Orris

Make a power point presentation for me as JR1 JC presentation

Reading File
Reading File
Reading File
Running Command

python3 -c " import pdfplumber pdf_path = '/home/daytona/workspace/attachments/522ee521-c822-4b85-8834-5f96e07304c0/feasibility_and_outcomes_of_laparoscopic.12.pdf' with pdfplumber.open(pdf_path) as pdf: print(f'Total pages: {len(pdf.pages)}') for i, page in enumerate(pdf.pages): text = page.extract_text() print(f'\\n===PAGE {i+1}===') print(text) "

Running Command

mkdir -p /home/daytona/workspace/jc-presentation && ls /home/daytona/workspace/jc-presentation/

Writing File

~/jc-presentation/create_pptx.js

const pptxgen = require("pptxgenjs");

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Laparoscopy in Perforation Peritonitis – JR1 Journal Club";

// ─── THEME ───────────────────────────────────────────────────────────────────
const C = {
  navy:    "0D2137",
  teal:    "1A7A6E",
  tealLt:  "25B59E",
  gold:    "E8A020",
  white:   "FFFFFF",
  offWhite:"F4F7F9",
  grey:    "8C9BAB",
  greyLt:  "D6DFE8",
  dark:    "111B24",
  red:     "C0392B",
  green:   "1E8B60",
  orange:  "D4750F",
};

// helper: horizontal rule
function addRule(slide, y) {
  slide.addShape(pres.ShapeType.rect, { x: 0.5, y, w: 9, h: 0.03, fill: { color: C.tealLt }, line: { color: C.tealLt } });
}

// helper: section badge
function addBadge(slide, label, x, y, w) {
  slide.addShape(pres.ShapeType.rect, { x, y, w: w || 2.2, h: 0.32, fill: { color: C.teal }, line: { color: C.teal }, rectRadius: 0.05 });
  slide.addText(label, { x, y, w: w || 2.2, h: 0.32, fontSize: 9, bold: true, color: C.white, align: "center", valign: "middle" });
}

// helper: stat box
function statBox(slide, label, value, unit, x, y, w, h, accent) {
  slide.addShape(pres.ShapeType.rect, { x, y, w, h, fill: { color: C.offWhite }, line: { color: accent || C.teal, pt: 2 }, rectRadius: 0.08 });
  slide.addText(value, { x, y: y + 0.08, w, h: h * 0.55, fontSize: 26, bold: true, color: accent || C.teal, align: "center", valign: "middle" });
  slide.addText(unit, { x, y: y + h * 0.52, w, h: h * 0.22, fontSize: 9, color: C.grey, align: "center", valign: "top" });
  slide.addText(label, { x, y: y + h * 0.72, w, h: h * 0.28, fontSize: 9.5, bold: true, color: C.navy, align: "center", valign: "middle" });
}

// helper: dark section divider slide
function dividerSlide(label) {
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.navy }, line: { color: C.navy } });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 2.4, w: 10, h: 0.06, fill: { color: C.tealLt }, line: { color: C.tealLt } });
  s.addText(label, { x: 0.5, y: 1.7, w: 9, h: 1.2, fontSize: 36, bold: true, color: C.white, align: "center", valign: "middle", charSpacing: 2 });
  return s;
}

// helper: slide with standard header
function contentSlide(title, badge) {
  const s = pres.addSlide();
  // left accent bar
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.06, h: 5.625, fill: { color: C.teal }, line: { color: C.teal } });
  // header background
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.95, fill: { color: C.navy }, line: { color: C.navy } });
  // slide title
  s.addText(title, { x: 0.25, y: 0, w: 9.5, h: 0.95, fontSize: 20, bold: true, color: C.white, valign: "middle", margin: 8 });
  // background
  s.addShape(pres.ShapeType.rect, { x: 0.06, y: 0.95, w: 9.94, h: 4.675, fill: { color: C.offWhite }, line: { color: C.offWhite } });
  if (badge) addBadge(s, badge, 7.5, 0.65, 2.3);
  return s;
}

// =============================================================================
// SLIDE 1 – TITLE
// =============================================================================
{
  const s = pres.addSlide();
  // full dark background
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.navy }, line: { color: C.navy } });
  // teal accent stripe
  s.addShape(pres.ShapeType.rect, { x: 0, y: 3.6, w: 10, h: 0.08, fill: { color: C.tealLt }, line: { color: C.tealLt } });
  // gold top stripe
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.08, fill: { color: C.gold }, line: { color: C.gold } });

  s.addText("JR1 Journal Club", { x: 0.6, y: 0.25, w: 8.8, h: 0.45, fontSize: 13, bold: true, color: C.gold, charSpacing: 3 });
  s.addText("Feasibility and Outcomes of Laparoscopic Management in Perforation Peritonitis", {
    x: 0.6, y: 0.75, w: 8.8, h: 1.8, fontSize: 28, bold: true, color: C.white, valign: "middle", align: "left"
  });
  s.addText("A Prospective Cohort Study with Propensity Score Matching", {
    x: 0.6, y: 2.45, w: 8.8, h: 0.5, fontSize: 14, italic: true, color: C.tealLt
  });
  addRule(s, 3.1);
  s.addText("Soni S, Parihar YK, Chaudhary R, et al.  |  Journal of Minimal Access Surgery 2026; 22(2):180–186", {
    x: 0.6, y: 3.25, w: 8.8, h: 0.38, fontSize: 10.5, color: C.greyLt
  });
  s.addText("AIIMS Jodhpur  |  Prospective Cohort  |  Jan 2022 – May 2023", {
    x: 0.6, y: 3.62, w: 8.8, h: 0.32, fontSize: 10.5, color: C.grey
  });
  s.addText("Presented by: JR1  |  Date: " + new Date().toLocaleDateString("en-GB", { day:"2-digit", month:"short", year:"numeric" }), {
    x: 0.6, y: 4.9, w: 8.8, h: 0.38, fontSize: 10.5, color: C.grey, italic: true
  });
}

