pertussis whooping cough

mkdir -p /home/daytona/workspace/pertussis-vaccines && ls /home/daytona/workspac…

~/pertussis-vaccines/build.js

const pptxgen = require("pptxgenjs");

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Acellular vs Whole-Cell Pertussis Vaccines";
pres.author = "Orris";

// ─── Color Palette ───────────────────────────────────────────────────────────
// Deep navy dominant, teal accent, warm amber highlight, off-white text
const C = {
  navy:      "0D1B3E",  // dominant bg
  navyMid:   "152550",  // card bg
  teal:      "1A8C8C",  // whole-cell accent
  amber:     "E8A020",  // acellular accent
  green:     "2EAF7D",  // positive
  red:       "D64045",  // negative / warning
  white:     "F5F7FA",
  offWhite:  "C8D4E8",
  lightGray: "8A9BB8",
};

// ─── Helper: slide background ────────────────────────────────────────────────
function darkBg(slide) {
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: 10, h: 5.625,
    fill: { color: C.navy }, line: { color: C.navy }
  });
}

// ─── Helper: section label pill ──────────────────────────────────────────────
function pill(slide, text, color, x, y, w = 2.5) {
  slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
    x, y, w, h: 0.3, fill: { color }, line: { color }, rectRadius: 0.15
  });
  slide.addText(text, {
    x, y, w, h: 0.3, fontSize: 9, bold: true, color: C.navy,
    align: "center", valign: "middle", margin: 0
  });
}

// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 1 — TITLE
// ─────────────────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  darkBg(s);

  // Top accent bar
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: 10, h: 0.08, fill: { color: C.teal }, line: { color: C.teal }
  });

  // Germ icon hint — decorative circles
  for (const [cx, cy, r, op] of [
    [8.6, 1.2, 1.4, 8], [9.1, 2.4, 0.9, 6], [8.0, 2.8, 0.6, 5]
  ]) {
    s.addShape(pres.shapes.OVAL, {
      x: cx - r/2, y: cy - r/2, w: r, h: r,
      fill: { color: C.teal, transparency: 100 - op },
      line: { color: C.teal, transparency: 100 - op - 20, width: 1.5 }
    });
  }

  // Subtitle tag
  pill(s, "IMMUNOLOGY  |  VACCINOLOGY", C.teal, 0.55, 1.4, 3.2);

  s.addText("Acellular vs\nWhole-Cell\nPertussis Vaccines", {
    x: 0.55, y: 1.75, w: 7.5, h: 2.6,
    fontSize: 40, bold: true, color: C.white,
    align: "left", valign: "top",
    charSpacing: 0.5
  });

  s.addText("A comparative analysis of composition, immunogenicity,\nefficacy, safety, and public health impact", {
    x: 0.55, y: 4.25, w: 7.8, h: 0.85,
    fontSize: 14, color: C.offWhite, align: "left"
  });

  // Bottom bar
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 5.45, w: 10, h: 0.175, fill: { color: C.amber }, line: { color: C.amber }
  });
}

// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 2 — BACKGROUND: THE PERTUSSIS PROBLEM
// ─────────────────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  darkBg(s);

  s.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: 10, h: 0.08, fill: { color: C.teal }, line: { color: C.teal }
  });

  s.addText("Background: The Pertussis Problem", {
    x: 0.5, y: 0.2, w: 9, h: 0.6, fontSize: 22, bold: true, color: C.white, align: "left", margin: 0
  });

  // 4 stat cards
  const stats = [
    ["16M", "estimated cases\nper year globally"],
    ["200K+", "deaths/year in\npre-vaccine era"],
    ["84%", "of US deaths in\ninfants <2 months"],
    ["~1M", "adult cases/year\nin the US alone"],
  ];
  stats.forEach(([num, label], i) => {
    const x = 0.3 + i * 2.38;
    s.addShape(pres.shapes.RECTANGLE, {
      x, y: 0.95, w: 2.15, h: 1.55,
      fill: { color: C.navyMid }, line: { color: C.teal, width: 1.5 }
    });
    s.addText(num, {
      x, y: 1.05, w: 2.15, h: 0.65,
      fontSize: 28, bold: true, color: C.amber, align: "center", margin: 0
    });
    s.addText(label, {
      x, y: 1.72, w: 2.15, h: 0.72,
      fontSize: 11, color: C.offWhite, align: "center", margin: 4
    });
  });

