Sergeant Capca on the staff non-commissioned officer in charge for the Marine Corps shooting team from Weapons Training Battalion, Quantico, Virginia. We're currently conducting the Marine Corps competition east in Stone Bay, Camp Lejeune, North Carolina, where we're training Marines in advanced markship skills more than what they would receive at a typical annual rifle qualification. Any Marines can come and compete in these, so if they have the desire to come out and get some additional training and their commanders will allow them to come out for a couple of weeks to get some advanced training from the Marine Corps shooting team, then we conduct a competition on the second week that they're here. So you see the first week where they're getting trained on advanced level stuff that maybe they're not used to. Week two they're actually going to put all of those techniques together and train and compete against each other in a competition. So as the staff and SOIC of the shooting team, my job is to support my members, my Marines of the shooting team. We are comprised of three teams. We have a rifle team, we have a pistol team, and we have an action shooting team. What the Marines obtain when they come out here is that advanced level training that we're providing them, different from what they would receive at an annual rifle qualification. They're going to be receiving instruction on how to be shooting more accurately, shooting faster, putting those things together. And that's what's making Marines more lethal. And commanders can enjoy that too because there's a return on investment. They're sending their Marines out to us for a couple of weeks, getting out of work. But what they're doing is they're going to be returning to their commands with an advanced skill set that they can in turn train the rest of their Marines and make them more lethal as well. So that's what we're really trying to do is help Marines feel more comfortable with the weapon systems, maneuvering with a weapon around obstacles, engaging multiple targets, transitioning between targets quicker, and putting their feet together with that. So it's all about speed and accuracy. And that's what we're looking to do out here. So the basic life cycle for the Marine Corps shooting team, which start, if you think the fiscal year, starting in the fiscal year, October, we start conducting these competitions. We have five regional competitions that we conduct starting at the National Capital Region in Quantico, Virginia. And then we go to Okinawa, Japan for the Far East competition. We go to Hawaii for the Pacific, Camp Pendleton for the Western matches. And then we come here for the Eastern competition before moving on to Quantico for the Marine Corps championships. What we do at all of these competitions, as you're seeing here at Stone Bay, is we have a competition where the top 10% will receive a medal on rifle or individual pistol. Those winners will be invited to the Marine Corps championships in Quantico, which is conducted April 4th through April 11th. From those competitors that won at the regional matches, they're going to compete against each other to see who's the best, who's the true best rifle and best pistol shooter in the Marine Corps. And that's what we're looking for. Additionally, what we'll do at that point is we will screen all of those competitors and we're going to select about 10 to 20 of them to come augment us throughout the summer competition season. So the difference in the summer is that's when the Marine Corps shooting team will then go compete in matches and represent the Marine Corps at local, state, regional, inner service and national level competitions. We have Marines of all different skill level come out here. If you've never shot a pistol before, you can come compete.  We're looking to make those Marines. We start from a basic level and we move quick, but we're going to advance those skill sets from zero to hero at a rapid pace. So we're looking for those Marines that, you know, whether you've competed before or not, don't be, you know, hesitant to come out here and learn something because I promise you this, regardless, at the end of the day, you're going to walk off the range and know more about yourself. You're going to be a better marksman.


So without any more delay, we're going to go ahead and get started. So I'd like to introduce the moderator for this particular forum. Stephanie Holden-Apron, please give it up for Stephanie Holden-Apron. Very much. All right. Wow. Great to see so many awesome faces out here this afternoon. On behalf of the Athens Anti-Primation Movement, ADM, both of Jasmine Johnson and Noah Johnson, I am incredibly excited and honored to welcome you on this lovely afternoon to an opportunity to meet the 2022 candidates for the Athens-Clarke County Mayor's Race. Welcome to our candidates from other races who are here. Alan Jones from District 7, a representative if you'd like to wave. Are there any other candidates for other offices that are here? Okay, sir. What's your name? Let's know. Sorry, I told that you were a candidate. Jared Bailey. I used to be in the commission of District 5. Yes, sir. So Jared Bailey, District 5. Okay. Thank you, sir. Any other candidates from other races who board here? Okay. Great. Excuse me for one hour. I'm sorry? Oh. Paul Walton, current mayor of Hull in the Mettson County, Georgia, running for 10th congressional district. Atstanding. Thank you, sir. Thank you for being here. Appreciate that. Okay. Is that it? Yes. Diego's olives. Paul, it is so important that we're here. This is your candidate. It's not easy running. Right? So thank you all for being here. Whoever it is that you support, this is part of the demographic process. And I just want to thank you for being here. I see you're saying that. I also want to point out that we do have a few commissioners here as well. Thank you. Thank you. Thank you. Thank you. All right. Thanks. I'm not a politician. I didn't realize that y'all were here. Thank you for being here commissioners. Thank you. Thank you. Okay. Anybody else? I don't want to forget anybody else. Thank you all for being here. As said, my name is Chapman Cole Napper. And although I was born and raised here in Athens, I've only been living back here for less than two years. I am super proud of my hometown. And I hope that my hometown of Athens, Georgia, is proud of me too. Because the two things that I always like to talk about are the things that I'm most proud of, my education and my military service. You see, I hold three master's degrees in education, technology and media, including two from the Ivy League and an undergraduate degree from the historically black Spelman College in Atlanta, Georgia. In addition, I've proudly served for over a decade as an active duty Army officer and non-commissioned officer, deploying on four separate tours of duty to the Middle East and supportive operations in Iraq and Afghanistan. And I've had the very best that America has to offer, both the stellar education and the opportunity to serve my country during wartime. And it is only because I know who I am that I was born right here in this beautiful city, the city that nurtured me and made sure that I had the very best education that this country can offer. Because I know that Athens is a magical place. It's a special place. And I believe it is a transformational place. And if we are to move forward as a country, as a city, as a state, I believe that we must unite in ways that our forefathers never direct of. I believe that this requires waking up. We have allowed some people to tell us that the things that we know that are good for us are somehow bad for us. See, we have some folks who believe that it's okay to be asleep at the wheel. They have convinced us that being woke is a bad thing. Well, I'm here today to tell you, Athens, Georgia, it's time for us to get woke. It's time to wake up to the hatred that is out there. It's time to wake up to the violence that is being waged on our country and our schools and in our neighborhoods. Wake up to the suffering of others. Finally, we need to wake up to the light and death urgency of global warming and climate change.  See, our planet is on fire, but many of us are asleep. And I'm here today to say that we got to wake up and help each other put out this fire that we have caused with our stellar dependence on fossil fuels. But you need to know that once you're woke, Athens, Georgia, you won't be able to get back to sleep and that's not a bad thing. Because there are people in the state who want you to stay asleep while the house is on fire. As you leave here today, I hope that your hearts and minds are awakened by the words of these transformational candidates that we have on the stage today.  Help us by making sure that every commissioner, every school board member, every police officer, every principal, every University of Georgia student and professor, every school teacher, every, well, our governor, and all of the Board of Regents knows that being woke is a good thing. Don't let people take that back and try and politicize it It is only by being woke that we are going to be able to get better. So, I want you all to feel the power that is in this room today. I want you to look around because this is our strength. It is a multicultural, multiracial, multi-ethnic, intergenerational group of people in the city and I know that we can change if we want to, but we gotta wake up first.  Get woke. Stay woke. Get woke. Stay woke. Get woke. Stay woke. Doug won right. Now, let's go admins. Now that y'all are awake and pumped up, we are here today to appreciate our First Amendment rights to pre-assembly and free speech. Again, on behalf of AADM, we are excited to have four of the six mayoral candidates here with us today. We have Kelly Gertz, Pearl Hall, Micisha Ross, and Benny Coleman. Ms. Mars and Niga wanted to participate but had a scheduling conflict and we were unable to confirm Mr. Fred Mormon. So, without further delay, let's get started with some questions. First, each of our four candidates will have up to two minutes to get an introduction and to tell you a little bit about themselves and why they're running for mayor of the classic city. We will have four rounds of prepared questions. Then at around two, we'll open it up to questions from the audience and ones that have been submitted on the AADM website. So, and we will rotate the order that we go with these questions. So, first up, Mr. Kelly Gertz, please tell us a little bit about yourself and why you're running for a term as mayor of this great city. Thank you, Chaplain. And I appreciate everybody being here and particularly want to appreciate the other candidates here. Thanks for that. I've got the green light. Is it working? All right. Well, thank you to AADM. Thank you, Chaplain Cole. And thanks especially to all the candidates who are running here in the classic city. People don't give up themselves easily for any reason. You give it yourself as a candidate because you love the community you live in and so I want to offer affirmation to everybody who's here on stage. And I know I'm going to learn from the experience of this campaign as I have from past campaigns and I hope we all do because I think it was stated in the introduction that's the nature of democracy that we should always be learning and growing. It's a benefit of being alive and being on this planet. We, Athens, really have been forged in the fire the last few years. You know, we've had challenges that I don't think any of us ever woke up or went to bed imagining that we would have to face. And of course, we know that for some Athenians they've lived lifetimes full of challenge and what I'm grateful to be here for is the opportunity to meet those challenges to offer foundational supports to Athenians because that I think is what we're called to do to figure out how can we in a way that's going to create generational impact make sure that our young people are well resourced in every neighborhood and in every community from access to public spaces to opportunities for fresh food to the opportunity to move into productive and healthy lives and great jobs. And we of course need to make sure that we're thinking of lifelong needs for health Athenians. We