// =============================================================================
// SLIDE 2 – OUTLINE
// =============================================================================
{
  const s = contentSlide("Presentation Outline", "Overview");
  const items = [
    ["01", "Background & Introduction", "Why is perforation peritonitis a challenge?"],
    ["02", "Study Design & Methods",    "Prospective cohort, PSM, inclusion/exclusion"],
    ["03", "Key Results",               "Operative time, hospital stay, pain, morbidity"],
    ["04", "Discussion",                "Conversion rate, learning curve, context"],
    ["05", "Conclusion & Appraisal",    "Strengths, limitations, take-home message"],
  ];
  items.forEach(([num, title, sub], i) => {
    const y = 1.1 + i * 0.83;
    s.addShape(pres.ShapeType.rect, { x: 0.35, y, w: 0.52, h: 0.52, fill: { color: C.teal }, line: { color: C.teal }, rectRadius: 0.05 });
    s.addText(num, { x: 0.35, y, w: 0.52, h: 0.52, fontSize: 13, bold: true, color: C.white, align: "center", valign: "middle" });
    s.addText(title, { x: 1.05, y: y + 0.02, w: 8.5, h: 0.28, fontSize: 13.5, bold: true, color: C.navy });
    s.addText(sub,   { x: 1.05, y: y + 0.28, w: 8.5, h: 0.22, fontSize: 10.5, color: C.grey });
  });
}

// =============================================================================
// SLIDE 3 – BACKGROUND
// =============================================================================
{
  const s = contentSlide("Background", "Introduction");
  s.addText("Perforation Peritonitis: The Problem", { x: 0.35, y: 1.05, w: 9.3, h: 0.38, fontSize: 15, bold: true, color: C.navy });

  const pts = [
    "Common emergency surgical admission — significant cause of worldwide morbidity and mortality",
    "Caused by gastrointestinal perforation → severe intra-abdominal infection",
    "Most patients present haemodynamically unstable, requiring urgent surgery",
    "Most common cause: peptic ulcer disease (PUD), followed by ileal and appendicular perforation",
    "Traditional standard of care: open laparotomy (e.g., Graham's patch repair for PUD)",
  ];
  s.addText(pts.map(p => ({ text: p, options: { bullet: { code: "2022" }, breakLine: true, paraSpaceAfter: 6 } })),
    { x: 0.5, y: 1.52, w: 5.7, h: 2.6, fontSize: 11.5, color: C.dark, valign: "top" });

  // right panel: challenges of open surgery
  s.addShape(pres.ShapeType.rect, { x: 6.45, y: 1.05, w: 3.2, h: 3.1, fill: { color: C.navy }, line: { color: C.teal, pt: 2 }, rectRadius: 0.1 });
  s.addText("Limitations of Open\nLaparotomy", { x: 6.55, y: 1.1, w: 3.0, h: 0.6, fontSize: 11.5, bold: true, color: C.gold, align: "center" });
  const openlims = ["Large midline incision", "Higher post-op pain", "Longer hospital stay", "More wound complications", "Slower recovery"];
  openlims.forEach((item, i) => {
    s.addShape(pres.ShapeType.rect, { x: 6.6, y: 1.75 + i * 0.44, w: 3.0, h: 0.35, fill: { color: C.dark }, line: { color: C.dark }, rectRadius: 0.05 });
    s.addText("✗  " + item, { x: 6.6, y: 1.75 + i * 0.44, w: 3.0, h: 0.35, fontSize: 10.5, color: C.white, valign: "middle" });
  });

  s.addText("Laparoscopy first described for PUD perforation in 1990 (Mouret et al.)", {
    x: 0.35, y: 4.25, w: 9.3, h: 0.38, fontSize: 10.5, italic: true, color: C.teal
  });
}

// =============================================================================
// SLIDE 4 – CLINICAL QUESTION
// =============================================================================
{
  const s = contentSlide("Clinical Question & Rationale", "PICO");
  s.addShape(pres.ShapeType.rect, { x: 0.35, y: 1.1, w: 9.3, h: 1.5, fill: { color: C.navy }, line: { color: C.tealLt, pt: 2 }, rectRadius: 0.1 });
  s.addText("Research Question", { x: 0.5, y: 1.15, w: 9.0, h: 0.35, fontSize: 12, bold: true, color: C.gold });
  s.addText("In adult patients presenting with perforation peritonitis, is laparoscopic management feasible and does it offer comparable or improved perioperative outcomes compared to open laparotomy?",
    { x: 0.5, y: 1.5, w: 9.0, h: 0.95, fontSize: 13, color: C.white, italic: true, valign: "middle" });

  const pico = [
    ["P", "Population",    "Adults ≥18 yrs with GI perforation peritonitis (haemodynamically stable)"],
    ["I", "Intervention",  "Laparoscopic management (repair/appendectomy)"],
    ["C", "Comparator",    "Open laparotomy"],
    ["O", "Outcomes",      "Operative time, hospital stay, VAS pain, 30-day morbidity & mortality"],
  ];
  pico.forEach(([letter, label, desc], i) => {
    const y = 2.85 + i * 0.54;
    s.addShape(pres.ShapeType.rect, { x: 0.35, y, w: 0.38, h: 0.38, fill: { color: C.teal }, line: { color: C.teal }, rectRadius: 0.05 });
    s.addText(letter, { x: 0.35, y, w: 0.38, h: 0.38, fontSize: 14, bold: true, color: C.white, align: "center", valign: "middle" });
    s.addText(label + ":", { x: 0.82, y: y + 0.04, w: 1.5, h: 0.3, fontSize: 11, bold: true, color: C.navy });
    s.addText(desc, { x: 2.4, y: y + 0.04, w: 7.2, h: 0.3, fontSize: 11, color: C.dark });
  });
}