  // Key points
  const pts = [
    "Bordetella pertussis — gram-negative coccobacillus; transmission via aerosol droplets",
    "Whole-cell (wP) vaccines introduced in 1940s → dramatic case reduction, but reactogenicity concerns arose",
    "Acellular (aP) vaccines replaced wP in developed nations in the 1990s — fewer side effects, but waning immunity",
    "Resurgence since 2000s linked to: waning aP immunity, pertactin-deficient strains, cocooning failure",
    "WHO (2019): countries using wP should continue; aP countries need additional boosters + maternal vaccination",
  ];
  s.addText(pts.map((t, i) => ({
    text: t,
    options: { bullet: { type: "bullet", indent: 15 }, breakLine: i < pts.length - 1, color: i === 4 ? C.amber : C.offWhite, fontSize: 12.5 }
  })), { x: 0.4, y: 2.65, w: 9.2, h: 2.7, valign: "top" });
}

// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 3 — COMPOSITION
// ─────────────────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  darkBg(s);
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: 10, h: 0.08, fill: { color: C.teal }, line: { color: C.teal }
  });

  s.addText("Vaccine Composition", {
    x: 0.5, y: 0.2, w: 9, h: 0.55, fontSize: 22, bold: true, color: C.white, align: "left", margin: 0
  });

  // Left panel — wP
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0.3, y: 0.9, w: 4.3, h: 4.55,
    fill: { color: C.navyMid }, line: { color: C.teal, width: 2 }
  });
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0.3, y: 0.9, w: 4.3, h: 0.42,
    fill: { color: C.teal }, line: { color: C.teal }
  });
  s.addText("Whole-Cell Pertussis (wP)", {
    x: 0.3, y: 0.9, w: 4.3, h: 0.42,
    fontSize: 13, bold: true, color: C.navy, align: "center", valign: "middle", margin: 0
  });

  const wpPts = [
    "Killed, intact B. pertussis bacteria",
    "Contains ALL antigens: ~3,000+ proteins",
    "Preserves native LPS (lipopolysaccharide)",
    "Elicits TH1 + TH17 immune response",
    "Induces mucosal IgA → blocks colonization",
    "Reduces nasopharyngeal bacterial load",
    "Used in: DTP, DTwP combinations",
    "Still standard in LMICs (WHO recommendation)",
  ];
  s.addText(wpPts.map((t, i) => ({
    text: t,
    options: { bullet: { type: "bullet", indent: 12 }, breakLine: i < wpPts.length - 1, fontSize: 12, color: C.offWhite }
  })), { x: 0.4, y: 1.4, w: 4.1, h: 3.9, valign: "top" });

  // Right panel — aP
  s.addShape(pres.shapes.RECTANGLE, {
    x: 5.4, y: 0.9, w: 4.3, h: 4.55,
    fill: { color: C.navyMid }, line: { color: C.amber, width: 2 }
  });
  s.addShape(pres.shapes.RECTANGLE, {
    x: 5.4, y: 0.9, w: 4.3, h: 0.42,
    fill: { color: C.amber }, line: { color: C.amber }
  });
  s.addText("Acellular Pertussis (aP)", {
    x: 5.4, y: 0.9, w: 4.3, h: 0.42,
    fontSize: 13, bold: true, color: C.navy, align: "center", valign: "middle", margin: 0
  });

  const apAntigens = [
    ["Pertussis Toxoid (PT)", "all formulations"],
    ["Filamentous Hemagglutinin (FHA)", "all formulations"],
    ["Pertactin (PRN)", "most formulations"],
    ["Fimbriae types 2 & 3", "some (e.g. Adacel)"],
  ];
  s.addText("Purified subunit antigens only:", {
    x: 5.5, y: 1.42, w: 4.1, h: 0.3,
    fontSize: 12, bold: true, color: C.amber, align: "left", margin: 4
  });
  apAntigens.forEach(([name, note], i) => {
    const y = 1.78 + i * 0.52;
    s.addShape(pres.shapes.RECTANGLE, {
      x: 5.5, y, w: 4.05, h: 0.44,
      fill: { color: "1C2E52" }, line: { color: C.amber, transparency: 60 }
    });
    s.addText(name, { x: 5.55, y: y + 0.03, w: 2.8, h: 0.22, fontSize: 11.5, bold: true, color: C.white, margin: 2 });
    s.addText(note, { x: 5.55, y: y + 0.23, w: 3.9, h: 0.18, fontSize: 9.5, color: C.lightGray, margin: 2, italic: true });
  });

  s.addText([
    { text: "Elicits TH2-biased response  ", options: { bullet: { type: "bullet", indent: 10 }, breakLine: true, fontSize: 12, color: C.offWhite } },
    { text: "No mucosal IgA induction → colonization possible", options: { bullet: { type: "bullet", indent: 10 }, breakLine: true, fontSize: 12, color: C.offWhite } },
    { text: "Used in: DTaP (children), Tdap (adolescents/adults)", options: { bullet: { type: "bullet", indent: 10 }, fontSize: 12, color: C.offWhite } },
  ], { x: 5.5, y: 4.0, w: 4.0, h: 1.3, valign: "top" });