need to make sure that we're working with our partners across the state and across the nation to bring better healthcare resources to all and particularly as we found so challenging in these last couple of years mental health resources and behavioral health resources to all. And we need to take care of the core infrastructure that maintains our ability to have a community that not just in five years but in 50 years is going to continue to be a magnetic space and as a government, as an organization we need to be doing all we can to reach out to every corner and every community within Athens-Clarke County because every individual is important every young person, every person of every color every person of every nationality no matter who you love or how you express yourself we want you to be welcome here in the classic city. Thank you Mr. Gerks. Ms. Hall. Good afternoon. As co-said, my name is Pearl Hall. I am a true resident of Athens, Georgia. I love Athens-Clarke County. I was raised. I was educated and came back and truly loved the city that I love. And you ask the question, Pearl why do you want a wealth of merit? Many reasons. Number one, I got my heart broken late on a Saturday afternoon. Oh how I loved UGA and I loved to watch the cheerleaders on Saturday I go down Hancock because I was born in on Hancock and it's always been like home to me and will be. And as I journeyed down Hancock riding in my car I saw to my right the red and black, the pompoms cheering and how happy my heart was I cheered, I cheered and I cheered but as I drove on down I noticed on my right there was a mother with five children one in her arm, one little seven year old pulling wagon with clothes and she's struggling with the baby that dropped my heart to pieces I kept on going, I wanted to stop I wanted to help them but I knew I couldn't if I had picked that mother up with her children, had an accident then the good I would have tried to do would have gone solid bad because they didn't have a car seat and as continued on I began to cry I cried and I cried I cried for that little seven year old because as she looked over to the side and stopped her mother dragged her and pulled her but all she wanted to do was look at those cheerleaders just like I did and as I looked and she cried more and she began to cry more and I began to cry more and I said Lord what can I do I look, I usually have a bonbon I didn't have one but I was afraid if I had one what would the mother say she may have said that I couldn't give it to her so Thank you Just so you all know we have a timekeeper right out here with red and red, yellow and green cards to help with our timekeeping so if you all could keep your eyes on Mr. Paul that would be great, thank you man Next is my Keisha Ross Hello everybody First of all I'd like to say thank you all for having me here The question is why I ran for mayor a little bit of what I do every day is I wake up with two children my son Kimon and my daughter Marie who I'm currently looking for in Holly but it's not here but every day I have a duty a responsibility to respond to the community feedback that I'm receiving as community outreach with them our organization used its life and a lot of what I do is partner with stakeholders and individuals in the community to form collaboration partnership and unity what's important to me is unity I don't see it in your hands so how can I address it I can start continually to start those meetings continue to gather those individuals who need to sit at a table with each other to discuss a better important community so my every day work not what I'm promising but what my actions are every single day is to address homelessness Clark County School District and the limited resources that we have for our youth that's why I build the organizations to help them build their own brand and to identify their sales because it starts with our youth what are they going to inherit to get their love with nothing and right now they have nothing but a generation of lost souls who's been crying out for this city some here stand up and fight for it hopefully but a lot of what I do each and every day is secure the food for the homeless I have an organization that addresses those issues I don't just drive by the homeless I go out to the homeless I meet them where they are a lot of what happens is lacking is the meeting them where they are and that's who I am I meet you where you are thank you thank you and Mr. Coleman it's a deep pleasure to be here it's a deep pleasure to be here I'm here to represent the little people my name is Benny Coleman I've been married for 40 years I have three kids and two grandkids we all have different ways of expressing ourselves in Clark County we all have different dreams different ways to live our lives as in Clark County is a melting pot as we all know we come from different races different backgrounds nationalities and well the little people here in Clark County need help we need someone to stand for them and we need to acknowledge the ones that are fortunate than we are the one who has the opportunity to do better than others the little people here in Clark County feel like they are nobody they are nobody as you can notice people sitting around in the library bus stops tents they are sad we are sad my choice here in Clark County is to represent everybody as many people as I can to bring unity among all people God is my master as you know so I owe nothing to no one here so I come here to give my love to everybody here in Clark County to run for mayor to have an open heart to have an open policy to hear each and every person idea and to accept what they may have among us I know I am green never ran for any office here in Clark County before I never stood before or sit before as many people as you are today but I'm willing to serve the people because that's my life thank you Mr. Coleman thank you all of our candidates for those questions now we are going to move into our first question our first question of the day is and the order for these questions is going to be Ms. Pearl Hall Mr. Gertz Ms. Ross and Mr. Coleman for this first question so starting with you Ms. Hall what do you see as your primary role as mayor of Athens Clark County do I see as my primary role as mayor for Clark County my primary role is trying to bring our city together in unity I want everyone to care for everyone regardless of where you live of what status you are I know that's hard to say I understand that because I got calls from people that live in Firepoint a place that I really never had the opportunity to visit other than to go to the store and to the back in that area because I had no other reason over there and I always wondered what it would like to really know someone which I do but to socialize in that area so and I'm sure there may be someone in here who never been into the Brock Spring of all of that area but we want to know what it's really like in that area and that's what I would like for us to do join together in unity and see what it's like for someone who is less fortunate than you are or who you may think is less fortunate than you are and exactly not so that's my purpose and that's really my heart Thank you very much Ms. Hall Mr. Gerbers there are certainly some formal tasks of the Mayor that are outlined in the Charter of the Unified Government what I'd identify broadly is that the role of the Mayor is to be something of a funnel and to reach out and take in all of the needs of the Athens-Clarke County community across every piece of our geography across every background and work to integrate those needs into a policy making framework that's going to work to our mutual benefit and so of course that means doing lots of listening and lots of outreach and lots of engagement and I've done that and will continue to seek to do that as your Mayor and then taking all of that formal outreach that you do through electronic mechanisms and in-person gatherings and gathering with the Athens-Clarke County Commission the policy making body to translate the needs of the community and the direction to figure out how do we put policies in place that are going to be supportive of the population in a permanent way around housing, around health care around youth needs around access to public resources and then putting the budget together together so that we actually have the direction of the funds and the staffing to make those things happen so it really is working from concept where you draw from the full community to execution where you're seeing tangible things happening on the ground for the community's needs so making that translation sees the key role of the Mayor of Athens-Clarke County Thank you Mr. Gertz Ms. Ross Yes just not saying things but Kelly just explained it perfectly and that's what I do every day so I'm laughing because that's my everyday role in this community so as mayor if you stay ready you don't have to get ready so with all of those things as a mayor you have to implement those when it comes to addressing the community my first thing we'll do will be to clean up the leadership do we have true real leadership here in Athens I don't think we do I think in leadership you have to have that experience you have to see people for who they are that's in all demographics but with that being said you gotta go out and implement an action plan so what is our sustainability plan what is the things that we wanna actually do for the homeless to help them get to another place so as mayor my first role will be to clean up the leadership as well as go over the budget and implement a community feedback coalition that will consist of a committee of people who are able to come to the meetings that they're aware of not forty four, forty eight hours in advance but to be able to address their real concerns and implement that stuff so that we can actually get some things done so as mayor I would say that my proposal will be to actually implement a community feedback and not just listen but take action thank you thank you Mr. Ross Mr. Coleman what do you see as your primary role as mayor I see it as my primary role as a mayor that serves and protects the city of Athens my main focus for running for mayor is to help my people we have belittled ourselves so much that we don't care anymore it's time to flip the switch in Clark County it's time for all the black people young and old to unite with unity to get an education to have a family to love one to grow wealth, to be happy to marry, to love just to be alive so my main focus here in Clark County is first to hit the low income area to show them how possible it will be for you to be somebody it's very important the last pandemic we had was called the COVID-19 pandemic has divided the black family they have pitted husband against wife, girlfriend against boyfriend, sisters against brothers white against white black against black if I had that position as the mayor at the time when it first came out I would acknowledge the situation since we don't know anything about as merchants decided to claim to know I would advise people wear your mask if you feel unsafe for those who don't feel they need to wear a mask that's their will that's their right that's their liberty that's their hope see this government and as in Clark County we speak in two different languages we speak in a language of the black man we speak in a language of the white man and we cannot communicate because one want to be over the other want to have power over the other but I'm here to join us all together as one one just so everyone knows we will be taking questions from the audience up until 1.45 1.45 so if you have a question that you would like to ask we hope to be able to ask three full questions at the end of this so that's why we're trying to keep our timing so tight so if you have a question that you would like to ask then please raise your hand and someone will bring you an index card and then we will sort those out and we will start asking questions at 2 o'clock yes sir raise your hand you're lucky you're right next to the intern that can help you Cassidy Cassidy is an Athens Anti-Discrimination movement intern and she is here to bring you a card and a pen if you have if you would like to ask a question okay we're going to move