// =============================================================================
// SLIDE 5 – STUDY DESIGN
// =============================================================================
{
  const s = contentSlide("Study Design & Setting", "Methods");
  // flow boxes
  const boxes = [
    { x: 0.3,  label: "Setting",   val: "AIIMS Jodhpur\nTertiary referral centre" },
    { x: 2.85, label: "Design",    val: "Prospective\nobservational cohort" },
    { x: 5.4,  label: "Period",    val: "Jan 2022 –\nMay 2023 (17 months)" },
    { x: 7.95, label: "Ethics",    val: "IEC approved\n(AIIMS/IEC/2021/3611)" },
  ];
  boxes.forEach(b => {
    s.addShape(pres.ShapeType.rect, { x: b.x, y: 1.1, w: 2.3, h: 1.25, fill: { color: C.navy }, line: { color: C.teal, pt: 2 }, rectRadius: 0.1 });
    s.addText(b.label, { x: b.x, y: 1.12, w: 2.3, h: 0.36, fontSize: 10, bold: true, color: C.gold, align: "center" });
    s.addText(b.val,   { x: b.x, y: 1.48, w: 2.3, h: 0.8, fontSize: 11.5, color: C.white, align: "center", valign: "middle" });
  });
  // arrows between boxes
  for (let i = 0; i < 3; i++) {
    s.addText("▶", { x: 2.55 + i * 2.55, y: 1.55, w: 0.35, h: 0.35, fontSize: 14, color: C.tealLt, align: "center" });
  }

  s.addText("Patient Flow", { x: 0.35, y: 2.6, w: 9.3, h: 0.35, fontSize: 13, bold: true, color: C.navy });
  addRule(s, 2.95);

  // Flow diagram
  const flowY = 3.1;
  const flowBoxes = [
    { x: 0.3,  label: "140 patients enrolled\n(perforation peritonitis)" },
    { x: 3.5,  label: "64 planned for\nlaparoscopic management" },
    { x: 6.8,  label: "30 laparoscopy\ncompleted" },
  ];
  flowBoxes.forEach((b, i) => {
    const col = i === 0 ? C.teal : (i === 1 ? C.navy : C.green);
    s.addShape(pres.ShapeType.rect, { x: b.x, y: flowY, w: 2.9, h: 0.9, fill: { color: col }, line: { color: col }, rectRadius: 0.08 });
    s.addText(b.label, { x: b.x, y: flowY, w: 2.9, h: 0.9, fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle" });
    if (i < 2) s.addText("▶", { x: b.x + 2.95, y: flowY + 0.25, w: 0.4, h: 0.4, fontSize: 16, color: C.tealLt, align: "center" });
  });
  // branch arrow down
  s.addText("▼", { x: 5.85, y: flowY + 0.88, w: 0.4, h: 0.35, fontSize: 16, color: C.red, align: "center" });
  s.addShape(pres.ShapeType.rect, { x: 5.4, y: flowY + 1.2, w: 2.9, h: 0.75, fill: { color: C.red }, line: { color: C.red }, rectRadius: 0.08 });
  s.addText("34 converted to\nlaparotomy (53.1%)", { x: 5.4, y: flowY + 1.2, w: 2.9, h: 0.75, fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle" });

  // PSM note
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: flowY + 1.2, w: 4.7, h: 0.75, fill: { color: C.greyLt }, line: { color: C.teal, pt: 1.5 }, rectRadius: 0.08 });
  s.addText("After 1:1 Propensity Score Matching → 28 patients per group (n = 56 matched)", {
    x: 0.4, y: flowY + 1.2, w: 4.5, h: 0.75, fontSize: 11, bold: true, color: C.navy, align: "center", valign: "middle"
  });
}

// =============================================================================
// SLIDE 6 – INCLUSION / EXCLUSION
// =============================================================================
{
  const s = contentSlide("Inclusion & Exclusion Criteria", "Methods");
  // inclusion
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.1, w: 4.5, h: 3.6, fill: { color: C.offWhite }, line: { color: C.green, pt: 2 }, rectRadius: 0.1 });
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.1, w: 4.5, h: 0.48, fill: { color: C.green }, line: { color: C.green }, rectRadius: 0.1 });
  s.addText("✔  Inclusion Criteria", { x: 0.3, y: 1.1, w: 4.5, h: 0.48, fontSize: 12.5, bold: true, color: C.white, valign: "middle", margin: 8 });
  const inc = [
    "Age ≥ 18 years",
    "Radiological or intraoperative confirmation of GI perforation",
    "Haemodynamically stable at presentation\n(SBP ≥90 mmHg after resuscitation)",
    "Written informed consent obtained",
  ];
  s.addText(inc.map(t => ({ text: t, options: { bullet: { code: "2714" }, breakLine: true, paraSpaceAfter: 8 } })),
    { x: 0.45, y: 1.7, w: 4.25, h: 2.9, fontSize: 11.5, color: C.dark, valign: "top" });

