All Skills

Use this skill when the user asks about refrigerated (reefer) trucking — cold chain compliance, FDA temperature recording requirements, Sanitary Transportation Rule (STR / 21 CFR 1.900-1.934), commodity-specific temperature ranges, refrigeration unit operation, temperature recorder calibration, and how a load is challenged if temperature deviates. Cite 21 CFR Part 1 Subpart Q.

Use this skill when referring a driver to SAP after a positive test or refusal. Covers SAP selection, the evaluation/treatment cycle, return-to-duty test, and follow-up testing schedule.

Use this skill when a driver wants to use a CMV for personal travel after duty hours. Covers what qualifies as legitimate personal conveyance vs. work-related driving, FMCSA guidance on lodging/meals/home travel, and documentation requirements.

Use this skill when the user asks about weigh-station bypass services — Drivewyze, PrePass, BestPass, NORPASS, OOIDA toll savings — how they work, eligibility criteria, costs, and how they tie into CSA scores. Reference each provider's coverage area + pricing.

Audit, write, or revise .vale.ini, or work through vale findings on a repo. Use when adding Vale, troubleshooting silent passes or noisy findings, evolving config, or applying the suggestion → warning → error cleanup cascade after a vale run (interactive or pre-commit failure). Applies the two-hook pre-commit pattern (sync + lint), explicit Packages and per-format BasedOnStyles, scoping/ignores for false positives, and a shared accept.txt vocabulary.

Audit, write, or revise renovate.json. Use when adding Renovate, troubleshooting unexpected (or missing) update PRs, hardening against supply-chain attacks, or evolving an existing config.

Relate GitHub issues and PRs — pick the right edge type (blocked-by via GraphQL, parent/sub-issue, Closes/Fixes in PR body, plain mention) and apply it. Use when asked to link, block, depend on, make a subtask of, or close-on-merge.

Plan a multi-file refactor with proper sequencing and rollback steps

Triage and resolve Debian Linux issues with apt, systemd, and AppArmor-aware guidance.

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).

Select oral and injectable glucose-lowering agents for a newly diagnosed patient with type 2 diabetes using a compelling-indication hierarchy (heart failure → ASCVD → DKD → obesity) followed by glucose-pattern matching. Incorporates modern GLP-1 receptor agonists — Ozempic (semaglutide SC, T2D), Mounjaro (tirzepatide), and Wegovy/Noveltreat (semaglutide 2.4 mg, obesity). Use when a clinician asks "what drug to start for newly diagnosed T2D", "which OAD to use", "first-line diabetes medication", "SGLT2i vs GLP-1 in new T2D", or presents a newly diagnosed T2D patient needing a personalised medication plan.

Titrates GH replacement dose to keep IGF-1 below the upper limit of normal and reduces dose when side effects appear. Use when monitoring GH replacement therapy; triggers include patient on GH replacement needing dose adjustment.

Calculate the Maryland Aggregate Pathology Index (MAPI) on a deceased donor procurement kidney biopsy to predict graft survival and decide single vs dual vs discard allocation. Trigger when a clinician asks "what's the MAPI score", "interpret donor kidney biopsy", "should I use this marginal kidney", "MAPI cutoff for transplant", "procurement biopsy scoring", or has histology results from a deceased donor kidney and needs an objective grading.

Interprets the saline infusion test (SIT) to assess the probability of primary aldosteronism when a patient has a positive aldosterone-to-renin ratio (ARR) and requires confirmatory testing. Triggers include evaluating post‑infusion plasma aldosterone concentration (PAC) after a positive ARR, hypertension work‑up, or when deciding whether to proceed to adrenal venous sampling (AVS).

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.

This skill suggests using approved weight‑loss medication over no pharmacological therapy to ameliorate comorbidities and improve physical activity in adults with BMI ≥30 kg/m² or BMI ≥27 kg/m² with at least one comorbid condition. It is triggered when a clinician asks, for example, 'Should I add medication to help maintain weight loss in this patient with BMI 31 and diabetes?' or 'Is pharmacotherapy appropriate for long‑term weight control in a patient with BMI 28 and hypertension?'.

