「chi」の検索結果

This skill recommends that all patients with Cushing’s syndrome receive monitoring and adjunctive treatment for cortisol-dependent comorbidities including psychiatric disorders, diabetes, hypertension, hypokalemia, infections, dyslipidemia, osteoporosis, and poor physical fitness. Apply when managing any CS patient to address associated health issues; triggers include confirmed or suspected hypercortisolism, preoperative evaluation, postoperative follow‑up, or persistent hypercortisolism despite treatment.

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This skill directs lifelong treatment of cardiovascular risk factors, osteoporosis, and psychiatric symptoms in all patients with Cushing's syndrome until biochemical resolution of hypercortisolism. Use when managing any CS patient for long‑term comorbidity control; triggers include persistent hypertension, dyslipidemia, low bone density, depression, anxiety, or cognitive changes in the setting of known or suspected CS.

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This skill recommends educating patients and families about the clinical features of remission in Cushing's syndrome when a patient achieves biochemical remission after treatment. Use when a CS patient has postoperative normal cortisol levels, reports symptom improvement, and requires guidance on long-term expectations and monitoring for recurrence.

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This skill recommends obtaining a postoperative pituitary MRI within 1–3 months after successful transsphenoidal surgery (TSS) to establish a new baseline for future recurrence assessment. Use when a Cushing’s syndrome patient has achieved biochemical remission post‑TSS and is entering routine follow‑up.

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Recommends switching specific anti-hypertensive medications to reduce false-positive and false-negative screening results for primary aldosteronism. Triggered when a clinician notes 'The patient is on ACE inhibitors/ARBs' or suspects medication interference with screening results.

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Guides choice among spironolactone, eplerenone, and esaxerenone for primary aldosteronism based on comparative efficacy, safety, and patient-specific factors. Triggers include when initiating MRA therapy and asking 'Which MRA should I prescribe?' or considering switching agents due to adverse effects, cost, or need for potassium supplementation.

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Establishes age- and gender-specific blood pressure goals for pediatric patients with primary aldosteronism (PA) using published normative data to assess treatment adequacy and avoid over-treatment. Use when managing hypertension in children with PA to evaluate if BP is adequately controlled; triggers include pediatric PA hypertension, BP not normalized with glucocorticoid therapy, and need for age‑specific BP targets.

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Determines when to test for germline KCNJ5 mutations indicating familial hyperaldosteronism type III in very young patients with primary aldosteronism. Triggered by severe early-onset hypertension with hypokalemia in infants or young children (<20 years) with confirmed PA.

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Determines age- and body weight-appropriate glucocorticoid dosage for pediatric patients with primary aldosteronism, particularly glucocorticoid-remediable aldosteronism (GRA), to avoid over-treatment. Use when prescribing glucocorticoids to children with confirmed or suspected PA; triggers include pediatric PA, GRA, or need to dose glucocorticoid based on age and weight.

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Recommends fludrocortisone 100 µg daily for children with primary adrenal insufficiency and confirmed aldosterone deficiency; for infants under 12 months, adds sodium chloride supplementation. Triggered by PAI with aldosterone deficiency, evidenced by salt craving, hyponatremia, hyperkalemia, or elevated renin with low aldosterone.

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Determines follow‑up interval for patients with primary adrenal insufficiency (PAI) based on age: annual visits for adults and children, and every 3–4 months for infants. Triggered when establishing routine endocrine care after PAI diagnosis or during stable management.

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Recommends initiating hydrocortisone replacement at a total starting dose of 8 mg/m2 body surface area per day, given in three or four divided doses, for children with confirmed primary adrenal insufficiency (PAI). Use when starting glucocorticoid therapy in pediatric PAI patients, adjusting the dose according to individual clinical response, growth, and need for stress coverage.

