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In patients with primary aldosteronism receiving mineralocorticoid receptor antagonist therapy, the guideline recommends titrating the MRA dose upward to raise renin when blood pressure remains uncontrolled and renin is suppressed. Consider this step when hypertension is not at goal despite MRA therapy and plasma renin activity (or direct renin concentration) is low.

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Recommends using mineralocorticoid receptor antagonists rather than epithelial sodium-channel inhibitors for medical treatment of primary aldosteronism. Use when a clinician asks whether to use an MRA or ENaC inhibitor for medical treatment of PA.

日本語の概要は準備中です。原文の説明を表示しています。

Clinicians educate adrenal insufficiency patients taking nondexamethasone glucocorticoids who initiate enzyme-inducing antiepileptic drugs about early signs of adrenal insufficiency. Trigger when an AI patient on nondexamethasone GC starts an enzyme-inducing AED such as phenytoin, carbamazepine, or oxcarbazepine.

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Screen a child with obesity for red flags suggesting monogenic, syndromic, or secondary endocrine causes — distinguishing atypical from typical exogenous obesity. Trigger when a clinician asks whether obesity could be genetic or hormonal, suspects Prader-Willi syndrome, Cushing disease, hypothyroidism, ROHHAD, Bardet-Biedl syndrome, leptin deficiency, or craniopharyngioma, or when a child has early-onset severe obesity, short stature with obesity, hyperphagia, hypotonia, dysmorphic features, or developmental delay with weight gain.

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Guide pre-endoscopy management decisions for patients on GLP-1 receptor agonists (semaglutide, tirzepatide, liraglutide etc.), deciding whether to proceed, delay, or modify the approach based on GI symptoms, fasting status, and indication. Trigger when a clinician asks about GLP-1 RA and endoscopy, semaglutide before colonoscopy, Ozempic before procedure, or whether to hold a GLP-1 agonist before endoscopy.

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Select the right pharmacologic agent for a child aged 12+ with obesity using the CMAJ 2025 guideline — choosing between GLP-1 receptor agonists, metformin, or orlistat with monitoring guidance. Trigger when a clinician asks which medication to use for pediatric obesity, whether to start semaglutide or metformin in a child, or how to manage obesity pharmacologically in adolescents.

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Complete bedside prescribing reference for Mirago (mirabegron, beta-3 adrenoceptor agonist) for overactive bladder — covering contraindications, safety screening, drug interactions, dose selection in special populations, titration, and administration. Use when a clinician asks how to start mirabegron, what dose to use in renal or hepatic impairment, is mirabegron safe in this patient, mirabegron drug interactions, or Mirago for OAB.

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MANDATORY skill for ALL code generation. Enforces top-down composition, consistent abstraction layers, and proper module hierarchy. Apply every time you write or modify code — in any language — no exceptions.

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The primary tool for code-navigation questions in ANY language (frontend or backend) — walk the structural graph from an entry point (page, route, handler, command, `main`) down through imports to the IO boundary (network call, query, file read). Use this skill, in preference to the Explore agent or global grep, whenever the user asks "where does X come from?", "what API/data populates Y?", "what renders or wraps the Z panel?", "which file for feature F?", "how is this wired up?", or any code-navigation question mapping a UI element, route, or feature concept to source files. Also reverse queries ("what uses /api/foo?", "who consumes this service?"). Keyword search routinely picks up unrelated flows sharing a domain word and produces wrong answers; the walk follows the actual graph. The JS/TS `walk.mjs`/`discover.mjs` are an optional accelerator, not required — the walk is language-agnostic.

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Cycle-end retrospective converting recurring judgment failures into durable enforcement. Reviews the cycle's friction — repeated user corrections, guard trips, RCA themes, integrate failures — and turns each recurring one into a landmines.md entry, then proposes graduation candidates up the enforcement funnel (landmine → advisory hook → hard gate). Pairs with standup: standup says what shipped and what's next; retrospective says what kept going wrong and how to stop it structurally. Writes only memory entries and a report — graduation proposals are advisory and require the normal seed.md amendment path to become enforcement. Invoke at the end of a release cycle, an epic, or any stretch of work with repeated friction.