on to question number two and what would your budget priorities be for the Athens-Clarke County government and why and Mr. Gertz we'll go to you first thanks for the question and it's timely as I'm in the midst of preparing the budget for the fiscal year 23 as we speak and really as I look to not only this budget but the coming years we have a new arc of activity where we're creating the kind of firmament for Athens-Clarke County that's going to allow us to be successful now and successful well into the future and so that means that what I've programmed into this budget and certainly with some of our federal funds is a lot of youth support because we know that if we're supporting young people we're going to support a healthy future in this budget through our SPLOS program and other means an enormous amount of energy transition because we want to make sure that Athens is a community that's resilient and that's able to move sort of past a carbon carbon energy dynamic we've programmed a lot of funds for making sure that our streets are safer we know an enormous challenge over the course of the last couple of years has been an increase in vehicular accidents and vehicular deaths and so we want to make sure that we bend the curve on that and we similarly want to make sure that people can access all the things they need to do in the community employment, school, leisure in other ways other than just having a vehicle so we're programming more funds into bike and pedestrian facilities and public transit and we're also looking at a whole continuum of life need and so that includes support for seniors we've recently become an American Association of Retired Persons City and so we want to make sure that this is a place where you can gracefully age in place and we also are looking at those members of our community who may be returning citizens who may have been formerly incarcerated so that we can bend the curve on recidivism and make sure that people have opportunities here so we're putting resources into that as well Thank you Mr. Gurus Next we'll have Ms. Mikeisha Ross followed by Mr. Coleman and then Ms. Hall Ms. Ross again the question is what will your budget priorities be as mayor and why? So first my budget priorities it will actually cause a review at the review on the budget I would honestly change the staff who can distribute the budget which I would change the staff of the city manager I would propose to be able to you know get that position filled with someone that has a vision I'm not just I don't know if you have the vision that the community wants so having someone that actually has a vision for the community that's how you know where to distribute the money too so I would actually go into the awareness and resource that I would like to create for people to always know what's available to them because right now we have several resources and several jobs but I don't think our government do a good job at letting people know what's available so I would implement that and raise the salaries of teachers and the reason I say that you gotta want to be able to raise the salaries of teachers so they can deal with the issues that's happening and they can want to actually go to work but then actually making a sustainable development affordable housing plan that is actually important so that's what I would do with the budget but the main concern is for me to remove the people that is in control of the budget and making sure that they see the vision for the community that's my answer Thank you Ms. Ross Mr. Coleman What will your budget priorities be as mayor and why? Can we use that my reference? Yeah My budget priority is to make sure that the money is here Just put it a little closer So just put it a little closer Okay My main budget priority is to make sure that the money is here in Clark County that all the taxes are paid all the fines and fees are paid make sure all the roads and the driveable conditions make sure if I'm going to be able to live a lovely life in Clark County But let's be for real I'm not script for this type of you got it I have to come straight from my heart I can promise you a lot of things the action counts louder than words I would make sure that each and every one of you have an opportunity to call me up and please don't get on any of that I refuse to deal with emails call me up write me a letter of help to have personal contact and we as a citizen of Clark County we will make sure the budget is in line I'm green so you have an opportunity to mold me in a good way to understand that you have that opportunity in a good way that's why my budget for all of you is going to be to make sure the money is here in Clark County thank you Mr. Coleman Ms. Hall there's somebody you can see the library personnel can give us another microphone thank you Ms. Hall, yes ma'am what will your budget priorities be as mayor and why my budget priority for as mayor would be to make sure that all the citizens are able to obtain the things that they need I have gone through the budget for the 2022's that I have seen the commissioner put together and there are some things that I would like to put top priority as to what I have seen more five seniors I should see an area where we can say this money has been set aside for our seniors I understand fixing the street the trees and the highways and all those things but let's do something for the people in Clark County let's put set aside a budget that would help those that rent is due that can't be paid set aside a budget for those that need food we all help in every kind of way but I think there should be a budget set aside for the less fortunate for the senior, for the housing if there is a person as low in rent and can't pay it there should be a budget set up somewhere not to be misused but to say hey let's pay for their rent this is our town we are the peoples of this town and we need to take care of the people of this town so that will be my top priority is to do what the mayor should do no disrespect to you as to take care of the people in Clark County in whatever way you can thank you Ms. Hall we're going to move on to our next question in the order for this round is my Keisha Ross will go first Ms. Hall you will be second Ms. Penny Coleman third the question is for Ms. Ross what is your plan to address the affordable housing crisis in Athens? well honestly my plan would be I like to use models that go to other areas that have the same population that Clark County has was working and was not working so I traveled to a couple places and seen how they are actually answering affordable housing by connecting it to the resources and having new organizations and non-profit organizations available to them with the elders and the seniors attached to them I would like to address as well as with a sustainable development goal how can we do that you come up with a strategic plan of what is it that the people want to see because sometimes we're making these promises and not taking the action but also is that really what the people want what's the people wanting for the well-being of themselves the basic service needs that's also how you can address affordable housing and the people that's living in them but with that being said affordable housing is not here in Athens $1,400 a baby is not affordable housing UGA property is not affordable housing so making sure that the air of the people that hasn't here to land making sure that the people who can be able to stay with the job because we're underpaid, overworked and under employed so how can we be able to feel as people and I just I want to lead with you to make sure that we're using models that work what can address these because some of the arts and the people that apply rental assistance and wrap around service they're not really addressing our issues I've been in that position of property and been poor before and I was able to work my way out to the formula to address the affordable housing and so what I would do will feel something that is really affordable thank you thank you Ms. Ross before we go on to the next person Ms. Hall before you answer if you have a question now is you only have a few more minutes to fill out an index card so if you have a question or if you'd like to turn on a card now is the time to do it please raise your hand if you need some help Cassidy thank you sir anyone else okay thank you the question is what is your plan to address the affordable housing crisis in Athens Ms. Hall what shall I do about the housing you know that's a hard question for me because I don't know what is considered affordable housing you can live in a place where a teacher can make a great salary but she still can't afford a wonderful house so what do we consider affordable houses that's a good question I think we all need to think about what is affordable housing where you live is affordable if you're able to pay for it now there are some people who are living and they are struggling every day and with Athens there are places where we take so much pride and what we are there is so much shortage on houses so you're asking me about affordable houses I'm going to be honest once I find out the true meaning of affordable housing I will be able to answer that question thank you thank you Ms. Hall next Mr. Vinnie Colvin what is your plan to address affordable housing crisis in Athens well I've been working with I've been working for many of my home we've been called the manufacturer's home for 10 years we had came up with an idea of having a community a manufacturer's home at least 100 units in that community so manufacturer's homes are safe and affordable the minimum a maximum amount of monthly rent will be $500 or below that would be the excellent choice to something quick nothing that you could sit around and debate over years and years and then come out and say that to me no affordable homes we need something right now at this moment we need something on the ground going at this moment affordable housing is an opportunity for the new contractor that are coming out today but greed has overtaken all the contractors in Claude County and the city and the whole world material isn't as high as they seem to be it's just the label and the owner of the contractor company are making this so high so affordable housing just like Pearl said what exactly is affordable housing is what an individual can afford to pay at he or she level thank you thank you Mr Coleman Mr Curtis what is your plan to address the affordable housing crisis in Athens so we know that in Athens like in every attractive magnetic community in the country there's an affordable housing crisis and that crisis has really multiple layers there's simply the affordability element of it but then broadly there's also the availability element of it it's the volume of housing relative to the population so we got census data in the autumn and if you look at the last 20 years us in contiguous counties have grown from about 255,000 people to about 380,000 people and the housing stock has not grown at nearly the same rate so part of what we need to do is simply get more units on the ground as any of the kids who went through my economics class in the 7 years when I taught that would tell you part of this is a supply and demand question and so I'm really proud of an enormous number of things that we've launched here in Athens-Clarke County some of my commission colleagues are here in the audience who've been a big part of this just a week ago we launched an inclusionary zoning policy which is going to incentivize people who own old strip malls and parking lots to redevelop that property into housing from places where they never had housing in the first place and some of that will have to be permanently affordable housing and so as we see the volume rise some of that volume is going to be affordable we also have launched the SPLOST program that had the highest proportion devoted to affordable housing of any community in the state so I'm really proud of that work and finally we've devoted 11 million dollars of our American Rescue Plan Act funds to housing more than any of our other peer communities in the state saw a lot of communities those ARPA funds to garbage trucks or short term programs but we're devoting that to housing and that's