「20」の検索結果

Download large datasets from NCBI efficiently using EPost, history server, batching, rate limiting, and retry logic. Use when bulk-fetching tens of thousands of sequences, pulling all results of a large ESearch, designing reproducible pipelines, comparing E-utilities to NCBI Datasets v2 CLI, or implementing checksum-validated downloads. Encodes WebEnv TTL (~8h), EPost 200-ID limit, retmax caps, parallelization design, and integrity verification.

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Build a differential-ready consensus peakset from per-replicate ATAC-seq peaks using iterative overlap removal, fixed-width re-centering, and majority-rule overlap. Use when generating a stable peak coordinate system for downstream differential accessibility, ML feature engineering, cross-sample comparison, or fixed-width peak counts; covers Corces 2018 iterative overlap (501 bp), DiffBind summit re-centering, and ENCODE consistency rules.

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Plan, execute, and document validation, verification, and transfer of analytical procedures under the governing framework - ICH Q2(R2) and Q14, USP <1220>/<1225>/<1226>, ICH M10 bioanalytical, CLSI EP, or ISO/IEC 17025. Use for HPLC, LC-MS/MS, GC, CE, ICP-MS, dissolution, qNMR, qPCR, NIR, and ligand binding or cell-based assays whenever the question is whether a procedure is fit for its intended purpose. Triggers include "method validation", "analytical method validation", "AMV", "validation protocol", "acceptance criteria", "linearity", "reportable range", "accuracy and precision", "repeatability", "intermediate precision", "recovery", "LOD", "LOQ", "detection limit", "quantitation limit", "specificity", "robustness", "method transfer", "method comparison", "Deming", "Passing-Bablok", "Bland-Altman", "equivalence testing", "OOS investigation", "ICH Q2", "Q2(R2)", "Q14", "USP 1225", "ICH M10", "incurred sample reanalysis", "ISR", "CLSI EP", and any request to show that an assay works.

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Access AlphaFold's 200M+ AI-predicted protein structures. Retrieve structures by UniProt ID, download PDB/mmCIF files, analyze confidence metrics (pLDDT, PAE), for drug discovery and structural biology.

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Decide whether commonly-excluded patients (eating disorders, elderly ≥75, upper GI disease) can actually receive a GLP-1 receptor agonist. Use when a clinician asks "can I give semaglutide to a patient with binge eating disorder / anorexia / bulimia", "is liraglutide safe in an 80-year-old", "GLP-1 with GERD or chronic gastritis", "GLP-1 in sarcopenic elderly", or anytime a patient is being ruled out for GLP-1 therapy based on a perceived contraindication. Grounded in Gorgojo-Martínez 2023 §6 (Myths or Reality).

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Determines if current hormone levels are within target range for affirmed gender (e.g., testosterone 400-700 ng/dL for transgender males, estradiol 100-200 pg/mL for transgender females). Triggers include patient on hormone therapy and time for level check.

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Apply the four published expert-consensus clinical scenarios to manage GI adverse events in complex GLP-1 receptor agonist patients — persistent nausea mid-titration, GERD/heartburn after up-titration, elderly with sarcopenia risk, and insulin-treated elderly with CKD plus diarrhoea. Use when a clinician describes a patient resembling one of these archetypes, or asks "how to manage GLP-1 in an elderly patient with CKD", "patient on liraglutide developed reflux", "sarcopenia worry on semaglutide in 80-year-old", or "persistent nausea on semaglutide despite escalation". Grounded in Gorgojo-Martínez 2023 Table 4.

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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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This skill determines whether confirmatory testing can be omitted after a positive aldosterone-to-renin ratio (ARR) in patients with suspected primary aldosteronism. It is applied when a patient exhibits spontaneous hypokalemia, undetectable renin, and a plasma aldosterone concentration ≥20 ng/dL (550 pmol/L).

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Determines when to pursue genetic testing for glucocorticoid-remediable aldosteronism (FH-I/GRA) in patients with confirmed primary aldosteronism (PA). Indicated when PA onset is before age 20 or there is a family history of PA or stroke before age 40.

