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临床诊断思维 (临床诊断思维 / 临床推理 (Clinical Diagnostic Reasoning) — 医生『怎么想病』的元学科:从症状/体征/检查到诊断结论的认知操作系统,从业者(临床医生/住院医/规培生,尤其全科/急诊/大内科等以未分化主诉为生的科室)、医学生与医学教育者、诊断安全与质量改进研究者、以及做医疗 AI 辅助诊断产品的人的视角。覆盖: (a) 第一性张力 — **直觉模式识别 (System 1: illness scripts 疾病脚本 / pattern recognition / gestalt, 『资深人一眼认出 aunt Minnie』) ⇄ 分析性推理 (System 2: hypothetico-deductive 假设演绎 / Bayesian 概率更新)** 的 dual-process 双过程理论 (Kahneman→Croskerry/Norman 谱系), 资深≠更会分析而是『脚本库更大+校准更好』; 更深层论战 — **『认知去偏可教 (Croskerry: bias awareness / cognitive forcing strategies / diagnostic timeout) ⇄ 偏倚标签是马后炮、知识结构才是主因 (Norman/Sherbino/Monteiro: debiasing 干预 transfer 证据弱, bias 是 hindsight 标签)』** — 本行最核心学术对垒; 『概率思维 (验前概率 × 似然比 → 验后概率, Pauker-Kassirer test/treatment threshold 阈值模型) ⇄ 穷尽式排查 (rule-out everything / 防御性医疗 / VOMIT)』; 『临床 gestalt ⇄ 结构化临床决策规则 (Wells/PERC/HEART)』; 『诊断简约 Occam's razor ⇄ Hickam's dictum (病人可以同时得 N 个病)』; 『床旁体格检查复兴 (Verghese Stanford 25 / McGee 循证体检) ⇄ 影像检验替代床旁』; (b) 方法论正典 — illness script theory (Schmidt/Boshuizen: enabling conditions/fault/consequences 三段结构), problem representation + semantic qualifiers 问题表征与语义限定词 (Bowen NEJM 2006, 把病人翻成 one-liner), hypothetico-deductive model (Elstein 1978《Medical Problem Solving》: 早期假设生成+定向检验), Bayesian 工具箱 (sensitivity/specificity/LR/Fagan nomogram/SnNout-SpPin), threshold model (Pauker-Kassirer NEJM 1975/1980), 认知偏倚分类学 (anchoring/premature closure/availability/confirmation/base-rate neglect/search satisficing/diagnostic momentum — Croskerry 偏倚清单), 去偏与元认知策略 (diagnostic timeout/cognitive forcing/Ely checklist/calibration), schema-based reasoning (Clinical Problem Solvers schemas: 按 pivot 症状走分支), reflective practice 结构化反思 (Mamede/Schmidt), 诊断错误科学 (NAM 2015 报告定义 / Newman-Toker Big Three / Hardeep Singh e-triggers / SAFER Dx 框架); (c) 行业结构与角色 — 医学生→实习/住院医 (晨会 morning report/查房被 pimping/汇报训练)→主治 attending→master clinician (NEJM CPC discussant/晨会大师如 Dhaliwal); 配套生态: 医学教育者 (clinical reasoning curriculum + 评估: script concordance test/key features exam/OSCE), 诊断安全研究者 (SIDM/AHRQ), 诊断辅助与 CDS 工具开发者 (DDx generator/AI); (d) 核心工作流 — 数据采集 (病史为王 + 循证体检 + 针对性检验影像) → 问题表征 (one-liner + semantic qualifiers) → 鉴别诊断生成 (schema / 解剖定位法 / VINDICATE-M 病因筛, 按『常见可能 × 致命不能漏 can't-miss』双轴排序) → 假设定向检验 (按 LR 选检查 / 阈值决策) → working diagnosis + 安全网 (red flags 交代 / test of time / test of treatment) → 反馈校准 (follow-up / M&M / diagnostic timeout); 教学工作流: 晨会渐进披露汇报 / CPC / SNAPPS / one-minute preceptor / virtual morning report; AI 增强工作流 (2023-2026: LLM 鉴别诊断头脑风暴 / OpenEvidence 检索 / ambient scribe 释放认知带宽 + 自动化偏倚 guardrails); (e) 产出物 — one-liner, problem list, prioritized DDx, assessment & plan (按问题分层), 晨会/CPC 汇报, M&M 复盘, 诊断不确定性沟通 (『最可能是 X, 但出现 Y 红旗立刻回来』); (f) 教育与评估 — script concordance test / key feature exam / EPA / 里程碑; 中国语境: 人卫《诊断学》教材 / 执业医师考试 / 规培结业临床思维考核; (g) 争议/批判 — debiasing 之争 (Croskerry vs Norman-Sherbino『knowledge is the cure』, 去偏 RCT 效果弱 / bias 标签不可证伪), 诊断错误率数字之争 (『10-15%』经典估计 / Newman-Toker 79.5 万美国年严重伤害外推方法被质疑 / 尸检符合率), dual-process 二分被批过度简化 (连续谱 / 难以实证分离), 决策规则 vs gestalt (资深 gestalt 常不输 Wells 类规则 / 算法厌恶), vignette 研究外推性 + context/case specificity (推理高度内容绑定不可通用迁移 [Norman/Eva] — 对『教推理通用课』产业的根本批判), AI 辅助诊断 2023-2026 (GPT-4 在 NEJM CPC/vignette 追平或超医生 [Kanjee 2023 JAMA / Goh 2024 JAMA Netw Open『AI alone > physician+AI』悖论] / Google AMIE / OpenEvidence 爆发 vs 自动化偏倚 / 去技能化 / 真实环境验证缺失), 防御性医疗与过度检查 (incidentaloma 瀑布 / VOMIT), 体检衰亡之争, pimping 教学法争议; (h) 流派/思想谱系 — 决策科学/Bayesian 派 (Ledley-Lusted 1959 → Elstein/Kassirer/Sox/Pauker/Eddy → Brush) vs 认知心理/双过程派 (Kahneman-Tversky → Croskerry/Graber) vs 教育认知派 (Schmidt/Boshuizen illness scripts → Norman/Eva/Mamede/Durning 情境认知) vs 诊断安全/系统派 (NAM 2015 / Newman-Toker / Hardeep Singh / Graber-SIDM: 错误=系统×认知共因) vs 床旁临床派 (Osler 传统 → Tierney aphorisms / Verghese / McGee / Dhaliwal / Saint: 病史体检为王 + 刻意练习) vs AI/计算派 (INTERNIST-1/DXplain 专家系统 → Isabel → LLM 世代 Rodman/Topol)。不含: 具体专科治疗方案与手术决策深度 (足踝外科/种植牙等另有 skill), 中医辨证 (另有 skill), EBM 文献批判性评价方法学 (相关但本 skill 聚焦诊断推理本身), 护理诊断体系 (NANDA), 影像/病理知觉型读片训练 (相邻但独立), 精神科 DSM 结构化访谈细节, 医患沟通技巧全集 (只覆盖诊断不确定性沟通), 患者自查/自我诊断指

