"osteoarthritis"[MeSH Terms] AND "treatment"[MeSH Terms]

mkdir -p /home/daytona/workspace/osteoarthritis-ppt && ls /home/daytona/workspac…

~/osteoarthritis-ppt/make_ppt.js

const pptxgen = require("pptxgenjs");

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Osteoarthritis";
pres.author = "Orris Medical";

// ── Color Palette ──────────────────────────────────────────────
// Deep navy dominates; warm amber accent; soft slate for cards
const C = {
  navy:    "0D2B4E",
  navyMid: "14396A",
  amber:   "E8A020",
  amberLt: "F5C055",
  slate:   "1E3F6B",
  card:    "162E52",
  white:   "FFFFFF",
  offWhite:"EAF0F8",
  grey:    "A8BACE",
  red:     "C0392B",
  green:   "27AE60",
  teal:    "1A7F7A",
};

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

// ── Helper: accent bar ─────────────────────────────────────────
function accentBar(slide, y = 5.2) {
  slide.addShape(pres.ShapeType.rect, {
    x: 0, y, w: 10, h: 0.08,
    fill: { color: C.amber }, line: { color: C.amber }
  });
}

// ── Helper: section heading strip ─────────────────────────────
function sectionStrip(slide, text) {
  slide.addShape(pres.ShapeType.rect, {
    x: 0, y: 0, w: 10, h: 0.85,
    fill: { color: C.amber }, line: { color: C.amber }
  });
  slide.addText(text, {
    x: 0.3, y: 0, w: 9.4, h: 0.85,
    fontSize: 22, bold: true, color: C.navy,
    valign: "middle", margin: 0
  });
}

// ── Helper: card box ──────────────────────────────────────────
function card(slide, x, y, w, h, opts = {}) {
  slide.addShape(pres.ShapeType.rect, {
    x, y, w, h,
    fill: { color: opts.fill || C.card },
    line: { color: opts.border || C.slate, pt: 0.5 },
    shadow: { type: "outer", color: "000000", blur: 6, offset: 2, angle: 135, opacity: 0.2 }
  });
}

// ══════════════════════════════════════════════════════════════
// SLIDE 1 — Title
// ══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  darkBg(s);

  // Big amber left accent bar
  s.addShape(pres.ShapeType.rect, {
    x: 0, y: 0, w: 0.18, h: 5.625,
    fill: { color: C.amber }, line: { color: C.amber }
  });

  // Decorative circles
  s.addShape(pres.ShapeType.ellipse, {
    x: 7.2, y: -0.5, w: 3.5, h: 3.5,
    fill: { color: C.navyMid }, line: { color: C.navyMid }
  });
  s.addShape(pres.ShapeType.ellipse, {
    x: 8, y: 3.2, w: 2.2, h: 2.2,
    fill: { color: C.slate }, line: { color: C.slate }
  });
  s.addShape(pres.ShapeType.ellipse, {
    x: 6.5, y: 3.8, w: 1.2, h: 1.2,
    fill: { color: C.amber, transparency: 60 }, line: { color: C.amber, transparency: 60 }
  });

  s.addText("OSTEOARTHRITIS", {
    x: 0.5, y: 1.3, w: 6.8, h: 1.0,
    fontSize: 40, bold: true, color: C.white,
    charSpacing: 4, margin: 0
  });
  s.addText("A Comprehensive Fast Review", {
    x: 0.5, y: 2.35, w: 6.8, h: 0.55,
    fontSize: 18, color: C.amberLt, italic: true, margin: 0
  });

  s.addShape(pres.ShapeType.rect, {
    x: 0.5, y: 3.05, w: 3.8, h: 0.04,
    fill: { color: C.amber }, line: { color: C.amber }
  });

  s.addText([
    { text: "Definition  •  Epidemiology  •  Pathogenesis", options: { breakLine: true } },
    { text: "Morphology  •  Clinical Features  •  Diagnosis  •  Management" }
  ], {
    x: 0.5, y: 3.2, w: 7, h: 0.8,
    fontSize: 11, color: C.grey, margin: 0
  });

  s.addText("Sources: Goldman-Cecil Medicine | Robbins & Kumar Basic Pathology", {
    x: 0.5, y: 5.15, w: 9, h: 0.35,
    fontSize: 9, color: C.grey, italic: true, margin: 0
  });
}