going to include the rapid rehousing and permanent supportive housing that our unsheltered persons need Thank you Mr. Gertz okay we're going to move to our fourth question this will be our final prepared question and then we'll take questions from the audience or we will take those cards the order for this answer this round will be Mr. Coleman you will go first Ms. Ross you will be second Mr. Gertz third and then Ms. Hall the question is regarding the recently established Public Safety Civilian Oversight Board what steps do you plan to take to expedite implementation of the Board especially in light of the Athens-Clarke County Jail Safety concerns and the complaints of staff and inmates that were submitted to AADM Mr. Coleman well this is a very hard question because Claude County rewarded bad behavior so how I would implement the Board in gearing toward the safety of the Athens-Clarke County Jail is we may have to let the little people that are working there come up with ideas over the ones who are making a big money I know drugs have been felled in our jail homes all those crime crimes going inside the jail homes but being a black man living in a neighborhood like Claude County we got to be acceptable for our crimes we got to be accountable in many ways mothers got to stop allowing their kids to cause trouble fathers got to step up to keep their kids from going to jail the whole black neighborhood needs to unite together we will eliminate a lot of this crime that's going on Claude County I know black men are the only one committed crimes but we are the only one who can listen in the paper are committed crimes we stand before the board of commission we plead for help and it takes police a long time to get in our communities we need to patrol our own community we need police our own communities and then this crime in the black neighborhood I'm not a radical person I'm just speaking what's really going on what you are always thinking what you are always seeing is what comes from our mind but you're afraid to say something because of your status you're afraid to make us angry because you may be at a different race for communication among us that's very important and that is the main reason why crime is so harsh today kids are not being kids in school mothers are being children and children are being mothers we need to be a family we need to bring the law back into our lives okay Mr. Claude thank you sir okay and next Ms. Ross okay so when Andreessen came to the Public Safety Oversight Board I was actually a part of that process me and Ashley and Mary and when coming up with those ideas it was from the feedback that we were receiving from the community but how do you address public safety when people can't sit together communication partnership collaboration but how I would address it is what are our resource officers they apply the necessary awareness resources that they can give to the families not just calling the 911 but mental health we need a lot of mental health answers instead of the police answering those calls so with that being said we need to have a hotline or a hub inside the police department so that we can address those 911 calls it's not an emergency I think my wife is still on but the leadership is one thing the other thing is mandatory meetings we need to have all law enforcement sit down and have a conversation with our local government the other thing is if you don't know the police staff is short the sheriff is short it's shortage it's staff shortage we have to get people recruited to Ashley so how do we do that you might want to raise their pay so with that being said we got to come up with those ideas that can help people answer our questions and they might be increasing pay if you don't know a lot of people know their work now so they're not going to go to work for nothing so that's how I would address the oversight police is implementing mental health and having mandatory meetings all in force thank you Mr. Gerbs so I'm proud of having been both as a county commissioner and now as mayor an advocate for public safety oversight board it's important that the community and our law enforcement officers be able to engage with each other and grow in mutual understanding that really is the reason that I was an advocate for that board and so what I've done is engage with the public safety units so that those members can be onboarded and oriented and also engage with the National Association of Civilian Oversight of Law Enforcement so they can continue to be an outside resource so they don't just have experts from within Clark County but they have national experts as well at their disposal what I would certainly say to the Public Safety Oversight Board and would want everybody in this room to know is that the Department of Justice has an important office about investigation of those people who are in incarceration and you may know that in fact that Department of Justice outfit currently is investigating the Georgia Department of Corrections for some of the failures in that series of venues what I also would note is that what we can do best as an entire community if we want to benefit not only people who are incarcerated temporarily in our jail but also the employees there is really see reduction in violence community-wide we benefited from a 25-year arc of reduced crime in Athens-Clarke County but we know it's not at zero every aggravated assault and every one of the four murders we had last year was one incident too many and so we need to resource our community in a way that we are going to reduce violence because when we have less violence we're going to have less incarceration and we're going to benefit all of us Thank you Mr. Gertz Ms. Hall I was honored to sit at Aberdeen Baptist Church where our pastor had called a meeting with the chief of police and all the officers and thank you Gertz and what he had to tell us was very important shortage of health inmates being released before their time is finished what do we do we sit down and we discuss issues about what's going on in the jail there's fighting going on in the jail but if you he say I quote if you jump into it you may be hurt or you can be sued so what can they do so I told him maybe they need to come up with a plan where they can meet with all the police officers that includes the chef or any law enforcement and let's get with them and come up with a plan as to how we can keep these inmates in jail as well as keep them safe and keep our officers safe our officers are very important we need to respect our police officers and we need to do whatever we can to help them make that are in the prison system so this is what we'll do thank you Ms. Hall okay that is the end of our prepared questions we have four questions that we will try to get to and we'll just go ahead and dive right in the first question and the order for this for the responses will be Mr. Coleman, Ms. Ross Mr. Gertz, Ms. Hall the question is give us an example of how you solved a community problem include the steps that you took and your thought process I'll read again give me, give us an example of how you solved the community problem give us your steps and thought process Mr. Coleman I saw how I solved the community problem that was the incident when there was a marriage couple having a fight I had this choice of intervening of just to get by but I chose to calm down I calmed down by realizing and letting them know that each one of you is somebody that you all need to stop doing what you're doing and by coming with that decision a lot that actually came from this couple was they realized the angle was just a sharp fuse it only lasted as long as the weight burns if I keep adding to that fuse the angle will continue to get longer and longer and they had to stop and they appreciated me talking to them because they said the public didn't have to get involved my mother didn't have to get involved my father didn't have to get involved my sister didn't have to get involved my brother didn't have to get involved you was a stranger didn't have anything to do with this situation but yet you took the time to communicate with us to tell and talk to us and that's how I solved the problem okay Ms. Ross a problem that I see every day in the community is the youth development the crisis of the youth as well as homelessness so what did I do? I started youth this way and with that it started in my closet in my home giving clothes, donating clothes to the ones who had a lack of clothes we also have a program with addressing the homelessness and feeding them a free distribution center where people can come and shop for free and get their clothes that have sole items as well as partnering with different local grassroots organizations who are actually on the ground who want to work that don't get recognized but yeah, we address a lot of lack of food insecurity within the homeless population each and every day so not just one day as well as food and each and every day as well as my kids who supply community service I went in stonehenge I cleaned up the recreation center so that the kids can have some way to play I also proposed on the T-Splots committee that presentation to be able to that side where also the workers can get to and from work and the kids can get to the best people before to play now I'm just looking for a playground so that's how I address issues in the community Thank you Ms. Ross Mr. Gertz So I could select a number of examples but I think where we're sitting right now is the perfect place to start and it was brought to my attention around five years ago that the library here needed extra security in the afternoons dug in a little bit and found out well the kind of need for security was born from the number of middle school students who were coming over in an unstructured way after school in the afternoon and just hanging out but not in any way that was focused so realizing that well, we could put some more money into security but maybe we could do something that was more fundamental and deeper as a solution I brought together Clark County School District personnel Athens Clark County folks people from the Office of Service Learning on the University of Georgia's campus and library employees and management and what we determined is that really we just had the case of a lot of young people who were looking for an outlet looking for an opportunity in the afternoon and so together what we were able to build is the direction of a VISTA post undergraduate staff member from the Office of Service Learning who was assigned to the library and that VISTA worker created partnerships with community organizations around chess around sewing around music production around literacy in many other places and so you had a lot of young people who now had productive activities to do here in the afternoon and things that were going to enrich their lives and we were going to actually diminish the need for security as a result so it was a creative solution and it was one that involved a lot of community stakeholders which is the way that I think we best build a community here in the community Thank you Mr. Hertz Ms. Hall give us an example of how you solve a community problem include your steps in your thought process How I do this is my house is open to parents I have many parents that call me that's having an issue with their teenagers and I say bring them to me and they come to my house for the weekend and I ask what's the problem many children come they sit there they bless their mothers out and father but I find a solution for the answer I say now it's time for you to sit here think about what you said to your mother and you all would be surprised that the number of people that has my number that call me I'm not afraid of them because I know somebody got to love them and I know their parents love them but they've been out all night half of the night they don't know where to go they said what we going to call Ms. Hall and this came up from a lady that I know very well who used to have children from defects they called her at night she joined me in with the program and those are my steps to helping parents I will take your child I will bring them into my house I will feed them and I will give them back to you those are my steps I have that's the