  // exclusion
  s.addShape(pres.ShapeType.rect, { x: 5.25, y: 1.1, w: 4.5, h: 3.6, fill: { color: C.offWhite }, line: { color: C.red, pt: 2 }, rectRadius: 0.1 });
  s.addShape(pres.ShapeType.rect, { x: 5.25, y: 1.1, w: 4.5, h: 0.48, fill: { color: C.red }, line: { color: C.red }, rectRadius: 0.1 });
  s.addText("✗  Exclusion Criteria", { x: 5.25, y: 1.1, w: 4.5, h: 0.48, fontSize: 12.5, bold: true, color: C.white, valign: "middle", margin: 8 });
  const exc = [
    "Haemodynamic instability / septic shock requiring vasopressors",
    "Previous major abdominal surgery (anticipated adhesions)",
    "Perforation secondary to malignancy",
    "Non-consenting patients",
  ];
  s.addText(exc.map(t => ({ text: t, options: { bullet: { code: "2718" }, breakLine: true, paraSpaceAfter: 8 } })),
    { x: 5.4, y: 1.7, w: 4.25, h: 2.9, fontSize: 11.5, color: C.dark, valign: "top" });
}

// =============================================================================
// SLIDE 7 – BASELINE CHARACTERISTICS
// =============================================================================
{
  const s = contentSlide("Baseline Characteristics (After PSM)", "Results");
  s.addText("1:1 Propensity score matching balanced confounders — 28 patients per group", {
    x: 0.35, y: 1.02, w: 9.3, h: 0.35, fontSize: 11, italic: true, color: C.teal
  });

  // Table header
  const cols = [2.5, 1.8, 2.0, 1.2];
  const headers = ["Variable", "Laparotomy (n=28)", "Laparoscopy (n=28)", "P-value"];
  const hx = [0.32, 2.9, 4.78, 6.88];
  headers.forEach((h, i) => {
    s.addShape(pres.ShapeType.rect, { x: hx[i], y: 1.45, w: cols[i], h: 0.38, fill: { color: C.navy }, line: { color: C.navy } });
    s.addText(h, { x: hx[i], y: 1.45, w: cols[i], h: 0.38, fontSize: 10.5, bold: true, color: C.white, align: "center", valign: "middle" });
  });

  const rows = [
    ["Age (mean ± SD, yrs)",        "39.35 ± 17.13",    "37.57 ± 15.56",    "0.686"],
    ["Sex (M/F)",                   "19 / 9",           "20 / 8",           "0.085"],
    ["Duration of symptoms (days)", "3.14 ± 1.5",       "3.07 ± 1.62",      "0.867"],
    ["Comorbidities (n)",            "3 / 28",           "2 / 28",           "0.639"],
    ["Peptic perforation",          "13",               "12",               "—"],
    ["Appendicular perforation",    "13",               "14",               "—"],
    ["Small bowel perforation",     "2",                "2",                "—"],
  ];
  rows.forEach((row, i) => {
    const rowY = 1.86 + i * 0.42;
    const bg = i % 2 === 0 ? C.white : C.offWhite;
    row.forEach((cell, j) => {
      s.addShape(pres.ShapeType.rect, { x: hx[j], y: rowY, w: cols[j], h: 0.38, fill: { color: bg }, line: { color: C.greyLt } });
      const isp = cell === "0.686" || cell === "0.085" || cell === "0.867" || cell === "0.639";
      s.addText(cell, { x: hx[j], y: rowY, w: cols[j], h: 0.38, fontSize: 10.5, color: isp ? C.green : C.dark, align: "center", valign: "middle", bold: isp });
    });
  });

  s.addText("Groups were well-balanced after PSM — no statistically significant differences in baseline characteristics", {
    x: 0.35, y: 4.75, w: 9.3, h: 0.35, fontSize: 10, italic: true, color: C.grey
  });
}

// =============================================================================
// SLIDE 8 – PRIMARY OUTCOMES
// =============================================================================
{
  const s = contentSlide("Primary Outcomes (Post-PSM, n=28 per group)", "Results");

  // Big stat boxes
  statBox(s, "Operative Time", "217 vs 182", "min  (P = 0.049)", 0.32, 1.1, 2.8, 1.5, C.orange);
  statBox(s, "Hospital Stay", "4.4 vs 8.7", "days  (P < 0.001)", 3.6, 1.1, 2.8, 1.5, C.teal);
  statBox(s, "30-day Mortality", "0% vs 3.6%", "laparoscopy vs laparotomy", 6.88, 1.1, 2.8, 1.5, C.green);

  // callout bars
  const barData = [
    { label: "Laparoscopy", val: 217, max: 260, color: C.orange },
    { label: "Laparotomy",  val: 182, max: 260, color: C.greyLt },
  ];
  const barData2 = [
    { label: "Laparoscopy", val: 4.4,  max: 12, color: C.teal },
    { label: "Laparotomy",  val: 8.7,  max: 12, color: C.greyLt },
  ];

  // operative time bars
  s.addText("Operative Time (min)", { x: 0.32, y: 2.85, w: 2.8, h: 0.3, fontSize: 10.5, bold: true, color: C.navy, align: "center" });
  barData.forEach((b, i) => {
    const bw = (b.val / b.max) * 2.5;
    s.addText(b.label, { x: 0.32, y: 3.2 + i * 0.52, w: 1.2, h: 0.38, fontSize: 9.5, color: C.dark, valign: "middle" });
    s.addShape(pres.ShapeType.rect, { x: 1.55, y: 3.23 + i * 0.52, w: bw, h: 0.28, fill: { color: b.color }, line: { color: b.color } });
    s.addText(b.val + "", { x: 1.6 + bw, y: 3.23 + i * 0.52, w: 0.45, h: 0.28, fontSize: 9.5, color: C.dark, valign: "middle" });
  });