  // VS badge
  s.addShape(pres.shapes.OVAL, {
    x: 4.62, y: 2.7, w: 0.76, h: 0.76,
    fill: { color: C.amber }, line: { color: C.amber }
  });
  s.addText("VS", {
    x: 4.62, y: 2.7, w: 0.76, h: 0.76,
    fontSize: 13, bold: true, color: C.navy, align: "center", valign: "middle", margin: 0
  });
}

// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 4 — IMMUNOGENICITY & MECHANISM
// ─────────────────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  darkBg(s);
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: 10, h: 0.08, fill: { color: C.amber }, line: { color: C.amber }
  });

  s.addText("Immunogenicity & Immune Mechanisms", {
    x: 0.5, y: 0.2, w: 9, h: 0.55, fontSize: 22, bold: true, color: C.white, align: "left", margin: 0
  });

  // Two column comparison table
  const headers = ["Parameter", "Whole-Cell (wP)", "Acellular (aP)"];
  const rows = [
    ["T-helper response", "TH1 + TH17 (balanced)", "TH2-biased"],
    ["Mucosal immunity (IgA)", "Yes — blocks colonization", "No — colonization persists"],
    ["Serum antibodies", "Broad (all antigens)", "Narrow (2–5 antigens)"],
    ["Duration of protection", "~10–12 years", "2–4 years (rapid waning)"],
    ["Memory B cells", "Broad repertoire", "Limited repertoire"],
    ["Blocks transmission", "Yes", "No"],
    ["Matches natural infection", "Closer match", "Divergent response"],
  ];

  const colW = [2.8, 3.1, 3.1];
  const colX = [0.3, 3.15, 6.3];
  const rowH = 0.52;
  const tableY = 0.9;

  // Header row
  headers.forEach((h, ci) => {
    s.addShape(pres.shapes.RECTANGLE, {
      x: colX[ci], y: tableY, w: colW[ci] - 0.04, h: 0.42,
      fill: { color: ci === 1 ? C.teal : ci === 2 ? C.amber : "1C2D55" },
      line: { color: C.navy }
    });
    s.addText(h, {
      x: colX[ci], y: tableY, w: colW[ci] - 0.04, h: 0.42,
      fontSize: 12, bold: true,
      color: ci === 0 ? C.offWhite : C.navy,
      align: "center", valign: "middle", margin: 0
    });
  });

  // Data rows
  rows.forEach((row, ri) => {
    const y = tableY + 0.42 + ri * rowH;
    const bgRow = ri % 2 === 0 ? "131F3C" : C.navyMid;
    row.forEach((cell, ci) => {
      s.addShape(pres.shapes.RECTANGLE, {
        x: colX[ci], y, w: colW[ci] - 0.04, h: rowH - 0.03,
        fill: { color: bgRow }, line: { color: "1E2D50" }
      });
      // Color code good/bad for wP vs aP
      let textColor = C.offWhite;
      if (ci === 1 && ["TH1 + TH17 (balanced)", "Yes — blocks colonization", "~10–12 years", "Yes", "Closer match"].includes(cell))
        textColor = C.green;
      if (ci === 2 && ["TH2-biased", "No — colonization persists", "2–4 years (rapid waning)", "No", "Divergent response"].includes(cell))
        textColor = C.red;

      s.addText(cell, {
        x: colX[ci] + 0.08, y, w: colW[ci] - 0.2, h: rowH - 0.03,
        fontSize: 11.5, color: textColor, valign: "middle", margin: 0,
        align: ci === 0 ? "left" : "center", bold: ci === 0
      });
    });
  });

  s.addText("Green = immunological advantage  |  Red = immunological limitation", {
    x: 0.3, y: 5.28, w: 9.4, h: 0.25,
    fontSize: 9.5, italic: true, color: C.lightGray, align: "left"
  });
}

// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 5 — EFFICACY & EFFECTIVENESS
// ─────────────────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  darkBg(s);
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: 10, h: 0.08, fill: { color: C.teal }, line: { color: C.teal }
  });

  s.addText("Efficacy & Real-World Effectiveness", {
    x: 0.5, y: 0.2, w: 9, h: 0.55, fontSize: 22, bold: true, color: C.white, align: "left", margin: 0
  });

