Background: Obesity is increasing at an alarming rate worldwide, with some estimates at a 40% rise in prevalence between 2000 and 2018. Recent data indicates that 42.2% of adults in the United States are obese. Obesity can increase morbidity and mortality as a consequence of complex physiologic changes, and as a result, has many consequences for health care delivery and management of these patients. Patients who are obese often need interventional pain procedures; however, perception of higher risk can lead to less opportunity for these often very needed procedures. Case Report: The present case report reviews technical aspects, safety, and efficacy of successful kyphoplasty in a morbidly obese patient. Discussion: This case helps expand the current knowledge base of kyphoplasty in the morbidly obese. Conclusion: Morbidly obese patients, in general, should have access to kyphoplasty similar to normal body mass index patients. Key words: Kyphoplasty, morbidly obese, obstructive sleep apnea, sedation, super-super obesity, vertebral fractures

Background: Metastatic bone pain is very difficult to treat and challenging to manage for health care professionals. Kyphoplasty or vertebroplasty has been used to reinstate the height of a compressed fractured vertebral body. OsteoCoolTM radiofrequency ablation (RFA) is a relatively new ablation technique and at present, current literature only supports its role for thoracic and lumbar vertebral metastases. Case Report: In the present case report, we utilized OsteoCoolTM RFA using anterolateral cervical kyphoplasty for cervical spinal metastasis with intractable pain and limited range of motion. Discussion: A successful palliative treatment was provided with a combination of kyphoplasty and OsteoCoolTM RFA. The patient has had great relief of pain and an increased range of motion of the cervical spine post procedure. Conclusion: Anterolateral balloon kyphoplasty provides stability to fractured vertebrae and when combined with OsteoCoolTM RFA, it potentially can provide effective pain relief in patients who have failed radiation and for whom surgery is contraindicated. Key words: Cervical kyphoplasty, cervical vertebral metastasis, kyphoplasty, OsteoCoolTM

Five academic libraries in Ontario (Canada) are collaborating in a shared last print copy repository project. The project, called Keep@Downsview, aims to consolidate and rationalize low-use print materials held by the partner libraries and ensure long-term preservation of these important scholarly materials in Ontario, while still providing access via document delivery and ILL. In doing so, each of the partner institutions demonstrates its commitment to the stewardship of print collections for future generations while repurposing valuable space on campus. This paper describes the background, rationale, challenges, and lessons learned for this unique Canadian project that leveraged funding from the province of Ontario, the University of Toronto's high density preservation facility at Downsview, and the commitment of all partners to preserve the scholarly record in Ontario.