// ══════════════════════════════════════════════════════════════
// SLIDE 2 — Definition & Epidemiology
// ══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  darkBg(s);
  sectionStrip(s, "Definition & Epidemiology");
  accentBar(s);

  // Definition card
  card(s, 0.3, 1.05, 9.4, 1.3);
  s.addText("DEFINITION", {
    x: 0.55, y: 1.1, w: 2, h: 0.35,
    fontSize: 9, bold: true, color: C.amber, margin: 0, charSpacing: 2
  });
  s.addText(
    "Failed repair of synovial joint tissues after intra-articular stress → breakdown of cartilage & bone → pain, stiffness, functional disability. Most common joint disease. Primarily degenerative; inflammation is secondary.",
    { x: 0.55, y: 1.42, w: 9.0, h: 0.8, fontSize: 12, color: C.offWhite, margin: 0 }
  );

  // Two epi cards side by side
  const epiItems = [
    ["500 M+", "people affected worldwide"],
    ["~40%", "of people >70 affected"],
    ["47%", "lifetime knee OA risk (women)"],
    ["85%", "of OA burden = knee OA"],
    ["25%", "US adults by 2040"],
    ["80%", "report movement limitations"],
  ];

  const cols = 3;
  epiItems.forEach((item, i) => {
    const col = i % cols;
    const row = Math.floor(i / cols);
    const x = 0.3 + col * 3.15;
    const y = 2.55 + row * 1.1;
    card(s, x, y, 2.9, 0.9, { fill: C.slate });
    s.addText(item[0], {
      x: x + 0.1, y: y + 0.05, w: 2.7, h: 0.42,
      fontSize: 22, bold: true, color: C.amber, margin: 0, align: "center"
    });
    s.addText(item[1], {
      x: x + 0.1, y: y + 0.48, w: 2.7, h: 0.34,
      fontSize: 9.5, color: C.grey, margin: 0, align: "center"
    });
  });
}

// ══════════════════════════════════════════════════════════════
// SLIDE 3 — Classification & Risk Factors
// ══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  darkBg(s);
  sectionStrip(s, "Classification & Risk Factors");
  accentBar(s);

  // Primary vs Secondary
  card(s, 0.3, 1.0, 4.5, 2.0, { fill: C.card });
  s.addText("PRIMARY (Idiopathic)", {
    x: 0.5, y: 1.05, w: 4.1, h: 0.4,
    fontSize: 13, bold: true, color: C.amber, margin: 0
  });
  s.addText([
    { text: "• Appears insidiously with aging", options: { breakLine: true } },
    { text: "• Oligoarticular (few joints)", options: { breakLine: true } },
    { text: "• Mainly weight-bearing joints", options: { breakLine: true } },
    { text: "• No identifiable cause", options: { breakLine: true } },
    { text: "• 95% of all OA cases" }
  ], { x: 0.5, y: 1.5, w: 4.1, h: 1.35, fontSize: 11.5, color: C.offWhite, margin: 0 });

  card(s, 5.2, 1.0, 4.5, 2.0, { fill: C.card });
  s.addText("SECONDARY", {
    x: 5.4, y: 1.05, w: 4.1, h: 0.4,
    fontSize: 13, bold: true, color: C.teal, margin: 0
  });
  s.addText([
    { text: "• ~5% of all OA cases", options: { breakLine: true } },
    { text: "• Younger individuals", options: { breakLine: true } },
    { text: "• Causes: prior joint injury,", options: { breakLine: true } },
    { text: "  joint deformity, obesity,", options: { breakLine: true } },
    { text: "  diabetes, metabolic disease" }
  ], { x: 5.4, y: 1.5, w: 4.1, h: 1.35, fontSize: 11.5, color: C.offWhite, margin: 0 });