love I have for people that's the love I have for children so everybody don't do that but I will do it so if you have a child that's unruly I see about them and I'm not afraid thank you Ms. Hall ok the next question that we have from the audience what are your thoughts on working with the Clark County school district to address issues of inequity and segregation of children within our K through 12 schools again what are your thoughts on working with Clark County school the Clark County school district towards addressing inequity and segregation of children within our K through 12 schools and this order will be Mr. Gerbs, Ms. Ross, Mr. Coleman and Ms. Hall so there was a great but I will say pretty lengthy and dense report that if you've got maybe a few hours of your time you might want to look at came out about five years ago and it was put together by the national superintendents round table and what an international bit of research found is that when you look at outcomes of school aged children a bit of those outcomes are born from what happens in the brick and mortar buildings of schools but a lot of those outcomes come from what happens in neighborhoods and communities but about a third of outcomes are born based on is this a healthy neighborhood do these kids have access to fun places to go to good things to do and so for us as the unified government an enormous thing that we can do is simply make for safer neighborhoods and neighborhoods that are better resourced where there are food resources accessible where there are parks accessible where their trails accessible and I think we should also take a step further and work directly with the Clark County school district which I'm in the midst of doing right now that about half a dozen times with a superintendent and one of the assistant superintendents and what I've recommended is that we put together an ongoing three way partnership between the Clark County school district the Athens Clark County unified government and the great array of community based nonprofits that are doing youth services work because we all care about the same kids we want to see the same positive outcomes and we should develop both information exchange platform and a funding scheme that allows us all to have mutual benefit for the young people in our community I've ever been a confidence that that's going to come to fruition this year at least in part with some of the American Rescue Plan Act dollars we've got but I think it's going to be a foundation that will be able to be utilized for decades to come so I'm very excited about that Thank you Mr. Gertz Ms. Ross Thank you for partying with me Any time Good things have no ownership I appreciate what you just say what I wrote so that's what I would do so yeah that's exactly what I would do because there is a model that if you collaborate and partner with the Clark County school district that you can have more community engagement you can have those organizations coming in because the community is relatable some of these kids as herning they're not relating to their teachers so with that being said you got to bring people from the outside that these teachers have our kids for probably eight hours nine hours a day and that's their release but then when they go back home to that environment you don't know what they're going through so even through the COVID and being out here and being able to give the packets and food and clothes for some of those kids their parents didn't know how to do the work their parents didn't know virtual learning they might not have internet and so addressing those issues and making sure that we're not just sitting back judging these people we're actually trying to find I don't want to say trying but we are finding a solution to their problem so with that being said and with Kelly sharing our idea I really do think we need to partner and if any one of us could really take that idea because the youth is very dear and passionate to my heart I have my own too over here and it's a life going on in the school district that we need to address but that's how we end school to prison pipeline that's my answer thank you Ms. Ross Mr. Coleman you know what I would totally do overhaul the whole school system if it possible to find them all get rid of them all I mean we're at the bottom of the list but how many years it doesn't make any sense to live in a universal system area to be at almost at the bottom of the list in the school system come on people something is wrong here isn't the kids or isn't the parents what is the problem so I guess you asked me what is the problem the problem is parents need to be parents kids needs to be kids teachers need to be teachers not law not babysitters not doctors, not lawyer, not chiropractors none of that they need to teach the school system so in order to have school system I think everybody who needs that school system need to be voted in by the public don't let anyone in the school system elect someone as superintendent the head teacher the teacher of the year let the people do because the people are the ones who are suffering understand the people are the ones who are suffering in the school system not the teachers and the kids are coming home to what distillation horror, fear uncertainty cannot even read cannot even count fussing and fighting so we need to overhaul the whole school system and at the law county thank you Mr. Coleman Ms. Hall as a retired Clark County school employee I always have to command the teachers the employees and everyone on a job where done what they try to do and work with what they have to work with we have to be honest about this thing there are so many things the school system needs they need more computers they need more laptop I think they need to bring their children for a great big training when we are off school and the kids don't have anyone to help them with math, science and social studies we can't blame the parents because they don't know because there are a lot of us in here that are grandparents that we don't know so there should be a setup somewhere in the system where we can help parents with children to come in and show them how to work with the children and not be embarrassed about it so I think if we can get more technology for the parents and get things brought in for the student to be able to care out their duties and responsibility and control the behavior which is unbearably in the school system and I can tell you that and there is so much that they can do the fighting is terrible and I'm here to tell you because I watched it I looked at it I woke them up the fighting is terrible and when you bring the parents in to say hey your child has done so and so then you got to deal with the parents so we have a problem with parents and student in the system so we need to work out a plan that we can work with the parents and the students that's my theory on how we can deal with the Clark County School District as a retired employee thank you Ms. Hall okay our next question please give us examples of situations where you have proven your ability to work with people who do not look like you or think like you specifically in regards to race economic issues or any area that you would like to comment on the order for this round will be Mr. Coleman Ms. Hall Mr. Gertz please give us examples of situations where you have proven your ability to work with people who do not look like you or think like you specifically in regards to race economic issues or any area that you would like to comment Mr. Coleman well I'm a former employee of the University of New York I was real here in Clark County and I was taught by my grandmother she said respect women just to laugh at you do respect a woman do not let a woman beat you down I used to work as a janitor there at the University of North Georgia I was opening doors for the young ladies you know what remark I would get you don't have to open a door for me I can open my own door that's the problem we have here today we don't want to understand and realize a woman is a woman a man is a man there are responsibilities for each and every one of us and what I would do and what I have done when I came upon a racial problem the best thing you could do is laugh it off because if you get too deeply involved into that problem you're going to become part of that problem you have to be the narrow rail which I was plenty time I've been called called names I've been spit on attacked even clans came after me yes here in Claude County but the reward that came from that a large percent of old people came back and said thank you Mr. Coleman for understanding what was going on understanding that's key we got to understand one another out here in this world and you and I are loved across one another and the best thing and the best advice like nearly anybody regardless of your race believe in yourself believe that you are somebody believe that you can make a difference and believe that you have the right and limited for the pursuit of happiness and joy Mr. Coleman Ms. Hall please give us examples of situations where you are proving your ability to work with people who do not look like you or think like you specifically in regards to race or economic issues or any area that you'd like to comment on that is very easy come to my family reunion we have all multi colors and we work together our family consists of black white, Hispanic so our children are able to play with each other and understand each other and we teach them that this is your family you can choose everything in life but you can't choose your family so we try to love each other and respect each other so that's how we carry out our way of diversity that is the way we learn to love one another regardless of race create a color because when you're sitting at your table for the family reunion you're looking at one of those faces so what can you say nothing but I love you so that is the way I handle situations when it comes to race create a color I always look back at my family so if you don't have any of us keep living they're coming thank you Ms. Hall Mr. Burris, please give us examples of situations where you have proven your ability to work with people who do not look like you or think like you specifically in terms of race, economic issues or anything you'd like to comment on so broadly the most important things I do direct engagement and outreach with this entire community I probably get the most fulfilling experience in that realm just by being on the streets on my feet talking to people that I encounter in any place in the community we've come through this really difficult couple of years where engagement has not looked like I think all of us are expecting engagement to look and people have seemed distant and I take it as a solemn oath of this role that I've got to work overtime now to continue to engage and that means meeting people where they are and certainly in the life that I've lived in Athens that have been lucky to live in Athens maybe the hallmark was the time that I worked for the Clark County School District and was doing homebound care and that meant that I had to go out to young people's homes if they were on long term disability and sit with them multiple times a week to make sure that they understood their lessons and often times those young people in their families didn't look like me didn't have backgrounds like I did so I think about Myra and I sat in her trailer with her mom Teresa and her week in week out African American family and I who had a master's degree being willing to have honest conversations and the necessity for me being willing to understand what their lives were like with no preconception but just understanding and taking in their experience so anyhow to them and all those young folks and their families who I was able to share time with that has been a blessing in my life Thank you Mr. Gertz Ms. Ross Do you have any situations where you have proven your ability to work with people you do not look like you or think like you specifically in regards to race economic issues or any area that you desire to come in on My everyday personal mission statement is to be the light and the darkness and my everyday job is community outreach specialist that's the everything I didn't know no matter