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概要と使いどころ
Suggests continuous subcutaneous insulin infusion (CSII) for adults with type 1 diabetes mellitus who desire increased insulin delivery flexibility or improved treatment satisfaction and are capable of using the device. Clinical triggers include statements such as 'Patient wants more lifestyle flexibility with insulin' or 'Consider pump for improved satisfaction in T1DM'.
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Recommends early delivery based on individualized risk assessment rather than expectant management for pregnant patients with preexisting diabetes mellitus (PDM). Consider when evaluating delivery timing in the presence of diabetes‑related complications, suboptimal glycemia, abnormal fetal growth, or maternal comorbidities that may increase perinatal risk beyond 38 weeks gestation.
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This skill recommends bilateral adrenalectomy for occult or metastatic ectopic ACTH secretion or as a life-preserving emergency treatment in patients with very severe ACTH‑dependent Cushing’s syndrome who cannot be promptly controlled by medical therapy. It is triggered by life‑threatening complications of uncontrolled hypercortisolism such as infection, pulmonary thromboembolism, cardiovascular catastrophe, or acute psychosis.
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This skill recommends discussing and offering age-appropriate vaccinations (influenza, herpes zoster, pneumococcal) to patients with Cushing’s syndrome due to increased infection risk. Use when reviewing preventive care for a CS patient; triggers include discussing preventive care, vaccination status, or infection risk in a CS patient.
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Identifies safe antihypertensive options for hypertensive disorders in pregnancy applicable to PA patients, with gestational age restrictions. Triggers include when managing hypertension in a pregnant or pregnancy-planning PA patient and asking 'What BP meds are safe?' or reviewing medications.
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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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Order and interpret lipoprotein(a) [Lp(a)] measurement at least once in a lifetime, apply the risk-enhancer threshold (≥125 nmol/L or ≥50 mg/dL), and run cascade screening of first-degree relatives for premature ASCVD, familial hypercholesterolaemia, or elevated Lp(a) per the 2026 ACC/AHA multisociety dyslipidaemia guideline. Covers the Class 1 lifetime measurement, how elevated Lp(a) affects LLT initiation and intensification, the cascade screening indications, the interaction of Lp(a) with ASCVD risk estimation, and current therapeutic limitations. Use when a clinician asks when to check Lp(a), how often to repeat Lp(a), elevated Lp(a) what next, treatment for high Lp(a), should I screen my patient's family, Lp(a) and statins, cascade screening indications. Grounded in the 2026 ACC/AHA multisociety dyslipidaemia guideline.
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Calculate and interpret the PREVENT-ASCVD risk score (10-year and 30-year) for primary prevention of atherosclerotic cardiovascular disease per the 2026 ACC/AHA multisociety dyslipidaemia guideline. Covers inputs required, risk-category thresholds (low <3%, borderline 3–<5%, intermediate 5–<10%, high ≥10%), when to use the 30-year calculation (adults 30–59), and how PREVENT differs from the older Pooled Cohort Equations (lower risk estimates by 40–50%, race-agnostic). Use when a clinician asks what the 10-year ASCVD risk is, how to calculate PREVENT, PCE vs PREVENT, risk category for this patient, does my patient need a statin, 30-year risk calculation, primary prevention risk assessment. Grounded in the 2026 ACC/AHA multisociety dyslipidaemia guideline.
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On-demand "what's new" generator. Main context (which knows the impending change) writes keepachangelog-style entries to a fragment file at `.claude/state/whatsnew/<slug>.json` (gitignored, transient). An optional per-project `project.json → whatsnew.route_workflow` names a routing workflow that consumes the fragment and renders it wherever the project wants (a site page, a release body, a docs page). Not a workflow phase — it never blocks a commit, and it never writes `CHANGELOG.md` (that file is owned solely by semantic-release in CI).
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Contract document for the binding test verdict file at .claude/state/last_test_result. Format spec for callers (integrate, simplify, chore, the verify-tick worker) that inline the four mechanical operations. Not Skill-tool-invocable.
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Triage an incoming request — pick the workflow entry phase (intake / spec / tdd / chore) and record the workflow statefile that the Track Guard reads.
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Read-only release + backlog recap. Reports the last release, commits-since-tag classified by conventional-commit type with the semver bump they trigger and pushed-vs-origin state, the backlog bucketed (open/picked-up/dropped with epic parent→child nesting), the roadmap epics with their per-task tallies, and condensed open questions — then recommends the next pickup. One `cli.mjs recap` call returns all six recap keys. Invoke any time (on demand) to plan a release or choose the next thing to build; a compact form is also surfaced at session start. Not a workflow phase; never writes CHANGELOG; never starts or commits work.