  // Risk factors strip
  s.addText("KEY RISK FACTORS", {
    x: 0.3, y: 3.15, w: 4, h: 0.3,
    fontSize: 9, bold: true, color: C.amber, charSpacing: 2, margin: 0
  });

  const risks = [
    ["🔢", "Age >50"],
    ["♀", "Female sex"],
    ["⚖", "Obesity (BMI ↑)"],
    ["🦵", "Prior joint injury"],
    ["🧬", "Genetics (GDF5, RUNX2)"],
  ];

  risks.forEach((r, i) => {
    const x = 0.3 + i * 1.88;
    card(s, x, 3.5, 1.75, 0.75, { fill: C.slate });
    s.addText(r[0] + "  " + r[1], {
      x: x + 0.08, y: 3.55, w: 1.6, h: 0.6,
      fontSize: 10.5, color: C.white, margin: 0, align: "center", valign: "middle"
    });
  });
}

// ══════════════════════════════════════════════════════════════
// SLIDE 4 — Pathogenesis
// ══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  darkBg(s);
  sectionStrip(s, "Pathogenesis");
  accentBar(s);

  const stages = [
    {
      num: "1",
      title: "Chondrocyte Injury",
      color: C.amber,
      items: [
        "Biomechanical stress + genetic predisposition",
        "Type II collagen network disrupted",
        "Proteoglycan concentration ↓",
        "Water content ↑ (matrix swells)"
      ]
    },
    {
      num: "2",
      title: "Early OA",
      color: "#2ECC71",
      items: [
        "Chondrocytes proliferate & secrete MMPs",
        "IL-1, IL-6, TNF, PGE₂, NO released",
        "TGF-β induces further MMP production",
        "Surface fibrillation develops"
      ]
    },
    {
      num: "3",
      title: "Late OA",
      color: C.red,
      items: [
        "Full-thickness cartilage sloughing",
        "Bone eburnation (ivory surface)",
        "Subchondral cysts form",
        "Osteophytes + loose bodies ('joint mice')"
      ]
    }
  ];

  stages.forEach((st, i) => {
    const x = 0.3 + i * 3.18;
    card(s, x, 0.95, 2.95, 4.1, { fill: C.card });

    // Number circle
    s.addShape(pres.ShapeType.ellipse, {
      x: x + 1.1, y: 1.05, w: 0.75, h: 0.75,
      fill: { color: st.color }, line: { color: st.color }
    });
    s.addText(st.num, {
      x: x + 1.1, y: 1.05, w: 0.75, h: 0.75,
      fontSize: 18, bold: true, color: C.navy, align: "center", valign: "middle", margin: 0
    });

    s.addText(st.title, {
      x: x + 0.12, y: 1.87, w: 2.71, h: 0.5,
      fontSize: 12.5, bold: true, color: st.color, align: "center", margin: 0
    });

    s.addText(
      st.items.map(it => "• " + it).join("\n"),
      { x: x + 0.15, y: 2.43, w: 2.65, h: 2.5, fontSize: 10.5, color: C.offWhite, margin: 0 }
    );
  });

  // Arrow connectors
  [1, 2].forEach(i => {
    const ax = 0.3 + i * 3.18 - 0.15;
    s.addShape(pres.ShapeType.rect, {
      x: ax, y: 2.85, w: 0.18, h: 0.08,
      fill: { color: C.amber }, line: { color: C.amber }
    });
  });
}

// ══════════════════════════════════════════════════════════════
// SLIDE 5 — Morphology
// ══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  darkBg(s);
  sectionStrip(s, "Morphology / Gross & Histologic Features");
  accentBar(s);

  const morph = [
    { term: "Fibrillation", desc: "Earliest change — cartilage surface clefts and splits", color: C.teal },
    { term: "Bone Eburnation", desc: "Full cartilage loss; exposed subchondral bone polished to ivory appearance", color: C.amber },
    { term: "Subchondral Cysts", desc: "Synovial fluid forced into bone via ball-valve mechanism; fibrous walls", color: "#9B59B6" },
    { term: "Osteophytes", desc: "Bony spurs at joint margins capped by fibrocartilage; driven by BMP & TGF-β", color: C.green },
    { term: "Loose Bodies", desc: "'Joint mice' — dislodged cartilage/bone fragments tumbling in the joint cavity", color: "#E74C3C" },
    { term: "Mild Synovitis", desc: "Mild congestion & fibrosis only (contrast: RA has destructive inflammatory pannus)", color: C.grey },
  ];