  // hospital stay bars
  s.addText("Hospital Stay (days)", { x: 3.6, y: 2.85, w: 2.8, h: 0.3, fontSize: 10.5, bold: true, color: C.navy, align: "center" });
  barData2.forEach((b, i) => {
    const bw = (b.val / b.max) * 2.5;
    s.addText(b.label, { x: 3.6, y: 3.2 + i * 0.52, w: 1.2, h: 0.38, fontSize: 9.5, color: C.dark, valign: "middle" });
    s.addShape(pres.ShapeType.rect, { x: 4.83, y: 3.23 + i * 0.52, w: bw, h: 0.28, fill: { color: b.color }, line: { color: b.color } });
    s.addText(b.val + "", { x: 4.88 + bw, y: 3.23 + i * 0.52, w: 0.4, h: 0.28, fontSize: 9.5, color: C.dark, valign: "middle" });
  });

  // morbidity callout
  s.addShape(pres.ShapeType.rect, { x: 6.88, y: 2.85, w: 2.8, h: 1.65, fill: { color: C.navy }, line: { color: C.navy }, rectRadius: 0.08 });
  s.addText("30-day Morbidity", { x: 6.88, y: 2.9, w: 2.8, h: 0.32, fontSize: 10.5, bold: true, color: C.gold, align: "center" });
  s.addText([
    { text: "Laparoscopy: ", options: { bold: true, color: C.tealLt } },
    { text: "10%  (3/28)\n", options: { color: C.white } },
    { text: "Laparotomy:  ", options: { bold: true, color: C.greyLt } },
    { text: "32%  (9/28)", options: { color: C.white } },
  ], { x: 6.95, y: 3.28, w: 2.65, h: 0.75, fontSize: 11, valign: "middle" });
  s.addText("SSI: 1 vs 6  |  Reoperation: 0 vs 2", {
    x: 6.88, y: 4.08, w: 2.8, h: 0.3, fontSize: 9.5, color: C.grey, align: "center"
  });

  s.addText("★ Significantly shorter hospital stay and lower morbidity with laparoscopy", {
    x: 0.35, y: 4.88, w: 9.3, h: 0.35, fontSize: 10.5, bold: true, italic: true, color: C.teal
  });
}

// =============================================================================
// SLIDE 9 – VAS PAIN SCORES
// =============================================================================
{
  const s = contentSlide("Post-operative Pain (VAS Scores)", "Results");
  s.addText("Visual Analogue Scale (0–10) recorded at POD 1, 3, 7 and 30", {
    x: 0.35, y: 1.02, w: 9.3, h: 0.35, fontSize: 11, italic: true, color: C.grey
  });

  // Manual bar chart
  const chartData = [
    { day: "POD 1", lap_open: 4.56, lap_lap: 3.63, p: "0.012" },
    { day: "POD 3", lap_open: 3.96, lap_lap: 2.39, p: "<0.001" },
    { day: "POD 7", lap_open: 2.54, lap_lap: 1.46, p: "<0.001" },
    { day: "POD 30",lap_open: 1.36, lap_lap: 1.07, p: "0.005" },
  ];
  const maxVAS = 6;
  const chartX = 0.5;
  const chartBottom = 4.6;
  const chartH = 2.8;
  const barW = 0.55;
  const groupW = 2.0;

  // y-axis gridlines & labels
  [0, 2, 4, 6].forEach(v => {
    const yPos = chartBottom - (v / maxVAS) * chartH;
    s.addShape(pres.ShapeType.rect, { x: chartX + 0.4, y: yPos, w: 8.5, h: 0.01, fill: { color: C.greyLt }, line: { color: C.greyLt } });
    s.addText(v + "", { x: chartX, y: yPos - 0.15, w: 0.38, h: 0.3, fontSize: 9, color: C.grey, align: "right" });
  });
  s.addText("VAS Score", { x: 0.08, y: 2.8, w: 0.5, h: 1.0, fontSize: 9.5, color: C.grey, rotate: 270, align: "center" });

  chartData.forEach((d, i) => {
    const groupX = chartX + 0.6 + i * groupW;
    const h1 = (d.lap_open / maxVAS) * chartH;
    const h2 = (d.lap_lap  / maxVAS) * chartH;

    // laparotomy bar
    s.addShape(pres.ShapeType.rect, { x: groupX, y: chartBottom - h1, w: barW, h: h1, fill: { color: C.greyLt }, line: { color: C.grey } });
    s.addText(d.lap_open.toFixed(2), { x: groupX, y: chartBottom - h1 - 0.22, w: barW, h: 0.22, fontSize: 8.5, color: C.dark, align: "center" });

    // laparoscopy bar
    s.addShape(pres.ShapeType.rect, { x: groupX + barW + 0.12, y: chartBottom - h2, w: barW, h: h2, fill: { color: C.teal }, line: { color: C.teal } });
    s.addText(d.lap_lap.toFixed(2), { x: groupX + barW + 0.12, y: chartBottom - h2 - 0.22, w: barW, h: 0.22, fontSize: 8.5, color: C.teal, align: "center", bold: true });

    // P-value
    s.addText("P=" + d.p, { x: groupX, y: chartBottom + 0.08, w: barW * 2 + 0.12, h: 0.28, fontSize: 9, color: C.red, align: "center", bold: true });
    // day label
    s.addText(d.day, { x: groupX, y: chartBottom + 0.36, w: barW * 2 + 0.12, h: 0.25, fontSize: 10.5, color: C.dark, align: "center", bold: true });
  });

  // Legend
  s.addShape(pres.ShapeType.rect, { x: 6.5, y: 1.45, w: 0.28, h: 0.2, fill: { color: C.greyLt }, line: { color: C.grey } });
  s.addText("Laparotomy", { x: 6.85, y: 1.45, w: 1.8, h: 0.2, fontSize: 10, color: C.dark });
  s.addShape(pres.ShapeType.rect, { x: 6.5, y: 1.72, w: 0.28, h: 0.2, fill: { color: C.teal }, line: { color: C.teal } });
  s.addText("Laparoscopy", { x: 6.85, y: 1.72, w: 1.8, h: 0.2, fontSize: 10, color: C.teal, bold: true });

  s.addText("Laparoscopy had significantly lower pain at ALL time points (all P < 0.05)", {
    x: 0.35, y: 5.22, w: 9.3, h: 0.3, fontSize: 10.5, bold: true, italic: true, color: C.teal
  });
}

