A practical road map to develop effective leadership behaviors in clinicians is provided.The history of research in anesthetic mechanisms is examined. See the accompanying Editorial View on page 451 Poor achievement test scores were more common in children who had undergone anesthesia and surgery during infancy than in a normative population. See the accompanying Editorial View on page 459 Noninvasive ventilation is now standard practice. Anesthesiologists need to understand the limitations of domiciliary noninvasive ventilation devices in the hospital environment.Recent discoveries have led to improved treatments for familial dysautonomia patients, greatly reducing the incidence of dysautonomic crises and diminishing symptoms overall.Point-of-care (POC) measurements of hemostatic therapy algorithms have shown benefit in reducing coagulopathies in patients undergoing cardiac surgery. A prospective, randomized trial, comparing conventional coagulation analyses to POC assessment, was conducted in 100 patients undergoing complex cardiac surgery. The study was terminated after the interim analysis because a significantly lower rate of transfused units of packed erythrocytes was found in the POC group compared with the conventional group. Secondary outcomes also favored the POC group including decreased plasma and platelet transfusion rates, length of intensive care unit stay, and 6-month mortality. This study confirms that hemostatic therapy based on POC testing is beneficial to patients undergoing cardiac surgery.In patients undergoing ambulatory surgery, postdischarge nausea and vomiting is a significant problem; however, there are no current methods for predicting risk. A large, prospective multicenter study was conducted in 2,170 patients undergoing general anesthesia at ambulatory surgery centers to assess risk factors for postdischarge nausea and vomiting. Overall, 37% of patients experienced postdischarge nausea and vomiting. Independent predictors of postdischarge nausea and vomiting included female sex, a history of nausea and vomiting after previous anesthesia exposure, opioid administration, or nausea in the postanesthesia care unit. This study suggests that at least one in three patients may suffer from postdischarge nausea and vomiting. Furthermore, this study developed and validated a simplified risk score for patients who would benefit from long-acting prophylactic antiemetics at discharge from ambulatory care centers. See the accompanying Editorial View on page 454 Muscle relaxants are often used to achieve adequate face mask ventilation; however, previous studies have failed to show direct benefits. In this prospective study, 42 consecutive patients undergoing elective surgeries received either rocuronium or succinylcholine during general anesthesia. Succinylcholine significantly increased total tidal volumes; however, no significant effects were observed after rocuronium administration. Changes in face mask ventilation are specific to the particular muscle relaxant administered. See the accompanying Editorial View on page 456