This skill recommends computed tomography (CT) as the initial imaging modality for primary aldosteronism (PA) evaluation in Japan, citing its accessibility and comparable performance to MRI. It is triggered when a clinician orders imaging for suspected PA and asks 'What imaging should I start with?' or seeks a cost-effective initial evaluation.

Recommends administering stress-dose glucocorticoids before surgery and tapering after surgery in patients with adrenal insufficiency before repeat testing. Triggers include preoperative planning for surgery in a patient with known or suspected adrenal insufficiency.

Recommends a shared decision‑making process that provides patients with quantitative estimates of the expected weight effect of antidepressants to inform drug choice, also considering expected treatment length. Triggers include clinician questions such as ‘How should I discuss weight‑change risks with this patient starting an antidepressant?’ or ‘What tool can I use to show expected weight impact of sertraline vs bupropion?’.

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.

Advises assessing efficacy and safety at least monthly for the first 3 months, then at least every 3 months for all patients prescribed weight‑loss medications. Triggers include clinician questions such as “How often should I check progress after starting orlistat?” or “What is the follow‑up schedule for a patient on liraglutide?”.

This skill determines whether serum insulin-like growth factor-1 (IGF-I) levels alone can be used to diagnose growth hormone deficiency (GHD) in childhood cancer survivors exposed to hypothalamic-pituitary axis radiotherapy. Triggers include questions such as “Can I rely on IGF-I alone to diagnose GHD after cranial radiation?” or “Is IGF-I sufficient for GHD assessment post-HP RT?”

Recommends measurement of plasma ACTH to establish primary adrenal insufficiency (PAI) diagnosis in patients with confirmed cortisol deficiency; a plasma ACTH concentration ≥2-fold the upper limit of the reference range supports PAI. Use when evaluating plasma ACTH in a patient with low morning cortisol or abnormal corticotropin stimulation test.

Provides guidance on acceptable blood sampling conditions for primary aldosteronism screening when ideal early‑morning supine fasting conditions cannot be met. Triggers include when a clinician says “The patient wasn’t fasting/supine” or questions whether non‑ideal sampling affects screening validity.

This skill guides selection of an appropriate provocative test for growth hormone deficiency (GHD) diagnosis in childhood cancer survivors when clinicians ask, "What test should I use to diagnose GHD in this survivor?" or "Which provocative test is appropriate for GHD evaluation?" It recommends using the same testing modalities as in the noncancer population, tailored to patient-specific contraindications.

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Recommends careful DDAVP and fluid intake titration including frequent weighing and serum sodium level monitoring for adipsic diabetes insipidus. Use when managing adipsic DI requiring fluid balance management.

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.

Determines whether to screen a patient with hypertension for primary aldosteronism based solely on the presence of hypertension. Use when a clinician asks whether to screen a hypertensive patient for PA, triggered by phrases such as "should we screen for aldosteronism" or "evaluate for secondary hypertension".

Use when the task involves reading, creating, or editing `.docx` documents, especially when formatting or layout fidelity matters; prefer `python-docx` plus the bundled `scripts/render_docx.py` for visual checks.

ElevenLabs text-to-speech with mac-style say UX.

Parallel/distributed computing. Scale pandas/NumPy beyond memory, parallel DataFrames/Arrays, multi-file processing, task graphs, for larger-than-RAM datasets and parallel workflows.

iMessage/SMS CLI for listing chats, history, watch, and sending.

Remote-control tmux sessions for interactive CLIs by sending keystrokes and scraping pane output.

Facebook's library for efficient similarity search and clustering of dense vectors. Supports billions of vectors, GPU acceleration, and various index types (Flat, IVF, HNSW). Use for fast k-NN search, large-scale vector retrieval, or when you need pure similarity search without metadata. Best for high-performance applications.

Run Python code in the cloud with serverless containers, GPUs, and autoscaling. Use when deploying ML models, running batch processing jobs, scheduling compute-intensive tasks, or serving APIs that require GPU acceleration or dynamic scaling.