// =============================================================================
// SLIDE 10 – CONVERSION & OPERATIVE DETAILS
// =============================================================================
{
  const s = contentSlide("Conversion to Laparotomy & Surgical Technique", "Results");

  // conversion stats
  s.addShape(pres.ShapeType.rect, { x: 0.32, y: 1.1, w: 4.3, h: 2.4, fill: { color: C.navy }, line: { color: C.navy }, rectRadius: 0.1 });
  s.addText("Conversion Rate", { x: 0.32, y: 1.12, w: 4.3, h: 0.4, fontSize: 12.5, bold: true, color: C.gold, align: "center" });
  s.addText("34 / 64  =  53.1%", { x: 0.32, y: 1.55, w: 4.3, h: 0.55, fontSize: 22, bold: true, color: C.white, align: "center" });
  s.addText("of patients planned for laparoscopy\nrequired conversion to open", {
    x: 0.32, y: 2.1, w: 4.3, h: 0.5, fontSize: 10.5, color: C.grey, align: "center"
  });
  // reasons
  const reasons = [
    ["Poor visibility (purulent contamination)", "15 (44%)"],
    ["Dense adhesions",                          "11 (32%)"],
    ["Inadequate peritoneal lavage",             " 8 (24%)"],
  ];
  reasons.forEach(([r, n], i) => {
    s.addShape(pres.ShapeType.rect, { x: 0.4, y: 2.68 + i * 0.5, w: 4.1, h: 0.4, fill: { color: C.dark }, line: { color: C.dark }, rectRadius: 0.05 });
    s.addText(r, { x: 0.5, y: 2.68 + i * 0.5, w: 3.0, h: 0.4, fontSize: 10, color: C.white, valign: "middle" });
    s.addText(n, { x: 3.55, y: 2.68 + i * 0.5, w: 0.9, h: 0.4, fontSize: 10, color: C.gold, valign: "middle", bold: true, align: "right" });
  });

  // technique bullets
  s.addShape(pres.ShapeType.rect, { x: 4.85, y: 1.1, w: 4.8, h: 1.1, fill: { color: C.offWhite }, line: { color: C.teal, pt: 1.5 }, rectRadius: 0.1 });
  s.addText("Laparoscopic Technique", { x: 4.95, y: 1.12, w: 4.6, h: 0.3, fontSize: 11, bold: true, color: C.teal });
  const laptech = ["Modified lithotomy position | Open Hasson technique", "10mm supraumbilical camera port + two 5mm working ports", "Thorough lavage/suction → bowel walk → site identification", "Intracorporeal repair: 2-0 absorbable sutures ± Graham's patch", "Laparoscopic appendectomy for appendicular perforation"];
  s.addText(laptech.map(t => ({ text: t, options: { bullet: { code: "25B8" }, breakLine: true, paraSpaceAfter: 3 } })),
    { x: 5.0, y: 1.45, w: 4.55, h: 0.68, fontSize: 9.5, color: C.dark });

  s.addShape(pres.ShapeType.rect, { x: 4.85, y: 2.3, w: 4.8, h: 1.1, fill: { color: C.offWhite }, line: { color: C.grey, pt: 1.5 }, rectRadius: 0.1 });
  s.addText("Open Technique", { x: 4.95, y: 2.32, w: 4.6, h: 0.3, fontSize: 11, bold: true, color: C.navy });
  const opentech = ["Midline laparotomy under GA", "Suction of contaminated peritoneal fluid", "Site repair ± omental (Graham's) patch ± stoma", "Thorough peritoneal lavage + drain placement", "Abdominal closure in layers"];
  s.addText(opentech.map(t => ({ text: t, options: { bullet: { code: "25B8" }, breakLine: true, paraSpaceAfter: 3 } })),
    { x: 5.0, y: 2.65, w: 4.55, h: 0.68, fontSize: 9.5, color: C.dark });

  s.addShape(pres.ShapeType.rect, { x: 4.85, y: 3.55, w: 4.8, h: 0.82, fill: { color: C.greyLt }, line: { color: C.grey }, rectRadius: 0.08 });
  s.addText("📌  Comparator: Agresta et al. 2006 reported only 23.2% conversion rate — our higher rate likely reflects delayed patient presentation and greater intra-abdominal contamination", {
    x: 4.95, y: 3.6, w: 4.6, h: 0.72, fontSize: 9.5, color: C.navy, valign: "middle"
  });
}

// =============================================================================
// SLIDE 11 – DISCUSSION
// =============================================================================
{
  const s = contentSlide("Discussion", "Critical Appraisal");