  morph.forEach((m, i) => {
    const row = Math.floor(i / 2);
    const col = i % 2;
    const x = 0.3 + col * 4.85;
    const y = 1.05 + row * 1.3;
    card(s, x, y, 4.6, 1.1, { fill: C.card });
    s.addShape(pres.ShapeType.rect, {
      x, y, w: 0.18, h: 1.1,
      fill: { color: m.color }, line: { color: m.color }
    });
    s.addText(m.term, {
      x: x + 0.28, y: y + 0.08, w: 4.2, h: 0.38,
      fontSize: 12.5, bold: true, color: m.color, margin: 0
    });
    s.addText(m.desc, {
      x: x + 0.28, y: y + 0.48, w: 4.2, h: 0.52,
      fontSize: 10, color: C.offWhite, margin: 0
    });
  });

  // Nodes reminder
  card(s, 0.3, 5.0, 9.4, 0.45, { fill: C.slate });
  s.addText(
    "Hand nodes:  Heberden's nodes = DIP osteophytes     |     Bouchard's nodes = PIP osteophytes",
    { x: 0.5, y: 5.0, w: 9, h: 0.45, fontSize: 11, color: C.amberLt, align: "center", valign: "middle", margin: 0 }
  );
}

// ══════════════════════════════════════════════════════════════
// SLIDE 6 — Clinical Features
// ══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  darkBg(s);
  sectionStrip(s, "Clinical Features");
  accentBar(s);

  // Joints column
  card(s, 0.3, 1.0, 2.5, 4.15, { fill: C.card });
  s.addText("JOINTS AFFECTED", {
    x: 0.4, y: 1.08, w: 2.3, h: 0.38,
    fontSize: 9.5, bold: true, color: C.amber, charSpacing: 1.5, margin: 0
  });
  const joints = ["Knees (most common)", "Hips", "Hands (DIP > PIP)", "Lumbar/Cervical spine", "Feet (1st MTP)"];
  joints.forEach((j, i) => {
    s.addShape(pres.ShapeType.rect, {
      x: 0.42, y: 1.58 + i * 0.65, w: 0.12, h: 0.35,
      fill: { color: C.amber }, line: { color: C.amber }
    });
    s.addText(j, {
      x: 0.65, y: 1.58 + i * 0.65, w: 2.0, h: 0.35,
      fontSize: 11, color: C.offWhite, margin: 0, valign: "middle"
    });
  });

  // Symptoms column
  card(s, 3.05, 1.0, 3.2, 4.15, { fill: C.card });
  s.addText("SYMPTOMS", {
    x: 3.15, y: 1.08, w: 3.0, h: 0.38,
    fontSize: 9.5, bold: true, color: C.teal, charSpacing: 1.5, margin: 0
  });
  const syms = [
    "Mechanical pain (activity, end of day)",
    "Morning stiffness < 30 min",
    "Crepitus / grating",
    "Functional limitation",
    "Locking / catching (knee)"
  ];
  syms.forEach((sy, i) => {
    s.addText("• " + sy, {
      x: 3.15, y: 1.55 + i * 0.68, w: 3.0, h: 0.6,
      fontSize: 11, color: C.offWhite, margin: 0
    });
  });

  // Signs column
  card(s, 6.5, 1.0, 3.2, 4.15, { fill: C.card });
  s.addText("SIGNS", {
    x: 6.6, y: 1.08, w: 3.0, h: 0.38,
    fontSize: 9.5, bold: true, color: "#9B59B6", charSpacing: 1.5, margin: 0
  });
  const signs = [
    "Joint line tenderness",
    "Bony swelling (osteophytes)",
    "Crepitus on movement",
    "Decreased ROM",
    "Effusion (knee)",
    "Varus / valgus deformity"
  ];
  signs.forEach((sg, i) => {
    s.addText("• " + sg, {
      x: 6.6, y: 1.55 + i * 0.6, w: 3.0, h: 0.55,
      fontSize: 11, color: C.offWhite, margin: 0
    });
  });
}

// ══════════════════════════════════════════════════════════════
// SLIDE 7 — Diagnosis + OA vs RA
// ══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  darkBg(s);
  sectionStrip(s, "Diagnosis");
  accentBar(s);