  // Efficacy bars — wP
  s.addText("WHOLE-CELL (wP)", {
    x: 0.4, y: 0.88, w: 4.2, h: 0.32, fontSize: 11, bold: true, color: C.teal, align: "left", margin: 0
  });
  const wpBars = [
    ["Initial efficacy (3 doses)", 0.94],
    ["After 10 years", 0.55],
    ["Nasopharyngeal clearance", 0.80],
    ["Transmission blocking", 0.75],
  ];
  wpBars.forEach(([label, pct], i) => {
    const y = 1.25 + i * 0.72;
    s.addText(label, { x: 0.4, y, w: 4.1, h: 0.22, fontSize: 11, color: C.offWhite, margin: 0 });
    const barW = 4.0 * pct;
    s.addShape(pres.shapes.RECTANGLE, {
      x: 0.4, y: y + 0.24, w: 4.0, h: 0.28,
      fill: { color: "1C2D50" }, line: { color: "1C2D50" }
    });
    s.addShape(pres.shapes.RECTANGLE, {
      x: 0.4, y: y + 0.24, w: barW, h: 0.28,
      fill: { color: C.teal }, line: { color: C.teal }
    });
    s.addText(`${Math.round(pct * 100)}%`, {
      x: 0.4 + barW + 0.1, y: y + 0.24, w: 0.55, h: 0.28,
      fontSize: 11, bold: true, color: C.teal, valign: "middle", margin: 0
    });
  });

  // Efficacy bars — aP
  s.addText("ACELLULAR (aP)", {
    x: 5.4, y: 0.88, w: 4.2, h: 0.32, fontSize: 11, bold: true, color: C.amber, align: "left", margin: 0
  });
  const apBars = [
    ["Initial efficacy (3 doses)", 0.85],
    ["After 4 years", 0.40],
    ["Nasopharyngeal clearance", 0.10],
    ["Transmission blocking", 0.05],
  ];
  apBars.forEach(([label, pct], i) => {
    const y = 1.25 + i * 0.72;
    s.addText(label, { x: 5.4, y, w: 4.1, h: 0.22, fontSize: 11, color: C.offWhite, margin: 0 });
    const barW = 4.0 * pct;
    s.addShape(pres.shapes.RECTANGLE, {
      x: 5.4, y: y + 0.24, w: 4.0, h: 0.28,
      fill: { color: "1C2D50" }, line: { color: "1C2D50" }
    });
    s.addShape(pres.shapes.RECTANGLE, {
      x: 5.4, y: y + 0.24, w: barW, h: 0.28,
      fill: { color: C.amber }, line: { color: C.amber }
    });
    s.addText(`${Math.round(pct * 100)}%`, {
      x: 5.4 + barW + 0.1, y: y + 0.24, w: 0.55, h: 0.28,
      fontSize: 11, bold: true, color: C.amber, valign: "middle", margin: 0
    });
  });

  // Divider
  s.addShape(pres.shapes.RECTANGLE, {
    x: 4.9, y: 0.88, w: 0.04, h: 4.2,
    fill: { color: C.lightGray, transparency: 60 }, line: { color: C.lightGray, transparency: 60 }
  });

  s.addText("Note: aP vaccines prevent clinical disease but do NOT reduce nasopharyngeal colonization, enabling silent transmission (\"cocooning\" failure).", {
    x: 0.4, y: 5.22, w: 9.2, h: 0.3,
    fontSize: 10, italic: true, color: C.amber, align: "left"
  });
}

// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 6 — SAFETY PROFILE
// ─────────────────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  darkBg(s);
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: 10, h: 0.08, fill: { color: C.amber }, line: { color: C.amber }
  });

  s.addText("Safety Profile", {
    x: 0.5, y: 0.2, w: 9, h: 0.55, fontSize: 22, bold: true, color: C.white, align: "left", margin: 0
  });