  const points = [
    {
      icon: "⏱", color: C.orange,
      title: "Longer operative time in laparoscopy",
      body: "217 vs 182 min (P=0.049) — attributable to learning curve for intracorporeal suturing in emergency setting. Surgeons with advanced skills may close this gap."
    },
    {
      icon: "🏥", color: C.teal,
      title: "Shorter hospital stay: major clinical advantage",
      body: "4.4 vs 8.7 days — significant implication for resource-limited settings; improved bed turnover and cost savings."
    },
    {
      icon: "🩹", color: C.green,
      title: "Reduced wound complications",
      body: "SSI 3.6% vs 21.4%. Smaller incisions with laparoscopy substantially reduce wound morbidity."
    },
    {
      icon: "🔄", color: C.red,
      title: "High conversion rate (53%) — key limitation",
      body: "Delayed presentation → widespread contamination, adhesions. Careful patient selection is paramount."
    },
    {
      icon: "📊", color: C.navy,
      title: "PSM reduces confounding — but study is not randomised",
      body: "PSM balanced age, sex, duration of symptoms, comorbidities. However residual unmeasured confounders cannot be excluded."
    },
  ];
  points.forEach((p, i) => {
    const y = 1.1 + i * 0.83;
    s.addShape(pres.ShapeType.rect, { x: 0.32, y: y + 0.04, w: 0.5, h: 0.5, fill: { color: p.color }, line: { color: p.color }, rectRadius: 0.05 });
    s.addText(p.icon, { x: 0.32, y: y + 0.04, w: 0.5, h: 0.5, fontSize: 14, align: "center", valign: "middle" });
    s.addText(p.title, { x: 0.95, y: y + 0.04, w: 8.7, h: 0.26, fontSize: 11.5, bold: true, color: p.color });
    s.addText(p.body,  { x: 0.95, y: y + 0.3,  w: 8.7, h: 0.4,  fontSize: 10.5, color: C.dark });
  });
}

// =============================================================================
// SLIDE 12 – STRENGTHS & LIMITATIONS
// =============================================================================
{
  const s = contentSlide("Strengths & Limitations", "Critical Appraisal");

  // Strengths
  s.addShape(pres.ShapeType.rect, { x: 0.32, y: 1.1, w: 4.35, h: 3.5, fill: { color: C.offWhite }, line: { color: C.green, pt: 2 }, rectRadius: 0.1 });
  s.addShape(pres.ShapeType.rect, { x: 0.32, y: 1.1, w: 4.35, h: 0.42, fill: { color: C.green }, line: { color: C.green }, rectRadius: 0.1 });
  s.addText("✔  Strengths", { x: 0.32, y: 1.1, w: 4.35, h: 0.42, fontSize: 12.5, bold: true, color: C.white, valign: "middle", margin: 8 });
  const str = [
    "Prospective study design — reduces recall bias",
    "Propensity score matching — controls for major confounders",
    "Objective outcome measures (VAS, LOS, operative time)",
    "All procedures performed by consultant-level laparoscopic surgeons",
    "Consecutive recruitment from a high-volume tertiary centre",
    "Comprehensive follow-up to 30 days",
  ];
  s.addText(str.map(t => ({ text: t, options: { bullet: { code: "2714" }, breakLine: true, paraSpaceAfter: 7 } })),
    { x: 0.45, y: 1.6, w: 4.1, h: 2.9, fontSize: 11, color: C.dark, valign: "top" });

  // Limitations
  s.addShape(pres.ShapeType.rect, { x: 5.18, y: 1.1, w: 4.5, h: 3.5, fill: { color: C.offWhite }, line: { color: C.red, pt: 2 }, rectRadius: 0.1 });
  s.addShape(pres.ShapeType.rect, { x: 5.18, y: 1.1, w: 4.5, h: 0.42, fill: { color: C.red }, line: { color: C.red }, rectRadius: 0.1 });
  s.addText("✗  Limitations", { x: 5.18, y: 1.1, w: 4.5, h: 0.42, fontSize: 12.5, bold: true, color: C.white, valign: "middle", margin: 8 });
  const lim = [
    "Non-randomised — selection bias likely in choosing laparoscopy over open approach",
    "Small sample size (n=56 after PSM) — underpowered for mortality analysis",
    "Single-centre study at a tertiary institution — limited generalisability",
    "Pain management not standardised (analgesia ladder, not fixed protocol)",
    "High conversion rate (53%) may reflect local expertise rather than global applicability",
    "No long-term outcomes beyond 30 days",
  ];
  s.addText(lim.map(t => ({ text: t, options: { bullet: { code: "2718" }, breakLine: true, paraSpaceAfter: 7 } })),
    { x: 5.3, y: 1.6, w: 4.25, h: 2.9, fontSize: 11, color: C.dark, valign: "top" });
}

// =============================================================================
// SLIDE 13 – TAKE-HOME MESSAGE / CONCLUSION
// =============================================================================
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.navy }, line: { color: C.navy } });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.08, h: 5.625, fill: { color: C.tealLt }, line: { color: C.tealLt } });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0.9, w: 10, h: 0.04, fill: { color: C.teal }, line: { color: C.teal } });

  s.addText("Conclusion & Take-Home Message", {
    x: 0.25, y: 0.1, w: 9.5, h: 0.75, fontSize: 18, bold: true, color: C.gold, valign: "middle"
  });

  const msgs = [
    { icon: "✅", text: "Laparoscopy IS feasible in selected, haemodynamically stable patients with perforation peritonitis" },
    { icon: "📉", text: "Significant advantages: shorter hospital stay (4.4 vs 8.7 days), less pain, fewer SSIs, lower 30-day morbidity (10% vs 32%)" },
    { icon: "⏱", text: "Trade-off: longer operative time (217 vs 182 min) — acceptable with experienced teams" },
    { icon: "⚠️", text: "High conversion rate (53%) — patient selection is critical; delayed presentations should favour open approach" },
    { icon: "🎓", text: "Surgical training in emergency laparoscopy is essential; learning curve impacts outcomes" },
    { icon: "🔬", text: "Future work: larger multicentre RCTs, standardised analgesia protocols, longer-term follow-up" },
  ];

  msgs.forEach((m, i) => {
    const y = 1.08 + i * 0.72;
    s.addShape(pres.ShapeType.rect, { x: 0.35, y: y, w: 9.3, h: 0.6, fill: { color: C.dark }, line: { color: C.dark }, rectRadius: 0.07 });
    s.addText(m.icon, { x: 0.45, y: y, w: 0.45, h: 0.6, fontSize: 14, align: "center", valign: "middle" });
    s.addText(m.text, { x: 0.98, y: y, w: 8.55, h: 0.6, fontSize: 11.5, color: C.white, valign: "middle" });
  });

  s.addText("Soni S et al. J Min Access Surg 2026;22(2):180–186  |  DOI: 10.4103/jmas.jmas_135_25", {
    x: 0.35, y: 5.25, w: 9.3, h: 0.28, fontSize: 9, color: C.grey, align: "center"
  });
}