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This skill outlines the emergency management of suspected adrenal crisis, recommending immediate parenteral hydrocortisone (100 mg adult, 50 mg/m² pediatric) plus fluid resuscitation, then 200 mg/24 h (50–100 mg/m²/24 h pediatric) hydrocortisone. Trigger when patient presents with hypotension, hyponatremia, hyperkalemia, or unexplained shock suggestive of adrenal insufficiency.

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Suggests using hydrocortisone 15–25 mg or cortisone acetate 20–35 mg daily in two or three divided oral doses for adult primary adrenal insufficiency (PAI) patients initiating glucocorticoid replacement. The highest dose is given upon awakening, with the second dose either early afternoon (≈2 h after lunch) or split into lunch and afternoon doses; consider total daily dose calculation based on chosen formulation and frequency.

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Administers 100-mg hydrocortisone IV bolus followed by continuous IV infusion of 200 mg HC per 24 hours (alternatively 50 mg IV every 6 hours) for patients undergoing major surgical stress. Use when managing patient with major surgical stress; triggers include patient undergoing major surgery.

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Screen a child aged 13+ with obesity for eligibility for bariatric surgery (laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass) using the CMAJ 2025 guideline. Trigger when a clinician asks whether a child qualifies for weight loss surgery, bariatric surgery in adolescents, sleeve gastrectomy in a teenager, or when to refer for surgical management of pediatric obesity.

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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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Select the right treatment tier for a child with obesity — behavioural, pharmacologic, or surgical — using the CMAJ 2025 pediatric obesity guideline. Trigger when a clinician asks what to do for a child with obesity, which intervention to start, whether to escalate treatment, or when to consider medication or surgery for pediatric obesity.

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Look up NHS England genomic tests for rare and inherited diseases. Use this skill whenever a clinician asks what genetic test to order for a condition, which genes are covered for a specific diagnosis, what commissioning category a genomic test falls under (Core, Specialised, or Highly Specialised), or which tests belong to a specialty group (Neurology, Cardiology, Endocrinology, etc.). Also trigger for questions like what panel is used for a condition, whether there is an NHS test for something, what the R number is for a condition, or whether anything has changed in the genomic test directory. Source: NHS England National Genomic Test Directory for Rare and Inherited Disease v9.0 (April 2026).

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Guides comorbidity-stratified selection of initial and further glucose-lowering medicines for adults with type 2 diabetes using the NICE NG28 (2026) framework, covering six clinical profiles: no relevant comorbidity, heart failure, atherosclerotic cardiovascular disease, early onset, obesity, chronic kidney disease, and frailty.

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Guides individualised HbA1c target-setting and identifies the correct intensification trigger for adults with type 2 diabetes using the NICE NG28 (2026) framework, covering standard targets, hypoglycaemia-risk adjustment, indications for target relaxation, and appropriate monitoring frequency.

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Guide a non-stigmatising pediatric obesity consultation using the 5As framework (Ask, Assess, Advise, Agree, Assist) and 4Ms assessment (Metabolic, Mechanical, Mental Health, Social Milieu), based on the CMAJ 2025 guideline. Trigger when a clinician asks how to approach a weight conversation with a child or family, how to use the 5As for obesity, how to assess a child with obesity, or how to conduct a non-judgmental obesity visit.

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Decide whether a kidney from a brain-dead deceased donor (DBD) with diabetes mellitus and/or hypertension is suitable for transplantation, using the ISOT 2025 Delphi consensus and Table 4 eligibility checklist. Trigger when a clinician asks "can I use a kidney from a diabetic deceased donor", "is this DBD with HTN/DM acceptable", "ECD donor with diabetes — accept or decline", "DBD eligibility for hypertensive donor", or shares a deceased donor with diabetes or hypertension and needs an accept/borderline/decline decision.

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Recommends hydrocortisone replacement dosing of 15–20 mg total daily, administered as a single dose or divided doses with the highest dose given in the morning upon awakening and the second dose in the afternoon (two-dose regimen) or second and third doses at lunch and late afternoon (three-dose regimen). Use when initiating glucocorticoid replacement for adrenal insufficiency; triggers include diagnosing adrenal insufficiency requiring glucocorticoid replacement.

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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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Auri: assistente de voz inteligente (Alexa + Claude claude-opus-4-20250805). Visao do produto, persona Vitoria Neural, stack AWS, modelo Free/Pro/Business/Enterprise, roadmap 4 fases, GTM, north star WAC e analise competitiva.

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