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Draft a Workflow Phase 1 intake document capturing a new request — the problem, the desired outcome, constraints, and testable acceptance criteria. Use when a user brings a new feature, change, or investigation that doesn't yet have a spec. The output lives at `docs/intake/<slug>.md` and feeds `/scout`, `/research`, and `/spec` downstream.

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Oracle-bound spec-review check that every structured Rollout prerequisite binds to an enforcement-type acceptance criterion. A prerequisite whose `enforced-by` is missing, dangling, or points at a non-enforcement AC is a BLOCKER (hard-blocks implementation entry via the checker fan-out verdict); a prerequisite left in free prose is ADVISORY. Read-only. Runs in the spec-review fan-out before implementation.

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Bootstrap the central system spec at `docs/system/` for a repository that has never had one. Scans the governed surface, proposes a concept map clustered by directory, and materializes elements + shards ONLY after a human confirms that map. Use when adopting the baseline on an existing project, or when the corpus needs re-deriving from scratch. Re-runnable. Requires `memory.architecture_map.enabled` and a declared `governed_surface`.

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Use for design thinking, or when a product or service problem needs user understanding before solutions: "what do users really need?", "how might we...", "plan a discovery sprint", "validate this concept". Skip when the spec is frozen or the task is code maintenance.

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Use for Six Thinking Hats or de Bono's parallel thinking, or when a decision or idea needs facts, gut feel, risks, benefits and new options kept apart: "look at this from all sides", "full perspective check". Skip for plain factual questions or single-angle hot takes.

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Reverse engineer and security-test Telegram bots — API analysis, callback interception, exploit discovery, and vulnerability documentation

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Hardens code against vulnerabilities. Use when handling user input, authentication, data storage, or external integrations. Use when building any feature that accepts untrusted data, manages user sessions, or interacts with third-party services.

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Audits and designs iOS/macOS/watchOS/visionOS interfaces against the Apple Human Interface Guidelines, including the Liquid Glass design language (announced WWDC25, shipped with iOS 26/macOS Tahoe, Sept 2025). Use when reviewing an Apple-platform mockup or app for HIG compliance, checking contrast or tap-target sizes, or designing native-feeling Apple UI (e.g., 'audit my iOS app against the HIG', 'is this text readable on Liquid Glass?').

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Actorization converts existing software into reusable serverless applications compatible with the Apify platform. Actors are programs packaged as Docker images that accept well-defined JSON input, perform an action, and optionally produce structured JSON output.

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Expert in building 3D experiences for the web - Three.js, React Three Fiber, Spline, WebGL, and interactive 3D scenes. Covers product configurators, 3D portfolios, immersive websites, and bringing depth to web experiences.

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Practical UI refactoring and visual design review inspired by Refactoring UI by Steve Schoger and Adam Wathan. Use when an AI coding agent needs to improve an existing interface, audit visual polish, redesign a rough UI, review frontend code for hierarchy/spacing/typography/color/depth/image issues, or turn a plain implementation into a cleaner product-quality screen. Do not use for creating UI from scratch, scaffolding a new app, building a new landing page, or designing a new design system unless the user explicitly asks to review or refactor an existing interface.

日本語の概要は準備中です。原文の説明を表示しています。

Multi-layer validation to catch bugs before they escape

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Use when planning or upgrading an internal skill/workflow for business operations, especially when turning a messy idea into a structured skill plan, migration plan, acceptance checklist, or packaging decision. Particularly useful for Obsidian knowledge base consolidation, workspace migration, content library cleanup, and integrating multiple workbenches into one operating system.

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Interact with Langfuse and access its documentation. Use when needing to (1) query or modify Langfuse data programmatically via the CLI — traces, prompts, datasets, scores, sessions, and any other API resource, (2) look up Langfuse documentation, concepts, integration guides, or SDK usage, or (3) understand how any Langfuse feature works. This skill covers CLI-based API access (via npx) and multiple documentation retrieval methods.

日本語の概要は準備中です。原文の説明を表示しています。