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Recommends diagnostic testing to exclude primary adrenal insufficiency (PAI) in acutely ill patients presenting with otherwise unexplained volume depletion, hypotension, hyponatremia, hyperkalemia, fever, abdominal pain, hyperpigmentation, or hypoglycemia (especially in children). Use when clinical suspicion arises from these suggestive signs or symptoms suggestive of PAI.

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Diagnose monogenic and syndromic obesity in children and adolescents using a structured step-by-step algorithm. Use this skill whenever a clinician suspects a genetic cause of obesity, asks about leptin deficiency, MC4R mutation, POMC deficiency, PCSK1 deficiency, leptin receptor deficiency, Bardet-Biedl syndrome, Prader-Willi syndrome, Alström syndrome, or any case of early-onset severe obesity with hyperphagia. Also trigger for questions about targeted pharmacotherapy including setmelanotide or metreleptin, or when to order a genomic obesity panel. Cross-references the NHS Genomic Test Finder skill to surface the relevant R-code once a diagnosis is reached.

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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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Standard operating procedure for producing a documentation page end to end — gather source material, classify, draft against the measured corpus profile, then run the reader-level and humanizer passes and both gates. Use for any page on a documentation surface, or when rewriting a page that reads as machine-written. Orchestrates technical-writing, reader-level and humanizer in a fixed order.

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Write technical documentation that matches the measured profile of professionally-written docs. Carries the craft rules derived from 114k words of pre-2022 documentation (SQLite, PostgreSQL, Python, Django, Rust, Go, Pro Git, nginx), the per-Diátaxis-type numeric targets, and the copywriting register for page leads. Use when drafting or rewriting any documentation prose, or when a page is factually right but reads as machine-written.

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Write the production code that makes a pre-decided set of failing tests pass, within an explicit write_set, following an explicit behavior contract. Used by `/tdd` Step 3 and by `/swarm-dispatch` workers. The caller has already decided architecture, naming, file layout, and abstraction boundaries — this skill executes that recipe with code-structure discipline and a 5-iteration RALPH loop. No scope expansion, no design decisions, no test edits.

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Cross-consistency review of a drafted spec's diagrams. Verifies that C4 components appear in the dependency graph, class-diagram changes have matching DDL, every AC resolves to a concrete sequence, and the dependency graph is acyclic. Read-only. Run after `/spec-lint` passes and before implementation.

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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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Use when the user wants to design, redesign, shape, critique, audit, polish, clarify, distill, harden, optimize, adapt, animate, colorize, extract, or otherwise improve a frontend interface. Covers websites, landing pages, dashboards, product UI, app shells, components, forms, settings, onboarding, and empty states. Handles UX review, visual hierarchy, information architecture, cognitive load, accessibility, performance, responsive behavior, theming, anti-patterns, typography, fonts, spacing, layout, alignment, color, motion, micro-interactions, UX copy, error states, edge cases, i18n, and reusable design systems or tokens. Also use for bland designs that need to become bolder or more delightful, loud designs that should become quieter, live browser iteration on UI elements, or ambitious visual effects that should feel technically extraordinary. Not for backend-only or non-UI tasks.

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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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Workflow track for tasks that need no TDD — documentation edits, governance count bumps, vendored-skill content updates, configuration tweaks, formatting, typo fixes, dependency bumps where no project code changes. Skips `/scenario` and `/implement` (no failing test to drive) and runs the work directly. `archive`, `memory-sync`, `/grant-commit`, and `/commit` remain mandatory. `verify`, `simplify`, `integrate`, and `document` are conditional — required when the diff hits one of the listed triggers, optional otherwise. `verify` is skipped only when the diff is pure-docs/prose AND `project.json → test.kind` is `behavior` (absent/invalid `test.kind` → `structural` → verify runs). Chore is a stripped-down pipeline, not a bypass; never silently skip a conditional phase whose triggers apply.

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Write and maintain technical documentation. Trigger with "write docs for", "document this", "create a README", "write a runbook", "onboarding guide", or when the user needs help with any form of technical writing — API docs, architecture docs, or operational runbooks.

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。