where I go I am in a room of diversity if I might be the only African American woman in the room and with being that only person it gets to be you adapt to it you get flexibility from it so it's not so much as racism to me anymore or who likes you or what their opinion of you are you have to be able to sacrifice yourself sometimes take a stand and make a difference in life you got to be willing to sit at those tables and that's where some of the lack of leadership comes from because people are afraid to sit at those tables and I do that every single day so I'm on different committees, different boards and my everyday job is community outreach which is going into every area of this community and being able to be relatable with these individuals so it's a big challenge so that's the question Thank you Ms. Ross at this time that ends all of the questions that we had that ends all of the questions that we will have time for we would like to on behalf of the Athens Anti-Discrimination Movement I would like to thank you all for showing up today to become a part of the solution and for staying engaged in this community that has never been more important and so to see the beautiful diversity that Athens, Georgia has brought out is just really fantastic at this time I'd like to tell you just a little bit about the Athens Anti-Discrimination Movement ADM was created in 2016 by Mocha Jasmine Johnson and her husband Noah Johnson they launched it in an effort to combat repeated allegations of discrimination by bars and business owners in downtown Athens since that time they have worked tirelessly to build an effective movement the Athens Anti-Discrimination Movement advocates for racial and social justice and strives to combat discrimination through education and activism ADM offers various workshops, programs and resources designed to help citizens protect their civil and human rights they have three programs the Freedom Fund which addresses issues of police brutality the Teen Social Justice Program which is designed to cultivate future leaders build self-confidence and teach students how to respectfully use their voice to advocate for their rights the Education and Training for Change this program is designed to train community members to advocate for themselves gain more in-depth knowledge about the criminal justice institution improve race relations and develop activist skills they also have three services number one community service whether you need community service for school and independent activity or court order ADM can help you give back to your community and meet your community service requirements they have an Anti-Discrimination Advocacy Service advocates are available to provide support and guidance for people who they feel have been discriminated against by an individual or an institution they are here for clients as they seek resources and help provide them with a platform for their voice to be heard and then bail and legal support we understand at ADM that folks held in jail are innocent and so proven otherwise racial, economic and social inequalities create a system where more black and brown folks are forced into jails and given higher bonds these same inequalities create burdens for marginalized communities often making it difficult or outright impossible to pay the bond and leave the terrible conditions of jail ADM is committed to helping pay jail bail for those in need and to help reunite families and loved ones if you or loved one need support the number to contact ADM is<PHONE_NUMBER> you can also volunteer with the ADM movement by emailing admin at aadm aadm movement.org ok thank you all for coming thank you thank you thank you without any oh sorry let's just say one if we could get a round of applause for all of our candidates thank you


Thank you very much, Mithusha. It's both a pleasure and honor for me and today I'll be talking something different. I've had over the years occasion to talk on prostate cancer, but it's mostly been to do with multi parametric MR imaging and how things have changed over the years. I remember from endorectal MR that we used to do with the endorectal coil beginning in the year 2004 to today when multi parametric MR has become actually the modality of choice for prostate cancer diagnosis as well as for local regional staging. Today I've been asked by Dr. Sikandar to speak on the nuclear medicine aspects of prostate cancer and how that actually is where it falls in the entire armamentarium of imaging of prostate cancer. So, I hope you can see my slide. Yes, sir. Just trying to get it into, yes. So we'll talk today about imaging with nuclear medicine and theranostics. Now, one may wonder why is a radiologist talking about this. Actually, in the year 2000, 1999, actually Gangaram Hospital had approached me that they want to start an apartment of nuclear medicine and I had worked before that 1990 to 92 as a radiologist at INMAS, which is the preeminent institution at least was at that time for nuclear medicine in the country. Also got the country's first MRI in 1988 and that's how I actually got interested in nuclear medicine and started the center in the year 2000 in Gangaram Hospital and in 2006 we got the PET CT and I'll share with you and we've been since 2003 having DNB candidates in nuclear medicine and I'll share with you some of what we've done in the field of prostate cancer. Now, as you know, prostate cancer is the second most common cancer and the sixth most common cause of cancer death in men. When detected early, prostate cancer has more than a 90% cure rate. It's really looked upon today as a chronic disease rather than as cancer in the term that we tend to understand it. The treatment is highly individualized and molecular imaging technologies are dramatically improving the ways in which prostate cancer is diagnosed and treated. We know there's a variety of modalities available. We have the PET scan for a long time to look at bones. We had the technician bone scan over the last 15 years. There's also been waxing and waning interest in whole body diffusion weighted MR to look at the spread of prostate cancer. Of course, CT has its own role for spread, which now with PET CT being there, CT forms an important component from structural imaging standpoint. Of course, ultrasound, when you suspect a prostate problem, ultrasound is the first modality that is used and based on the suspicion that one may have or what one may find on ultrasound and Doppler, then really now it's established that one would go on and get a multi-parametric prostate MRI done and there also we have the multi-parametric and also the faster bi-parametric where you do a T2 weighted axial and diffusion and that also is showing a lot of promise but that's not the focus of my talk today. We will be focusing instead on where nuclear medicine modalities are playing an important role in this.  Both in primary diagnosis, staging and restaging of prostate cancer because prostate malignancies by and large are not FDG avid. They do not concentrate FDG within them but yet in certain limited instances, especially when it's poorly differentiated prostate malignancy, there may be FDG uptake and that really points to a poor prognosis. So, till PSMA which we will talk about in detail, prostate specific membrane antigen PET CT came in, FDG PET had hardly any role in imaging and that's the time also when whole body diffusion weighted imaging actually in the year 2009-10 when it became available it was showing promise till the time the PSMA PET came in. The limitations also of FDG PET are renal excretion of tracer in the urinary brada can hinder visualization of primary tumor and pelvic lymph nodes and that's why as in most cases when we are looking at the pelvis in any malignancy, we make the patient void, we even take delayed images so that we are able to overcome this limitation. FDG PET even has a very limited role in detecting osseous metastasis. Now gallium 68 PSMA PET CT and this we started, we were amongst the first few private institutions in the country which started doing PSMA PET CT in the year 2014 that's nine years ago and this uses a gallium generator. Now for those, I'm sure everyone knows but for the BGs who may have joined here, the FDG which is the preeminently used isotope is produced by a cyclotron. So FDG cyclotron produces it, it has a half-life of 1 hour 15 minutes and quickly from the cyclotron these companies rush the isotope to us and we use it for scanning. On the other hand, gallium 68 PSMA is a generator. It is a generator which is lying in our radiology, in our nuclear medicine departments and from this we elude the substance and then actually in a way marry it with PSMA so that we are able to do PSMA PET. So this is something which is available in-house of course the generator is very expensive costs nearly about 20 lakhs and it lasts really for about 8 to 9 months. So it's an expensive proposition but yet if we look at the cost versus benefit ratio of a PET CT it I think is weighed very very heavily towards benefit. Now prostate specific membrane antigens is expressed on the cell surface and is an integral membrane protein which is over expressed manifold in prostate cancer cells. It is not released into circulation and internalized after antibody binding to this called receptor mediated endocytosis and this PSMA is an excellent target for radionuclide imaging and also as we'll see later for therapy in prostate cancer. Now this is just an example to show you what is the difference in the same patient between a FDG PET CT and a PSMA PET. So this first image on the left is a FDG PET CT where you do see some uptake in these vertebral bodies and in the pelvic bones but just look at this. This is PSMA PET CT. It is so very avid you're able to pick up many more lesions which were not seen and this actually look at all the osseous lesions that are picked up. So this is the power of PSMA PET that even small lesions, tiny lesions, early lesions can be picked up be they osseous or in the lymph nodes or within the prosthetic bed itself. Again the same look at this FDG PET CT and look at that uptake on a PSMA PET CT. So one thing to clarify is that in case you want to do a PET CT in prostate cancer you have to specifically ask for a PSMA PET CT and not just write PET CT. Now what are the indications for gallium PSMA PET CT? It can differentiate BHV from carcinoma prostate. This is an indication which is rarely used. Targeted biopsy can be done after a previous negative biopsy in patients with high suspicion of prostate cancer. We do know that fusion biopsy is the preferred mode for prostate cancer where fusion is done of the multi-parametric MRI with the ultrasound and it's on that ultrasound guidance using this fusion which is how biopsy is done. But even there sometimes biopsy may fail because the lesion may not be as clearly depicted on the MRI and this is where in a failed biopsy PSMA PET CT can show exactly the location of the lesion and targeting can be done. Then it's useful of course in primary staging in high risk disease before surgical procedures or planning external beam radiation. It's important and useful in localization of tumor tissue in recurring prostate cancer. Now this is one area where we've done quite a bit of work and until now in these last nine years we've done about 5500 PSMA PET CTs. One of the major indications is when there is recurrence suspected because of rising PSMA after radical prostatectomy or after radiotherapy. The PSMA levels keep rising and that's when we know as radiologists that ultrasound and MRI haven't really been very useful. Unless it's a very prominent recurrence. This is one area where it's very, very useful apart from looking at primary disease staging. Then it's useful in monitoring treatment response to know whether your treatment is working or not. And in staging before and during PSMA directed radiolabeled therapy which is mainly in metastatic castration resistant prostate cancer. And we will talk about this Theranostics using Lutetium therapy which is again something which is PSMA mediated. Now in diagnosis this is a 63 year old male suspected carcinoma prostate with raised serum PSA levels. And this is as you can see here grossly enlarged prostate gland but you don't see any focal