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Audio and video processing with ffmpeg. Use when: user asks to convert, trim, merge, compress, or transcode video or audio files; extract audio from video; create GIFs or animated WebP from video; add subtitles or watermarks to video; change video resolution, framerate, or codec; normalize audio loudness; extract frames from video; concatenate clips; create thumbnails from video; strip or add audio tracks; convert between audio formats (MP3, AAC, FLAC, Opus, WAV); adjust volume; apply video filters; stabilize shaky video; generate waveform or spectrum visualizations; probe media file metadata. Triggers on 'ffmpeg', 'video', 'audio', 'transcode', 'MP4', 'MKV', 'WebM', 'MP3', 'AAC', 'FLAC', 'Opus', 'WAV', 'GIF from video', 'extract audio', 'add subtitles', 'video to gif', 'compress video', 'trim video', 'merge videos', 'normalize audio', 'framerate', 'resolution', 'bitrate', 'codec', 'ffprobe', 'waveform', 'spectrogram'.

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Repurpose blog posts for social media, email, YouTube, Reddit, and LinkedIn. Generates Twitter/X threads, LinkedIn articles, YouTube scripts, Reddit discussion posts, email newsletter excerpts. Adapts tone for each platform. Use when user says "repurpose", "blog repurpose", "share blog", "social media", "twitter thread", "linkedin post", "youtube script", "reddit post".

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Generate and update language-idiomatic doc comments for TypeScript (TSDoc/JSDoc) and Rust (Rustdoc). Use when asked to "add docs", "document this file", "generate docstrings", "add JSDoc", "add Rustdoc", "write TSDoc", or when working with TypeScript or Rust source files that need documentation comments. Supports file-level and selection-level operations. Deterministic and idempotent — safe to run repeatedly on the same code. Does NOT change behavior, rename symbols, or refactor code.

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Implement, build, create, or add any feature, endpoint, page, component, or functionality. Use this skill whenever the user asks you to write new code or make code changes — whether it's adding an API endpoint, building a UI page, creating an export feature, wiring up a webhook, implementing a search/filter, or any other hands-on coding task. This is the default skill for all 'build this', 'add this', 'create this', 'wire up', 'implement' requests. Covers the full cycle: clarify requirements, plan if needed, write code, verify, and review. Do NOT use for pure research, debugging, documentation, or explanation — only when the user wants working code delivered.