// =============================================================================
// SLIDE 14 – REFERENCES
// =============================================================================
{
  const s = contentSlide("References", "Appendix");
  const refs = [
    "1. Soni S, Parihar YK, Chaudhary R, et al. Feasibility and outcomes of laparoscopic management in perforation peritonitis: a prospective cohort study with propensity score matching. J Min Access Surg 2026;22(2):180-186.",
    "2. Mouret P, François Y, Vignal J, et al. Laparoscopic treatment of perforated peptic ulcer. Br J Surg 1990;77:1006.",
    "3. Agresta F, Ciardo LF, Mazzarolo G, et al. Peritonitis: laparoscopic approach. World J Emerg Surg 2006;1:9.",
    "4. Ge B, Wu M, Chen Q, et al. A prospective randomized controlled trial of laparoscopic repair versus open repair for perforated peptic ulcers. Surgery 2016;159:451–8.",
    "5. Tan S, Wu G, Zhuang Q, et al. Laparoscopic versus open repair for perforated peptic ulcer: a meta-analysis of randomized controlled trials. Int J Surg 2016;33:124–32.",
    "6. Vakayil V, Bauman B, Joppru K, et al. Surgical repair of perforated peptic ulcers: laparoscopic versus open approach. Surg Endosc 2019;33:281–92.",
    "7. Sermonesi G, Tian BW, Vallicelli C, et al. Cesena guidelines: WSES consensus statement on laparoscopic-first approach to general surgery emergencies. World J Emerg Surg 2023;18:57.",
  ];
  s.addText(refs.map(r => ({ text: r, options: { breakLine: true, paraSpaceAfter: 10 } })),
    { x: 0.35, y: 1.1, w: 9.3, h: 4.15, fontSize: 9.5, color: C.dark, valign: "top" });
}

// =============================================================================
// WRITE
// =============================================================================
const outPath = "/home/daytona/workspace/jc-presentation/JR1_JC_Laparoscopy_Perforation_Peritonitis.pptx";
pres.writeFile({ fileName: outPath }).then(() => {
  console.log("✅ Saved: " + outPath);
}).catch(err => {
  console.error("❌ Error:", err);
});
Running Command

cd /home/daytona/workspace/jc-presentation && node create_pptx.js

Your JR1 Journal Club presentation is ready!

JR1 JC Laparoscopy Perforation Peritonitis

Presentation · PPTX

The deck has 14 slides with a professional navy/teal/gold theme:
#Slide
1Title slide — paper citation, journal, presenter info
2Outline — numbered overview of all sections
3Background — why perforation peritonitis is a challenge, limitations of open surgery
4Clinical Question / PICO — clear research question framed in PICO format
5Study Design — setting, design, period, patient flow diagram (140 → 64 planned lap → 30 completed + 34 converted)
6Inclusion & Exclusion Criteria — side-by-side green/red panels
7Baseline Characteristics — formatted table showing PSM-matched groups
8Primary Outcomes — stat boxes + bar charts for operative time, hospital stay, morbidity
9VAS Pain Scores — grouped bar chart for POD 1, 3, 7, 30 with P-values
10Conversion & Surgical Technique — reasons for conversion, both operative techniques
11Discussion — 5 key discussion points with icons
12Strengths & Limitations — side-by-side panels
13Conclusion / Take-home Messages — dark closing slide with 6 key messages
14References — full citation list

Sermonesi G, Tian BW, Vallicelli C, Abu‑Zidan FM, Damaskos D, Kelly MD, et al. Cesena guidelines: WSES consensus statement on laparoscopic‑first approach to general surgery emergencies and abdominal trauma. World J Emerg Surg 2023;18:57. Add this study to the PPT

Reading File
Searching PubMed

Cesena guidelines WSES laparoscopic general surgery emergencies

Reading Article

PMID: 38066631

Reading File
Reading File
Editing File

~/jc-presentation/create_pptx.js

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/jc-presentation/create_pptx.js'
Editing File

~/jc-presentation/create_pptx.js

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/jc-presentation/create_pptx.js'
Editing File

~/jc-presentation/create_pptx.js

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/jc-presentation/create_pptx.js'
Running Command

cd /home/daytona/workspace/jc-presentation && node create_pptx.js

Done! Here's the updated presentation:

JR1 JC Laparoscopy Perforation Peritonitis

Presentation · PPTX

Here's what was added/updated across the deck:
New Slide 12 — Cesena Guidelines (WSES 2023) A full dedicated slide with two columns:
  • Left: Study overview table — type (consensus statement), year, scope, 323 studies from 7,409 screened, 54-expert international panel, DOI/PMID
  • Right: 5 key recommendations with icons, including the direct relevance to your primary paper (haemodynamic stability as the critical selection criterion, laparoscopy as safe/feasible/effective, surgeon training)
  • Footer strip: explicitly calls out why this guideline validates Soni et al.'s patient selection approach
Updated Slide 2 — Outline Added item 05 "Cesena Guidelines (WSES 2023)" so it appears in the structure overview.
Updated References slide Cesena guideline now listed as reference 2 with full citation and PMID, promoted to sit right after the primary paper.
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