uptake of PSMA in any in the prostate. So here you can see that there's no abnormal uptake and so we are dealing with most likely a benign prostatic enlargement. This is another 64 year old male suspected CA prostate and most of these patients have had their multi parametric MRI done before. In most of them a lesion is suspected, it is found and then PSMA PET CT is done for further staging. So let me point out that for primary diagnosis of prostate cancer I would still rely more on multi parametric MRI and the PSMA PET CT is supplemental as regards the primary prostate cancer but is more useful for looking at lymph node metastases and of course for distant metastases because this is where the spread can be found out. So whole body PET CT and you are able to see spread and here this is the CT and then suddenly you start seeing these brights uptake within the prostate gland and so this was a patient with a PSA of 44, biopsy done four times always picked up benign tissue and so with this we are absolutely certain that we are dealing with prostatic malignancy and based on this the biopsy was directed and this did turn out to be Gleason's 3 plus 4 lesion. This is a 65 year old suspected CA prostate, race serum PSA and here what you can see is this small area of uptake and this turned out to be Adenocarceroma. So for me as a radiologist actually this helps me because apart from looking at the CT images it tells me exactly where to look based on the uptake. So many times usually in most of other cancers we do a CCT with PET in prostate cancer we do it as and when necessary and so apart from the intravenous contrast this is another contrast where things actually light up like a light bulb that is how explicitly sensitive this PSMA PET is for cancer of the prostate. For staging again like I said this is a 62 year old recently diagnosed CA prostate serum PSA 33 and with that we know that this is not just going to be confined to the prostate so after the MRI has been done here you see this lesion which is shown showing uptake and what you can see is that there are no distant metastases again this turned out to be a 4 plus 4 lesion Gleason's 8. 68 year old recently diagnosed PSA 80 and here what you can see you can see of course the primary lesion this is the urinary bladder which also shows concentration of the isotope as you can see here as well but here you see the lesion in the prostate and you can see the iliac bone metastases fairly large with the soft tissue component and also metastatic deposits seen within the vertebral bodies along with nodal meds which you are able to see so what PSMA PET CT does better than MRI better than even diffusion weighted MRI where we generally use a B value of 1500 to 2000 is that lesions within distant lesions as well as lymph node lesions are picked up much more sensitively than what MR can and of course you can do multi modality fusion gallium PSMA PET CT can be fused offline with all these software exists with most of the new MR's and PET CT's and so once you've done MR we just heard a talk on the PET MR and here again we are using the power of MR along with the power of PET and these can be fused the MR of course has limitations in the chest in the lungs but since most of these patients already have had this done we can always use the previous MRI and fuse the two of them together to show the PET MR kind of lesion for treatment response evaluation it's again useful of course PSA levels themselves are also very useful but to see spread or to see the patient who had baseline had this liver met and you can see on follow up after treatment the lesion has become larger and also there's another lesion that we are seeing and so this is again baseline there was no uptake within the spine whereas here you're able to see uptake within the vertebral bodies so this definitely is a treatment that is not working now for recurrence and this is where this modality holds its own this is a post radiotherapy CA prostate rising PSA levels which rose from 0.05 to 0.6 nanograms per ml and here what you see is local recurrence here the small little lesion which you're able to see on the left side within the prosthetic you know the residual prostate remember this was post radiotherapy so the prostate though shrunken is still there and here you're able to pick up this would have been in fact an MR had been done and it wasn't able to pick up and I know as someone who's really more into MR than into PET CT that these are difficult even in post radiotherapy scenario they are difficult to pick up on MR and are very very tough in post radical prostatectomy now I'll share with you our experience which started like I said in 2014 and in the first five years we had done more than 4,000 PSMA PET CT scans so probably we've done more than 5,500 that I mentioned and we've done three thesis topics on this and in RSNA 2018 I had actually presented you know our data at that time it was I think 3,500 cases that we had presented in 2018 now in the first one we looked at the role of PSMA PET CT in patients with recently diagnosed oblique suspected carcinoma prostate there were 150 patients and our results were that we found a sensitivity of 90% a specificity of 80% a positive predictive value of 95% so when you found it you know it was very likely to be prostatic malignancy however the negative predictive value is low significant but still low which means that if you get a negative PSMA PET CT that doesn't still you know conclusively rule out the presence of a lower grade of prostate cancer 3 plus 3 even 3 plus 4 at times so most of them tend to be avid the overall accuracy was 88% which is very very high in the second you know research thesis we evaluated the role of PSMA PET CT in patients with biochemical recurrence of prostate cancer after definitive treatment 170 patients analyzed and correlated the findings with pro-streatment serum PSA levels and here determining whether recurrence is local within the prostate or at the urethral bladder anastomosis regional that is pelvic or distant disease is critical when considering appropriate further treatment options and early localization of disease recurrence after definitive treatment of prostate cancer is vital to determine suitability for salvage treatment now morphological imaging methods are fairly poor in picking up biochemical recurrence as are 18 FFTG or even 18 11 Carbon Choline and these were all you know work which was done before 2013 2014 when PSMA actually became available commercially in Europe and we were able to bring it from there and so this was our aim to localize and restage carcinoma prostate using this modality in patients with biochemical recurrence and to determine the relationship between detection rate of PSMA PET CT and serum PSA level along with the Gleason score and like I said you know we analyze these patients we included men with suspected recurrent prostate cancer based on an elevated post treatment level of more than 0.2 nanograms per ml after radical prostatectomy and over a threshold of 2 nanograms 10 times above the nadir value post radiation therapy the data collected also analyzed the relationship of pre scan PSA level and prior Gleason score to the probability of a positive scan finding for recurrent prostate cancer in 170 patients 124 had previous radical prostatectomy and 46 had prior radiotherapy the median serum PSA in the radical prostatectomy group was 1.8 nanograms and 5.2 in the post radiotherapy group and what we found is that the detection rate of gallium was 39.3% for PSA which was between 0.2 to 0.5 nanograms so very low levels 0.2 to 0.5, 47% for PSA 0.5 to 1, 68% for PSA 1 to 2 and 93% so very high percentage for PSA more than equal to 2 now this finding was actually at variance with what had been reported at that time in literature and those numbers were very small this number of 124 was relatively nearly 6 or 8 times larger than that number I need to tell you that PSMA PET got FDA approval US FDA approval only in October of last year so in the US whatever PSMA PET was done was only done as a research tool for research and only after the US FDA has given approval have the numbers started coming up we were lucky that we were given the permission to use this much earlier in 2014 so in this group local recurrence was identified in 28% and lymph nodal metastasis in 65% so important to note that lymph nodal meds are also responsible for rising PSA levels and it's not necessary that you have to find local recurrence in the prostate bed itself and this is just showing that and this is to show that as the PSA level rose the detection rate also rose and these are actually the sites of recurrence in the post RP group now the detection rate in post radiotherapy group was 88.8% for PSA 2 to 4 remember we had taken patients who were more than 2 in the post radiotherapy group so the detection rate was very high nearly 90% and it was 100% for PSA level more than 4 and so this is something which is quite dramatic, quite dramatic local recurrence after the radiotherapy was present in 80% of this group and 63% so had lymph node metastasis so note that between those who had radical prostatectomy we said the number of local recurrence in the prosthetic bed was 28% whereas it is nearly 80% in post radiotherapy group the prostate hasn't been removed maybe there's a message in this and we need to work more on this aspect and the lymph nodal metastasis numbers were 63% there, 63% here and this is again to a graphic representation of the same now what was the relationship of Gleason score with detection efficacy now if you look at that increased detection rates with increasing Gleason scores were seen detection rate 63% for Gleason score less than equal to 7 which increased to 76% for Gleason score more than equal to 8 so as the Gleason score rose the detection rate increased now this is a 73 year old adeno CA post radical prostatectomy and here you can see a small recurrence in a lymph node here was it disease which was not identified at the time but this is what a small sub centimeter lymph node showing FDG uptake this is a 61 year old radical prostatectomy pelvic lymphedinectomy raised PSA 3.8 and here you see PSMA avid Gleason in the prosthetic bed you see it here and of course domino pelvic lymphenopathy you see this in the lymphatic bed here 61 year old post radiotherapy his PSA rose from 0.72 at the baseline to 9.5 and here you see you know PSMA avid Gleason in the prosthetic bed as well as lymph nodal metastasis that you can see very well and this is another one Gleason score 8 post prostatectomy post adjuvant RT on hormonal therapy and with race serum PSA 3.5 and here again you can see the lesion in the bone you can see lesion within the prostate gland itself and lymph nodal metastasis all can be seen in recurrence there is of course the patient who had everything post radical prostatectomy PSA 29.5 and here you can see he has so many bony lesions which are detected very very easily there is also a left supraclab lymph node which is seen and surprisingly no lymph nodes seen in between now this is a paper we published in 2020 in the Indian Journal of Urology which was for localizing and restaging of carcinoma prostate and histopathology done and here what we found that out of 30 patients 16 had PSMA avid left pelvic lymph nodes and 18 had right pelvic lymph nodes on histopathology 19 patients were positive for left pelvic lymph node metastasis and 14 for positive were positive for right pelvic metastasis in the lymph nodes and on correlating both the results of gallium PSMA and histopathology the cones kappa value came to 0.68 for left side lymph node and 0.64 for right side and anything between 0.6 and 0.8 signifies substantial agreement or concordance and so this is useful so you know this is this is a case again ill-defined lesion you see in the prostate and there is this lesion here within the lymph node you can see a lesion here as well depicted now in conclusion theranostics and this is something again that we've started about six months ago in one of our centers for theranostics for treatment for those calculation we also need a gamma camera so you need a gamma camera along with a PET CT if you have only a PET CT alone you will not be able to do therapy now theranostics is the