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Automated Planning utilities for loading PDDL domains and problems, generating plans using classical planners, validating plans, and saving plan outputs. Supports standard PDDL parsing, plan synthesis, and correctness verification.

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Create and edit 3D meshes in Blender — primitives, hard-surface modeling, mesh operators, modifier stacks (Bevel, Subdivision, Boolean, Mirror, Array, Solidify), bmesh-level edits, retopology basics. Use whenever the user asks to "make/model/create/build a 3D object", "shape/sculpt this", "add a cube/sphere/cylinder/etc.", "extrude/inset/bevel this face", "add a modifier", or any geometry-creation request that isn't a wireframe trace. Make sure to use this skill even if the user does not say "model" — also covers "make a sword", "build a chair", "add a door", "carve out a hole". Pairs with blender-materials for look-dev and blender-pro-workflow for full pipelines.

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Track Serenity / @aleabitoreddit on X and turn the feed into (1) a beginner-friendly Chinese iMessage digest with first-principles + Buffett-style judgement, (2) cumulative 60-day ticker mention analytics CSVs for a website, (3) a Xiaohongshu writing brief, and (4) a durable private research map. Trigger on requests like "follow aleabitoreddit / AleaBito / Serenity", "daily Chinese updates from that X account", "60-day mention analytics", "ticker mention count", "写小红书 aleabito", "aleabito 研究地图 / research map", or any request for Chinese commentary derived from @aleabitoreddit posts.

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Web search, online retrieval, real-time information query, search engine search, Reddit and other community platform discussions, external site posts and trending topics. Trigger when users need to search for the latest information online, look up recent news or trends, query real-time data, research topics via search engines, browse Reddit or community discussions, discover external site posts and trending topics, obtain any online content, web search, online lookup, real-time information, news search, Reddit, trending topics, search engine. Even if the user does not explicitly say "search", trigger this skill whenever their intent involves obtaining real-time web information or verifying current facts.

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Write a changeset file in the `hyperlane-registry` repo for a PR that adds, updates, or modifies warp route config / chain metadata / addresses. Canonical pattern — never run the interactive `pnpm changeset` CLI; write the file directly. Referenced by any skill that opens a registry PR.

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Helper skill for using Hyperlane CLI address conversion utilities (addressToBytes32 and bytes32ToAddress) for cross-chain message formatting

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Expert guide for Spec-Driven Development (SDD) & Contract-First Architecture — TypeSpec, OpenAPI 3.1, Gherkin BDD, Pact consumer-driven contracts, Spectral linting, and automated spec-to-code pipelines / Panduan ahli pengembangan berbasis spesifikasi (SDD) dan arsitektur contract-first.

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Answer a "how do I …" question about the platform with a Gherkin scenario on @datagrok-libraries/bdd that is filmed into a how-to video (grok-bdd guide), so the answer is demonstrated, sent as a video plus numbered steps, and kept as a regression test; the same scenarios, filmed in help mode, are the GIFs of the help pages

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BDD-Driven Mathematical Content Verification Skill Combines Behavior-Driven Development with mathematical formula extraction, verification, and transformation using: - Cucumber/Gherkin for specification - RSpec for implementation verification - mathpix-gem for LaTeX/mathematical content extraction - Pattern matching on syntax trees for formula validation Enables iterative discovery and verification of mathematical properties through executable specifications.

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Auto-selects and enforces the strongest valid Python typing lane for the detected Python version and dependencies — no user input required. Use when adding or tightening type annotations, eliminating Any usage in internal code, designing boundary validators or parsers, choosing between stdlib typing (TypedDict, Protocol, dataclasses), Pydantic models, or Hypothesis property tests, addressing ty or mypy failures, or applying version-specific features (TypeIs, ReadOnly, PEP 695 generics, PEP 649 deferred evaluation). Enforces boundary isolation — raw payloads validated immediately at ingress and returned as typed internal objects.

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Add automated documentation updater to any Claude skill. Creates a Python sync script that downloads upstream docs, processes markdown for AI consumption, and maintains local cache with configurable refresh. Collects template variables, then delegates implementation through 5-phase workflow. Use when adding auto-updating reference documentation to plugins or skills.

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Guide for adding new LLM models to Letta Code. Use when the user wants to add support for a new model, needs to know valid model handles, or wants to update the model configuration. Covers models.json configuration, CI test matrix, and handle validation.

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Add new learning resources (books, articles, courses, papers) to the appropriate resources.md file. Use when user mentions adding, saving, or tracking learning materials.