  // wP safety
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0.3, y: 0.88, w: 4.3, h: 0.38,
    fill: { color: C.teal }, line: { color: C.teal }
  });
  s.addText("Whole-Cell (wP) — Adverse Events", {
    x: 0.3, y: 0.88, w: 4.3, h: 0.38, fontSize: 12, bold: true, color: C.navy, align: "center", valign: "middle", margin: 0
  });

  const wpSafety = [
    ["Local reactions", "Very common (>50%): redness, swelling, pain at injection site", C.red],
    ["Fever", "Common; often high-grade (>40°C in some cases)", C.red],
    ["Prolonged crying", "Up to 3% of doses; self-limiting", C.red],
    ["Febrile seizures", "Rare but reported (1–9 per 100,000 doses)", C.red],
    ["Hypotonic-hyporesponsive episode (HHE)", "Rare; generally self-resolving", C.red],
    ["Encephalopathy (claimed)", "Alleged but NOT causally proven (IOM 1994 review)", "#8A9BB8"],
  ];
  wpSafety.forEach(([ae, desc], i) => {
    const y = 1.34 + i * 0.6;
    s.addShape(pres.shapes.RECTANGLE, {
      x: 0.3, y, w: 4.3, h: 0.55,
      fill: { color: i % 2 === 0 ? "131F3C" : C.navyMid }, line: { color: "1E2D50" }
    });
    s.addText(ae, { x: 0.38, y: y + 0.02, w: 4.1, h: 0.22, fontSize: 11, bold: true, color: C.red, margin: 0 });
    s.addText(desc, { x: 0.38, y: y + 0.23, w: 4.1, h: 0.22, fontSize: 9.5, color: C.offWhite, margin: 0 });
  });

  // aP safety
  s.addShape(pres.shapes.RECTANGLE, {
    x: 5.4, y: 0.88, w: 4.3, h: 0.38,
    fill: { color: C.amber }, line: { color: C.amber }
  });
  s.addText("Acellular (aP) — Adverse Events", {
    x: 5.4, y: 0.88, w: 4.3, h: 0.38, fontSize: 12, bold: true, color: C.navy, align: "center", valign: "middle", margin: 0
  });

  const apSafety = [
    ["Local reactions", "Less common, milder than wP", C.green],
    ["Fever", "Less frequent; usually low-grade", C.green],
    ["Systemic reactions", "Significantly reduced vs wP", C.green],
    ["Large local reactions (LLR)", "Increased risk after multiple doses (4th–5th)", C.red],
    ["No neurological concerns", "No causal link to encephalopathy", C.green],
    ["Injection site nodule", "Rare; especially with aluminium adjuvant", "#8A9BB8"],
  ];
  apSafety.forEach(([ae, desc, color], i) => {
    const y = 1.34 + i * 0.6;
    s.addShape(pres.shapes.RECTANGLE, {
      x: 5.4, y, w: 4.3, h: 0.55,
      fill: { color: i % 2 === 0 ? "131F3C" : C.navyMid }, line: { color: "1E2D50" }
    });
    s.addText(ae, { x: 5.48, y: y + 0.02, w: 4.1, h: 0.22, fontSize: 11, bold: true, color, margin: 0 });
    s.addText(desc, { x: 5.48, y: y + 0.23, w: 4.1, h: 0.22, fontSize: 9.5, color: C.offWhite, margin: 0 });
  });

  s.addText("The switch to aP vaccines was largely driven by safety concerns about wP — but subsequent analysis showed most serious events were not causally linked.", {
    x: 0.4, y: 5.22, w: 9.2, h: 0.3,
    fontSize: 10, italic: true, color: C.lightGray
  });
}

// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 7 — WANING IMMUNITY & RESURGENCE
// ─────────────────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  darkBg(s);
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: 10, h: 0.08, fill: { color: C.red }, line: { color: C.red }
  });

  s.addText("Waning Immunity & Pertussis Resurgence", {
    x: 0.5, y: 0.2, w: 9, h: 0.55, fontSize: 22, bold: true, color: C.white, align: "left", margin: 0
  });

  // Timeline visual
  const timelineY = 1.4;
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0.5, y: timelineY + 0.12, w: 9.0, h: 0.06,
    fill: { color: C.lightGray }, line: { color: C.lightGray }
  });

  const events = [
    [0.5, "1940s", "wP introduced\nCases fall\n>99%"],
    [2.2, "1990s", "aP replaces wP\n(US, EU, Japan)\nFewer side effects"],
    [4.2, "2000s", "Waning immunity\nCases rebound\n~20,000/yr US"],
    [6.1, "2010–12", "Major outbreaks\n48,000 US cases\nin 2012"],
    [8.0, "2024–26", "Pertactin-\ndeficient strains\nSpreading globally"],
  ];

