm position Store programmed position System Positions System Positions 1. Move the unit to the required position, if not already done. System Positions 2. Set the primary collimator and the filter diaphragms, if not already Save Current Position done. Anatom. Positions Transfer Position 3. Touch C-Arm Position > System Positions > Save Current Position Direct Positions Left Side or – – C-Arm Position > Anatomical Positions > Save Current Position on Current Positions Head Side the touchscreen of the Pilot control module. The list of stored 3D App. Positions G Parking Position positions is shown on the touchscreen. C Automap 3D G RAO 0º, CRAN 0º 4. Touch the free memory position or required position. The current position of stand and table is stored under the selected memory G LAO 4%, CAUD 10 RAO 5º, CRAN 0º position/number. The previous position is deleted. 19 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Control Modules – Pilot Control Module (PCM) Touchscreen – C-arm position Storing Direct positions 1, 2, 3 System Positions 1. Move the unit to the required position. System Positions 2. Set the primary collimator and the filter diaphragms. Touch C-Arm Position > Direct Position. The respective submenu opens. Anatom. Positions 3. 4. To save a position press Save as Direct Position. Direct Positions 5. Select the slot Direct Position 1, 2 or 3. The current position is stored under Current Positions the selected memory position (number). The previous position is deleted. 3D App. Positions C Automap 3D G LAO 4º, CAUD 10; 20 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Control Modules – Pilot Control Module (PCM) Touchscreen – C-arm position Storing anatomical positions and direct positions with isocenter System Positions Table Normally, only the image geometry for a projection is restored with anatomical and direct positions. System Positions Transversal 8 cm As the system does not know the position of an examined organ within the current patient, the Anatom. Positions Longitudinal 4 cm position of the isocenter needs to be adjusted manually. If you apply Define as ROI before storing a position in the anatomical and direct positions, you can make the system aware of the desired Direct Positions O Define as ROI isocenter. If the tabletop position or table rotation needs to be changed during the procedure, the Current Positions Couple C-Arm system can then follow the table. 3D App. Positions BlockTable 1. Move the unit to the required position. Set the primary collimator and the filter diaphragms. Select Table > Define as ROI from the C Automap 3D 2. Block Rotation Touchscreen to allow the C-arm to follow the table. Activate Define as ROI. G LAO 4º, CAUD 10 Block Transversal 3. To save a position, touch C-Arm Position > Anatomical Positions > Save Current Position. or – – Touch C-Arm Position > Direct Positions > Save as Direct Position on the touchscreen of the Pilot control module. 5. Select the required memory position from the list. 21 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Control Modules – Pilot Control Module (PCM) Touchscreen – C-arm position Moving to Anatomical and Direct Positions with isocenter System Positions Table To move to the required position which has been stored with isocenter: System Positions Transversal 8 cm 1. Select Table > Define as ROI and activate Define as ROI. 2. Select C-Arm Position > Anatomical Positions. Anatom. Positions Longitudinal 4 cm –or – Direct Positions O Define as ROI Select C-Arm Position > Direct Positions. The respective submenu opens. Current Positions Couple C-Arm 3. Select the required position. 3D App. Positions BlockTable 4. The following message is displayed: Automatic run: Activate stand movement. 5. Touch and hold Hold to Drive. C Automap 3D Block Rotation or – G LAO 4º, CAUD 10 Block Transversal – Press the Stand/C-arm joystick down and deflect it away from you until the target position has been reached. or – – If hands free movement is configured: Press the configured hands free pedal on the footswitch. 6. The system performs the required movements. The following message is displayed: Automatic run: Position reached. The stored position with isocenter has been reached. 22 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Control Modules – Pilot Control Module (PCM) Je. Artis - Configuration Panel Touchscreen – C-arm position File 3D 4D Recon- Auto Delete Patient Certificate Organize/edit stored position Reconstruc struction JET Browser Handler 1. Select Options > Configuration... in the main menu to open the position editor. Screen Saver Close Patient Add Printer Transfer Audit Trail Filming Study Assistant Layout 2. Double-click the Organize Stored Positions icon. A list of the stored positions and a preview Filming Filming Patient Layout Layout Editor Registration Patient Software Reset Distribution Password L. of the selected position will open. Positions may be marked by a: 3D Time ImageText Editor 3D Calibration Layout Regional and Organize Overview Configurator Language . Stored Pos. Factory position (cannot be edited) Protected position (cannot be deleted or overwritten) Ready Organize Stored Positions Amtomi 3. To edit and arrange the positions to your needs and to your examination practice: Name of an Anatomica Position Space for thirty characters Preview Another Anatomica Position Protected and avail as SysPos WB Name of an Anatomica Position • Select a position and click the up or down arrow to change the sort order. Space for thirty characters Another Anatomica