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Decompose an approved spec into a dependency-ordered swarm plan — one task per component, each with an explicit write_set. Produces `.claude/state/swarm/<slug>.json` with tasks + waves. The wave scheduler guarantees pairwise-disjoint write_sets within each wave so parallel dispatch is provably conflict-free.
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Execute a swarm plan wave by wave with filesystem isolation via git worktrees. For each wave, main context decides the scenario recipe + implementation contract for every task, then spawns one swarm-worker per task in parallel. Each worker executes its recipe and reports JSON status. Worktree merge-audit verifies write-set discipline before changes land on main. Aborts remaining waves on any audit or task failure.
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Reconcile baseline-versioned files that the `create-baseline upgrade` CLI staged for LLM-assisted semantic merge. Use when the CLI prints "Open Claude Code and run /upgrade-project to reconcile". Reads the stage manifest at `.claude/state/upgrade/<ts>/manifest.json`, reasons through each pending file's three-way delta in main context, writes a reconciled LOCAL, then deletes the stage when every file lands. Supports `--dry-run` (preview the reconciled diff without writing) and a structured "needs-user-input" fallback when the conflict cannot be disambiguated automatically.
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Draft or revise English prose for any brief — documentation body, intake problem statements, spec context, RCA summaries, marketing copy, README sections, PR descriptions. Mandatorily invokes `Skill(humanizer)` as the final pass on every draft. Conditionally invokes `copywriting` for persuasive register, `documentation` for reference docs, `technical-tutorials` for tutorials. Used when any phase needs human-readable prose written or rewritten. Composition only — research and register-picking happen in the caller's context.
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Read-only view of the execution roadmap. Lists every epic with its per-status tallies, nests the still-open rows beneath their epic, collapses wholly-finished epics into one rollup line, and closes by naming the next planned task in file order. Four verbs — `list` (the reader's view), `tasks` and `epics` (filterable row and epic queries), `next` (the first planned task). Invoke any time to see what is left to build. Not a workflow phase; never writes; never starts or commits work.
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Phase 10.5 — move the slug's workflow artifacts (intake, scout, research, spec, approvals, swarm state, security reports, rendered diagrams) to docs/archive/<YYYY-MM-DD>/<slug>/. Runs before /commit so the committed tree is clean of work-in-flight files. workflow.json stays live and gets archived as the first step of /commit.
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Phase 10.6 — sync the project's execution roadmap (project.json → roadmap.path, default docs/roadmap-execution-plan.md) to the just-landed work. Flips the tasks named in workflow.json → roadmap_tasks[] from ⬜ to ✅ and promotes their epic headings ⬜→🟡→✅, preserving the standup parser format contract. On the epic track it appends instead — the epic's heading plus one row per slice — and stamps roadmap_epic back into the epic state. Also hosts the ad-hoc backfill that puts every epic already on disk onto the roadmap. Fail-open: never throws, no-ops when roadmap.path is unset/absent or no task matches, and never blocks a commit. Runs after /archive and before /memory-sync on every committing track.
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Propose the next dependency-ready sprint from the ALREADY-DECOMPOSED roadmap — standup's active sibling. Reads docs/roadmap-execution-plan.md + the memory backlog, computes per-task readiness from the roadmap's machine-readable status, orders with roadmap-planner's graph engine, and emits a proposed task-set (sprint-plan manifest shape) with per-feature done-criteria, excluding unready tasks and naming their unmet prerequisite. PROPOSES ONLY — the human confirms/edits before /triage routes it (typically to the `power` track). Distinct from `sprint-plan`, which decomposes a fresh vision.
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EXPERIMENTAL. Join or leave an org-team coordination channel as a session peer. `/companion on <channel_id> [peer_id]` registers this Claude Code session as a `pclass:"session"` peer and works the claim → execute → signal loop, escalating un-decidable forks to the lead (never deciding). `/companion off` deregisters. `/companion status` reports the current peer. Part of org mode (Article X), which is opt-in via `velocity.org_mode.enabled` and OFF by default. Use when a human launches a second session to act as a peer alongside a lead.
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Use ane for ALL file exploration, discovery, reading, and editing unless the user states otherwise. `ane exec <file> --chord "<chord>"` handles reads (Yank), searches (List), and edits (Change, Delete, Replace, Append, Prepend, Insert). Prefer ane over builtin file tools and shell utilities like grep, sed, and cat.
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。