  events.forEach(([x, year, text], i) => {
    const isTop = i % 2 === 0;
    const dotY = timelineY + 0.09;
    s.addShape(pres.shapes.OVAL, {
      x: x - 0.1, y: dotY, w: 0.22, h: 0.22,
      fill: { color: i < 2 ? C.teal : i < 4 ? C.amber : C.red },
      line: { color: C.navy }
    });
    s.addText(year, {
      x: x - 0.3, y: isTop ? dotY - 0.3 : dotY + 0.24,
      w: 0.9, h: 0.25, fontSize: 9, bold: true,
      color: i < 2 ? C.teal : i < 4 ? C.amber : C.red,
      align: "center", margin: 0
    });
    s.addText(text, {
      x: x - 0.45, y: isTop ? timelineY - 1.15 : timelineY + 0.55,
      w: 1.2, h: 0.85, fontSize: 9.5, color: C.offWhite,
      align: "center", margin: 0
    });
  });

  // Key reasons box
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    x: 0.3, y: 2.7, w: 9.4, h: 0.35,
    fill: { color: "1C2D55" }, line: { color: C.red, width: 1.5 }
  });
  s.addText("Why did pertussis resurge after aP vaccine introduction?", {
    x: 0.4, y: 2.7, w: 9.2, h: 0.35,
    fontSize: 13, bold: true, color: C.amber, valign: "middle", margin: 4
  });

  const reasons = [
    ["1. Rapid waning immunity", "aP protection wanes within 2–4 years after 5th/6th dose vs 10–12 years for wP"],
    ["2. TH2 vs TH1/TH17 bias", "aP does not elicit TH17 responses needed for mucosal immunity; natural infection and wP do"],
    ["3. Colonization not blocked", "aP recipients can carry and transmit B. pertussis silently — 'cocooning' fails"],
    ["4. Pertactin-deficient strains", "Vaccine-driven evolution: strains losing PRN (a key aP antigen) have spread globally (2024 systematic review)"],
    ["5. Underimmunization in adults", "Adult Tdap coverage was only 30.1% in US (2019) — large susceptible reservoir"],
  ];
  reasons.forEach(([title, desc], i) => {
    const y = 3.14 + i * 0.46;
    s.addShape(pres.shapes.RECTANGLE, {
      x: 0.3, y, w: 9.4, h: 0.43,
      fill: { color: i % 2 === 0 ? "131F3C" : C.navyMid }, line: { color: "1E2D50" }
    });
    s.addText(title, { x: 0.42, y: y + 0.03, w: 2.3, h: 0.38, fontSize: 10.5, bold: true, color: C.red, valign: "middle", margin: 0 });
    s.addText(desc, { x: 2.78, y: y + 0.03, w: 6.8, h: 0.38, fontSize: 10.5, color: C.offWhite, valign: "middle", margin: 0 });
  });
}

// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 8 — VACCINATION SCHEDULES & GLOBAL USE
// ─────────────────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  darkBg(s);
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: 10, h: 0.08, fill: { color: C.teal }, line: { color: C.teal }
  });

  s.addText("Vaccination Schedules & Global Use", {
    x: 0.5, y: 0.2, w: 9, h: 0.55, fontSize: 22, bold: true, color: C.white, align: "left", margin: 0
  });

  // Left: Developed nations (aP)
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0.3, y: 0.88, w: 4.3, h: 0.38,
    fill: { color: C.amber }, line: { color: C.amber }
  });
  s.addText("High-Income Countries (aP-based)", {
    x: 0.3, y: 0.88, w: 4.3, h: 0.38, fontSize: 12, bold: true, color: C.navy, align: "center", valign: "middle", margin: 0
  });

  const hiRows = [
    ["Vaccine", "DTaP"],
    ["Primary series", "2, 4, 6 months (3 doses)"],
    ["Booster 1", "15–18 months"],
    ["Booster 2", "4–6 years"],
    ["Adolescent", "Tdap at 11–12 years"],
    ["Adults", "Single Tdap (unvaccinated)"],
    ["Pregnancy", "Tdap at 27–36 wks (every pregnancy)"],
    ["HCW", "Tdap recommended"],
    ["Coverage (US)", "89.9% adolescents, 30.1% adults (2019)"],
  ];
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    const y = 1.35 + i * 0.43;
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      x: 0.3, y, w: 4.3, h: 0.40,
      fill: { color: i % 2 === 0 ? "131F3C" : C.navyMid }, line: { color: "1E2D50" }
    });
    s.addText(label, { x: 0.38, y, w: 1.6, h: 0.40, fontSize: 10.5, bold: true, color: C.amber, valign: "middle", margin: 4 });
    s.addText(val, { x: 2.0, y, w: 2.5, h: 0.40, fontSize: 10.5, color: C.offWhite, valign: "middle", margin: 4 });
  });