Position Name of an AnatomicaPosition Space for thirty characters Another Anatomica Position RAO CAUD • Select the position and click Rename to rename a position (which is not protected). Name of an AnatomicalPosition Space for thirty characters 20º 35 120cm 268cm -232cm • Select the position and click Enable Write Protection or Disable Write Protection to Pos. also avail. as SystemPos Another Anatómica Position Name of an AnatomicaPosition T protect or unprotect a position. Space for thirty characters Selected and avail as SysPos Another Anatomica Position Name of an AnatomicaPosition • Select the position and click Copy to System Positions or Copy to Anatomical Positions to Space for thirty characters Another Anatomica Position This one is protected copy a position to the other list. Name of an AnatomicaPosition Rename • Click the Undo or Redo icon to undo or redo the last action. Delete Enable Write Protection Copy to System Postions • Select the position and click Delete to delete a position (which is not protected). Save and Close | Save Close Help 4. You can also apply write protection to selected positions. 23 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Onscreen Menu Operating the Onscreen Menu • Press the menu key on the Pilot control module (PCM) to open the Onscreen menu. • Deflect the jog wheel away from you/towards you for navigating between items to navigate within the Onscreen menu. • Deflect the jog wheel left/right for navigating between pages. • Press the OK button on the jog wheel to select an item of the Onscreen menu. • To close the Onscreen menu: The available Onscreen Press the menu key again. menu functions depend on the system configuration, or – – the available licenses, and Press any other key on the Pilot control module. the selected workflow. or – – Press the OK button on the jog wheel when the correct item is selected. or – – Deflect the jog wheel to the left/right (when the selected item has no submenu). 24 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Layout Gallery Examination room 1. Select Display Layout from the touchscreen on the Pilot control module Display Layouts and select the required layout. or – – Live+Ref1+2 Bottom - Echo Live 4D Live 4D Ref1 4D Live Ref1 TrueFusion On the Pilot control module, press Open Layout selection key. or – – From Onscreen menu select Layout Gallery in the General menu (if , configured). 2. Deflect the jog wheel to the left/right to select a layout. 3. Press the OK button on the jog wheel to activate a layout. 25 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Layout Gallery – Layout Configurator X The Layout Configurator lets you configure the screen layout on the JE Artis - Configuration Panel File display in the examination room. You can customize the screen layout to your needs and to your examination practice. 3D 4D Recon- Auto Delete Patient Certificate Reconstruc struction JET Browser Handler Control room, Examination task card: 1. Select Options > Configuration in the main menu on the system Screen Saver Close Patient Add Printer Transfer Audit Trail Filming Study console. Assistant Layout 2. Double-click the Layout Configurator icon to open the Layout *** Configurator. Filming Filming Patient Patient Software Reset Layout Layout Editor Registration Search Distribution Password 3D Note: The Info segment is mandatory, and therefore, it is not listed in the Date and ImageText 3D Calibration Layout Regional and Organize • Time Editor Overview Configurator Language ... Stored Pos. Source area. • The Info segment cannot be removed or resized, only its position can be changed to right, bottom left, bottom right, or bottom. Ready • A vertical Info segment on left side is not allowed. 26 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 System Operation – SIEMENS Healthineers Layout Gallery – Layout Configurator Display Layout Configurato 1 1 Menu bar: New Layout, Duplicate Layout, Delete Layout, New Duplicate Delete Import/Export Configure Layout Layout Layout Save 3 Configuration Sources Save, Undo/Redo Layouts Sources 01. 2 Layout area: By clicking the arrow icon displayed to the left Appl. Live Ref 1 of the layout name, the default layout can be defined after 3D Wizard system startup, for CLEARstent Live, and during X-ray. If a * Info Live Live+Ref1 layout has been defined as a default, it is marked by a star. 02. * Ref 1 Live Ref 1 Live Ref 1 Info 3 Layout build-up area: You can drag and drop image Ref 2 segments from the Source to the layout build-up area and 2 5 Live+Ref1+2 03. Ref 2 select, move, resize or delete them. Ref 1 Appl Info 4 Segment Properties area: The size and position of the Live Ref 2 Endoscope selected image segment are displayed and can be changed Info Info Live+Ref1+2 Bottom in this area. Segment Properties Ref 1 Info Area Position Appl 5 Source area: The Source area lists the available image and 3D Wizard Live information sources. Ref 2 Ultrasound Right Bottom Left Bottom Right .Bottom Info 4 27 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020 SIEMENS Healthineers Please note that the learning material is for training purposes only! For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Note: Some functions shown in this material are optional and might not be part of your system. Certain products, product related claims or functionalities (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Phone: +49 9131 84 0 siemens.com/healthineers 28 Effective Date: 01/31/2020 | HOOD05162003063487 Unrestricted © Siemens Healthcare GmbH, 2020