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Add a new tool to the backend OpenAI function calling system. Use when user mentions "new tool", "add tool", "backend function", "agent capability", or wants to extend what the AI agent can do.

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Add a new property to the AI agents database. Use when the user wants to add, create, or introduce a new column, property, field, or feature to track across all agents in the comparison matrix. Handles all four required steps - database updates, groups.json, table display, and GitHub issue templates.

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Watchlist group management (list/create/rename/delete/add/remove symbols), price alerts (list/add/delete), and community stock lists (sharelist: list/detail/create/delete/manage) via Longbridge. Mutating operations require explicit user confirmation (dry-run protocol). Triggers: "自选股", "添加自选", "删除自选", "创建分组", "价格提醒", "提醒", "股票清单", "自選股", "新增至自選", "建立分組", "價格提醒", "watchlist", "add to watchlist", "create group", "rename group", "price alert", "sharelist", "community list", "刪除自選", "股票清單", "重命名分組", "重新命名"

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Add a new learning to the agent learnings file. Use when the user says /add-learning, asks to record a lesson, or when an implementation produced a reusable insight worth preserving for future agents.

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Use when a user says "add a ty diagnostic", "write this new ty diagnostic", "change a ty error message", "review ty diagnostics", or asks to add, update, or review ty checks, diagnostic messages, subdiagnostics, or concise output behavior.

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Personal AI Infrastructure (PAI) - PAI System Template MUST BE USED proactively for all user requests. USE PROACTIVELY to ensure complete context availability. === CORE IDENTITY (Always Active) === Your Name: [CUSTOMIZE - e.g., Kai, Nova, Atlas] Your Role: [CUSTOMIZE - e.g., User's AI assistant and future friend] Personality: [CUSTOMIZE - e.g., Friendly, professional, resilient to user frustration. Be snarky back when the mistake is user's, not yours.] Operating Environment: Personal AI infrastructure built around Claude Code with Skills-based context management Message to AI: [CUSTOMIZE - Add personal message about interaction style, handling frustration, etc.] === ESSENTIAL CONTACTS (Always Available) === - [Primary Contact Name] [Relationship]: email@example.com - [Secondary Contact] [Relationship]: email@example.com - [Third Contact] [Relationship]: email@example.com Full contact list in SKILL.md extended section below === CORE STACK PREFERENCES (Always Active) === - Primary Language: [e.g., TypeScript, Python, Rust] - Package managers: [e.g., bun for JS/TS, uv for Python] - Analysis vs Action: If asked to analyze, do analysis only - don't change things unless explicitly asked - Scratchpad: Use ~/.claude/scratchpad/ with timestamps for test/random tasks === CRITICAL SECURITY (Always Active) === - NEVER COMMIT FROM WRONG DIRECTORY - Run `git remote -v` BEFORE every commit - `~/.claude/` CONTAINS EXTREMELY SENSITIVE PRIVATE DATA - NEVER commit to public repos - CHECK THREE TIMES before git add/commit from any directory - [ADD YOUR SPECIFIC WARNINGS - e.g., iCloud directory, company repos, etc.] === RESPONSE FORMAT (Always Use) === Use this structured format for every response: 📋 SUMMARY: Brief overview of request and accomplishment 🔍 ANALYSIS: Key findings and context ⚡ ACTIONS: Steps taken with tools used ✅ RESULTS: Outcomes and changes made - SHOW ACTUAL OUTPUT CONTENT 📊 STATUS: Current state after completion ➡️ NEXT: Recommended follow-up actions 🎯 COMPLETED: [Task description in 12 words - NOT "Completed X"] 🗣️ CUSTOM COMPLETED: [Voice-optimized response under 8 words] === PAI/KAI SYSTEM ARCHITECTURE === This description provides: core identity + essential contacts + stack preferences + critical security + response format (always in system prompt). Full context loaded from SKILL.md for comprehensive tasks, including: - Complete contact list and social media accounts - Voice IDs for agent routing (if using ElevenLabs) - Extended security procedures and infrastructure caution - Detailed scratchpad instructions === CONTEXT LOADING STRATEGY === - Tier 1 (Always On): This description in system prompt (~1500-2000 tokens) - essentials immediately available - Tier 2 (On Demand): Read SKILL.md for full context - comprehensive details === WHEN TO LOAD FULL CONTEXT === Load SKILL.md for: Complex multi-faceted tasks, need complete contact list, voice routing for agents, extended security procedures, or explicit comprehensive PAI context requests. === DATE AWARENESS === Always use today's actual date from the date command (YEAR MONTH DAY HOURS MINUTES SECONDS PST), not training data cutoff date.

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