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    x: 5.4, y: 0.88, w: 4.3, h: 0.38,
    fill: { color: C.teal }, line: { color: C.teal }
  });
  s.addText("Low/Middle-Income Countries (wP-based)", {
    x: 5.4, y: 0.88, w: 4.3, h: 0.38, fontSize: 12, bold: true, color: C.navy, align: "center", valign: "middle", margin: 0
  });

  const lmicRows = [
    ["Vaccine", "DTwP or Pentavalent"],
    ["Primary series", "6, 10, 14 weeks (3 doses)"],
    ["Combination", "Often with HBV, Hib, IPV"],
    ["Global coverage", "~84% DTP3 globally (WHO 2022)"],
    ["Cost", "Significantly lower than aP"],
    ["WHO SAGE", "Countries using wP should continue"],
    ["Advantage", "Blocks transmission + colonization"],
    ["Limitation", "More reactogenic; cold-chain needed"],
    ["", ""],
  ];
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    const y = 1.35 + i * 0.43;
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      x: 5.4, y, w: 4.3, h: 0.40,
      fill: { color: i % 2 === 0 ? "131F3C" : C.navyMid }, line: { color: "1E2D50" }
    });
    if (label) {
      s.addText(label, { x: 5.48, y, w: 1.6, h: 0.40, fontSize: 10.5, bold: true, color: C.teal, valign: "middle", margin: 4 });
      s.addText(val, { x: 7.1, y, w: 2.5, h: 0.40, fontSize: 10.5, color: C.offWhite, valign: "middle", margin: 4 });
    }
  });
}

// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 9 — NEXT-GENERATION VACCINES
// ─────────────────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  darkBg(s);
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: 10, h: 0.08, fill: { color: C.green }, line: { color: C.green }
  });

  s.addText("Next-Generation Pertussis Vaccines", {
    x: 0.5, y: 0.2, w: 9, h: 0.55, fontSize: 22, bold: true, color: C.white, align: "left", margin: 0
  });

  s.addText("Current acellular vaccines prevent disease but fail to block transmission. The next generation must achieve sterilizing mucosal immunity.", {
    x: 0.4, y: 0.85, w: 9.2, h: 0.45,
    fontSize: 12.5, color: C.offWhite, italic: true
  });

  const candidates = [
    {
      title: "Live Attenuated Nasal Vaccine (BPZE1)",
      stage: "Phase II trials",
      stageColor: C.amber,
      pts: [
        "Delivered intranasally → optimizes mucosal TH1/TH17 response",
        "Mimics natural infection immunity profile",
        "Reduces nasopharyngeal colonization in animal models",
        "Potentially single dose; no cold chain dependency",
      ]
    },
    {
      title: "Outer Membrane Vesicle (OMV) Vaccines",
      stage: "Preclinical / Phase I",
      stageColor: C.lightGray,
      pts: [
        "Contains native LPS and surface proteins similar to whole-cell",
        "Retains TH1/TH17 stimulating capacity",
        "Better safety profile than whole-cell (no live bacteria)",
        "Could bridge wP immunogenicity with aP safety",
      ]
    },
    {
      title: "Polysaccharide-Protein Conjugate Vaccine",
      stage: "Early development",
      stageColor: C.lightGray,
      pts: [
        "Links B. pertussis capsule polysaccharide to pertussis toxin",
        "Novel antigen target not included in current vaccines",
        "May address pertactin-deficient strain evasion",
      ]
    },
  ];

  candidates.forEach((c, i) => {
    const y = 1.4 + i * 1.38;
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      x: 0.3, y, w: 9.4, h: 1.28,
      fill: { color: C.navyMid }, line: { color: C.green, width: 1.5 }
    });
    s.addShape(pres.shapes.RECTANGLE, {
      x: 0.3, y, w: 0.22, h: 1.28,
      fill: { color: C.green }, line: { color: C.green }
    });
    // Stage pill
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      x: 8.3, y: y + 0.08, w: 1.3, h: 0.26,
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    });
    s.addText(c.stage, {
      x: 8.3, y: y + 0.08, w: 1.3, h: 0.26,
      fontSize: 8.5, bold: true, color: C.navy, align: "center", valign: "middle", margin: 0
    });
    s.addText(c.title, {
      x: 0.62, y: y + 0.05, w: 7.5, h: 0.3,
      fontSize: 13, bold: true, color: C.green, margin: 0
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      text: p,
      options: { bullet: { type: "bullet", indent: 10 }, breakLine: pi < c.pts.length - 1, fontSize: 11, color: C.offWhite }
    })), { x: 0.62, y: y + 0.38, w: 9.0, h: 0.85, valign: "top" });
  });
}

// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 10 — HEAD-TO-HEAD SUMMARY
// ─────────────────────────────────────────────────────────────────────────────
{
  const s = pres.addSlide();
  darkBg(s);
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: 10, h: 0.08, fill: { color: C.teal }, line: { color: C.teal }
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  s.addText("Head-to-Head Summary", {
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  });

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  const colX2 = [0.25, 3.42, 6.72];
  const colW2 = [3.1, 3.22, 3.0];

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      x: colX2[ci], y: 0.88, w: colW2[ci] - 0.04, h: 0.38,
      fill: { color: ci === 1 ? C.teal : ci === 2 ? C.amber : "1C2D55" },
      line: { color: C.navy }
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    s.addText(h, {
      x: colX2[ci], y: 0.88, w: colW2[ci] - 0.04, h: 0.38,
      fontSize: 12, bold: true, color: ci === 0 ? C.offWhite : C.navy,
      align: "center", valign: "middle", margin: 0
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  const summaryRows = [
    ["Composition", "Killed whole bacteria", "Purified subunit proteins"],
    ["Antigens", "Thousands (all native)", "2–5 selected antigens"],
    ["Immune response", "TH1 + TH17", "TH2-biased"],
    ["Mucosal IgA", "Yes", "No"],
    ["Duration of protection", "~10–12 years", "2–4 years"],
    ["Blocks transmission", "Yes", "No"],
    ["Reactogenicity", "High", "Low"],
    ["Serious adverse events", "Rare but reported", "Very rare"],
    ["Cost", "Low (LMICs)", "Higher"],
    ["WHO recommendation", "Continue in wP countries", "Add boosters + maternal Tdap"],
    ["Resurgence risk", "Lower", "Higher (proven)"],
  ];

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        x: colX2[ci], y, w: colW2[ci] - 0.04, h: 0.36,
        fill: { color: bg }, line: { color: "1E2D50" }
      });
      let color = C.offWhite;
      if (ci === 1 && ["Yes", "~10–12 years", "TH1 + TH17", "Lower"].includes(cell)) color = C.green;
      if (ci === 2 && ["No", "2–4 years", "TH2-biased", "Higher (proven)"].includes(cell)) color = C.red;
      if (ci === 1 && ["High"].includes(cell)) color = C.red;
      if (ci === 2 && ["Low", "Very rare"].includes(cell)) color = C.green;
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        align: ci === 0 ? "left" : "center", bold: ci === 0
      });
    });
  });
}

// ─────────────────────────────────────────────────────────────────────────────
// SLIDE 11 — CONCLUSION & KEY TAKEAWAYS
// ─────────────────────────────────────────────────────────────────────────────
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  darkBg(s);
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: 10, h: 0.08, fill: { color: C.amber }, line: { color: C.amber }
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  s.addText("Key Takeaways", {
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    [C.teal, "wP > aP for population immunity", "Whole-cell vaccines block transmission and provide longer-lasting TH1/TH17 immunity. WHO recommends countries using wP continue to do so."],
    [C.amber, "aP wins on safety & tolerability", "Far fewer local and systemic reactions. Enabled high uptake globally. Reduced parent vaccine hesitancy."],
    [C.red, "Pertussis has resurged with aP", "Waning immunity + no transmission blocking = epidemics every 3–5 years. Pertactin-deficient strains are spreading (2024 systematic review, PMID 39686838)."],
    [C.green, "Maternal Tdap is the best bridge", "Tdap at 27–36 weeks is 90–93% effective at protecting infants <2 months — the highest-risk group. Recommended in every pregnancy."],
    [C.teal, "Next-gen vaccines must block transmission", "Live nasal (BPZE1) and OMV vaccines in trials aim to restore mucosal immunity. Sterilizing immunity is the ultimate goal."],
    [C.lightGray, "Adults & HCWs are a key reservoir", "Adult Tdap coverage only 30% in the US. Improving adult vaccination would reduce infant exposure significantly."],
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}

// ─── Write file ───────────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/pertussis-vaccines/Pertussis_Vaccines_aP_vs_wP.pptx" })
  .then(() => console.log("DONE"))
  .catch(e => console.error("ERROR:", e));

node /home/daytona/workspace/pertussis-vaccines/build.js

ls -lh /home/daytona/workspace/pertussis-vaccines/