combination of a diagnostic tool that helps to define the right therapeutic tool for a specific disease and in nuclear medicine theranostics is easy to apply and understand because of an easy switch of the radionuclide from diagnosis to treatment on the same vector and we all know radio iodine therapy which has been around for a long long time so here what is done is that the same PSMA is actually used and here instead of giving a diagnostic dose we give a much higher dose and we know that this PSMA is going to go and concentrate in the cancer cells they may be located anywhere in the body and so this is what is being used to actually treat and these are all patients now the inclusion criteria are multiple these are patients who failed everything you know and they are resistant to hormonal therapy they have extensive disease and so this is something which is helping this has been around now since some time and more and more patients are coming in for lutetium therapy with PSMA so there are some inclusion criteria of course the WBC levels have to be and remember these are all patients who are quite sick since it's extensive disease 2000 hemoglobin more than 8, platelets more than 75,000 creatinine should be less than 2 we rule out obstructive renal disease and the ECOG should be less than equal to 2 and what is ECOG? There is a ECOG performance scale and this actually is showing us the physical and capability of a patient ECOG score of 0 is when someone is fully active I'm going into this because this is something which we as radiologists actually don't really know about at least I didn't know about it 0 is fully active able to perform all pre illness activities without restrictions 1 is there is limitation in vigorous physical activity but he can stand and do soft work for example mild home and office work 2 is standing and doing his own work but unable to work and able to spend more than half of the daylight hours on his feet these are the people who will fall in the criteria to undergo lutetium therapy in their given clinical setting those who are in 3 and 4 where they have difficulty in self-care sleeping for more than half of the daylight hours or sitting in a chair or cannot self-care fully dependent on chair or bed these are patients who are as yet not to be included for lutetium therapy before treatment of course we need to get a good history from the patient collect information about pre-treatment stage of the disease the treatments that have been applied previous procedures pathology results everything so you know we as radiologists or nuclear medicine specialists need to do this very very thoroughly then we gallium 6 PSMA scan should have been done at least within 2 weeks before the treatment within that 2 week period if it has been done earlier then we need to repeat it of course complete blood count biochemistry and of course other biochemical parameters it's given intravenously takes about 30 minutes for the drug to infuse into the bloodstream of course we need to give anti nausea medicines and diuretics diuretics help to flush the lutetium from the system as quickly as possible and this is a outpatient treatment after you've given it patient has to wait in the department for a few hours or longer of course it's a special room shielded room where the patient is injected and waits and once his radiation levels start coming down within about 4 hours you can send him back home a day after treatment he'll have an imaging test a spec scan this checks to make sure therapy hit the right targets and it's a dosimetry scan it shows you where all the lutetium concentrated there can be side effects dry mouth dry eyes nausea of vomiting fatigue most of these symptoms go away in a few days there's a small chance dry eyes and mouth can be permanent a few people have a dip in blood counts because lutetium can affect the bone marrow lutetium can also target healthy organs that have very small amounts of PSMA like the salivary glands and that's why you get a dry mouth small intestine and the kidneys the recommended dose of course is about 200 micro curies and you know you inject this in 2 to 3 minutes and follow it with 500 ml of normal saline infusion over the next 30 to 40 minutes now how often can we give this depending on the response lutetium 177 can be administered every 4 to 6 weeks and till a maximum as yet of 6 doses of course depending absolutely on how the treatment affected and the side effects that a patient may encounter now this is one of our cases this is a initial free therapy image where you can see extensive metastatic disease and remember these are patients where everything has been tried surgery, radiotherapy, hormonal therapy, castration whatever everything has been tried and this is the final final treatment this is the change you see after the first cycle there is reduction in both the number as well as the size of the lesions further reduction after the second cycle and this nearly complete clearance after the third cycle and actually if necessary one today has the approval to go up to six cycles so like I said FDA, US FDA gave its approval on March 23, 2022 and like I said these are you know PSMA positive metastatic castration resistant prostate cancer who have been treated with androgen receptor pathway inhibition and taxin based chemotherapy still there is no response and of course it can be given every 6 weeks for up to 6 doses or until the disease progression or unacceptable toxicity so in conclusion let me say that prostate cancer which is a very very common cancer most of us would know some patient amongst our friend circle or amongst our relatives the PSA levels and it has been controversial whether PSA should be routinely done as a part of a health check or not I for one would say that I err on the side of doing it at least once a year and if there is suspicion of prostate abnormality then the first test to be done is an ultrasound if the PSA level is such and clinically you suspect remember the prostate cancer also has genetic undertones so then after that you do a multi parametric prostate MRI try to localize the lesion then a fusion biopsy if you have the fusion system or biopsy by whatever means that a radiologist or a urologist is familiar with and following that what I've talked about the PSMA PET CT and where necessary as a life-saving procedure the lutetium therapy. Theranostics I would say is not the future it is the present it is about personalized and precision molecular radiation therapy thank you so very much for a patient hearing and for giving me this opportunity to share some of our work with you thank you


What's up everybody? Jason here for Jasper's case brace calm another wax party promo break in the books 2021 Bowman Chrome Baseball hobby 12 box case break species number 24 guys number all cart ship and at the end of the break We will take all 30 customer names whether you want in a filler or bought straight up Randomize them and the top two get a spot in the wax party promo And here you go guys There's a customer names. So congrats to the winners from the team filler Now let's get This rolling guys So I'll probably rip four boxes at a time We'll stop Logan. Yeah, it's it's about that time you put back the jazz logo You pretty much usually put it back In the middle of the playoffs every year So you're right on time Maybe a little earlier than I expected That you would have that level there next week handing down who's a monster All right, I'm actually gonna do six boxes to do half the case of First and then we'll go to the next half losing crypto to look it comes to a pistol.  The other fans are happy They're the kings of first-run draft picks. They have enough first-run draft picks to open up. Good luck Oh Joy bottle blue and Jose buttoe to 250 For the Mets that's going to Brian got it from a team team filler gave me rice Pedro Bruneta And a Julia Carreras that is numbered to 250 I Don't the other floors got a Jesus Sanchez pink to 299 Hunter green redemption Pedro Bernetta pink or sorry purple shimmer to 250 Oakland is going to Garrett Lidolo blue Cohen Moreno for the Cubs Christopher O'Donnellan Luis Rodriguez bonechrome Prospect yellow refractor parallel of Malcolm Nunez for the Cardinals St. Louis Cardinals that is going to Incoo our next box Chris Bryant's help Chris Oliveris Loving Gilbert Vladdy yellow to 75 A lot of nice color so far Whoa, and Ryan Mountcastle. That's a bowman ascension. That's usually a case hit. This is actually an autograph on it 69 out of 100 for Baltimore Aaron Billings, there you go atomic Austin Martin Hector Perez or Hedbert Perez Fernandez from Milwaukee solo to 250 yeti And there's a case hit bowman ascensions Austin Martin Blue jays it's going to Michael and Tanner Murray rays that's going to Brian green Chris Bryant Yeah, it was a double case here, right? Oh man, I'm gonna kill this dude now Boom, that's a short print for the Phillies when a John I'm gonna Jose buys Jeremy Bagnetta 99 green shimmer Eduardo Garcia M. Shoff Costa Pedro Leone first that's a nice one I'm getting a lot of color. Oh looking for Christian Hernandez Raphael Morel Fosco Christian Avier to 299 Taylor de lard Refracted a 499 Bieber Francis is so freaking big All right, so look at this is all the color we got in our first six boxes like there's a lot of nice color I thought I seen a red rebel, but it was actually a pink All right, and these were the autographs in the first half with the short print there Not too many color autographs minus the delar with a refractor the purple Ascension and the redemption that was a yellow hopefully some more in the second half I Guys last six boxes here Julio Rodriguez and we got Josh For the Boston Reds, and I remember his actually he's like the only player that had like a black ink Winkowski and Kowalski to 499 shoomake As our first Christian Hernandez first common errors Dylan Carlson rookie to 250 JD or Maryfield To You got Cabrera Bouto gold Austin Hendrick Reds going to Andrew Nate Pearson and Alejandro or Sir Alexander Mojica Debbie Garcia the 75 Elijah Dunham Speckle first for the Yankees. I know it could be it could be in this book. It could be in these last four boxes though You just never know Nick Gonzalez. All it takes is one common errors Cepidus Adam Kerner I Had probably so much sugar Rex Celestino Carson Taylor JJ blade a cowhurt And are we saving the biggest hits for the last are just gonna be a dead case a lot of color though So Lea drew waters Franny albias Torbio or maybe not. What is this? LED Mookie bets Yeah, I was thinking like autograph or something Los Angeles that's going to Matthew Melvin Valdez Jesus Extra autumn Elijah Dunham. All right, shame and Cali and last box guys Redemption coming up Yeah, that's true. I specifically remember bow and chrome being really big hit or miss for sure And obviously I'm sure the box price has gone up So It's even more of a risk. All right. See a green. I see a couple greens and blues So hopefully one of those is an autograph Emerson Hancock to 99 first to 99 shall in Palanco. Okay. Well that that kind of helps Patrick Bailey All right, let's see what this redemption is 40 man futures autograph of Austin Hendrick for the Cincinnati Reds I Already guys and there you go. Oh Nothing craziest case we've seen before they get a case hit double case it with the autograph. I like bomb sharp print But first wise obviously not the best ones of that at the end. We did get a nice Charlotte Palanco Green to 99 but again, this is a poem or a promo break. So that's kind of the good thing to a lot of color though for a lot of teams Got two stacks worth of color So it's not bad right there. Let's switch things now and let's give away those two spots in the promo Promo All right, so let's get all the cousin renames here. Let's roll Four to four eight the hard way good luck top two get in one Two three four five Six seven and eighth and final time boom the Mac and Tyler Brenner look at that. I don't think I called you guys's names at all Cleveland Guardians and then Tyler has the Rangers Well, there you go. Boom. You guys are in Congratulations guys Let's put you guys right here and then this would be well All right, I appreciate you guys jasmu's case breaks calm. Thank you


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