  // Diagnosis criteria card
  card(s, 0.3, 1.0, 4.4, 4.15, { fill: C.card });
  s.addText("CLINICAL DIAGNOSIS", {
    x: 0.5, y: 1.08, w: 4.0, h: 0.38,
    fontSize: 10, bold: true, color: C.amber, charSpacing: 1.5, margin: 0
  });
  const diagPoints = [
    "Pain + brief morning stiffness + functional limitation",
    "Crepitus + restricted movement + bony enlargement",
    "NO routine labs required",
    "Imaging only for atypical presentations"
  ];
  diagPoints.forEach((d, i) => {
    s.addText("• " + d, {
      x: 0.5, y: 1.6 + i * 0.62, w: 4.0, h: 0.55,
      fontSize: 11, color: C.offWhite, margin: 0
    });
  });

  s.addText("X-RAY FINDINGS (4 Classic)", {
    x: 0.5, y: 3.55, w: 4.0, h: 0.38,
    fontSize: 10, bold: true, color: C.amberLt, charSpacing: 1.5, margin: 0
  });
  const xray = ["1. Joint space narrowing", "2. Subchondral sclerosis", "3. Subchondral cysts", "4. Osteophytes"];
  xray.forEach((x2, i) => {
    s.addText(x2, {
      x: 0.5, y: 3.98 + i * 0.3, w: 4.0, h: 0.28,
      fontSize: 10.5, color: C.offWhite, margin: 0
    });
  });

  // OA vs RA table
  card(s, 5.0, 1.0, 4.7, 4.15, { fill: C.card });
  s.addText("OA  vs  RA", {
    x: 5.15, y: 1.08, w: 4.4, h: 0.38,
    fontSize: 12, bold: true, color: C.amber, align: "center", margin: 0
  });

  const rows = [
    ["Feature", "OA", "RA"],
    ["Morning stiffness", "<30 min", ">1 hr"],
    ["Joints", "DIP, knees, hips", "MCP, PIP, wrists"],
    ["Inflammation", "Minimal", "Severe (pannus)"],
    ["Serology", "Negative", "RF / ACPA +ve"],
    ["Systemic features", "None", "Yes"],
    ["Nodes", "Heberden (DIP)", "None"],
  ];

  rows.forEach((row, ri) => {
    const isHeader = ri === 0;
    const ry = 1.55 + ri * 0.5;
    const bg = isHeader ? C.amber : (ri % 2 === 0 ? C.navyMid : C.card);
    const tc = isHeader ? C.navy : C.offWhite;

    s.addShape(pres.ShapeType.rect, {
      x: 5.05, y: ry, w: 4.55, h: 0.44,
      fill: { color: bg }, line: { color: C.slate, pt: 0.3 }
    });
    [row[0], row[1], row[2]].forEach((cell, ci) => {
      const cw = [1.85, 1.3, 1.3];
      const cx = 5.05 + cw.slice(0, ci).reduce((a, b) => a + b, 0);
      s.addText(cell, {
        x: cx + 0.05, y: ry, w: cw[ci] - 0.1, h: 0.44,
        fontSize: isHeader ? 9 : 8.5, bold: isHeader, color: tc,
        valign: "middle", margin: 0
      });
    });
  });
}

// ══════════════════════════════════════════════════════════════
// SLIDE 8 — Management
// ══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  darkBg(s);
  sectionStrip(s, "Management");
  accentBar(s);

  // Step labels
  const steps = [
    {
      label: "STEP 1",
      title: "Core Non-Pharmacologic",
      color: C.green,
      items: ["Education & self-management", "Weight loss (5-10% of body weight)", "Aerobic exercise (walking, cycling, swimming)", "Therapeutic exercise (quadriceps strengthening)", "Physiotherapy / dietitian referral"]
    },
    {
      label: "STEP 2",
      title: "Pharmacologic",
      color: C.amber,
      items: ["Topical NSAIDs (first-line; knee/hand)", "Oral NSAIDs (if topical insufficient)", "Intraarticular corticosteroids (short-term)", "Duloxetine (central sensitization)", "⚠ Avoid: opioids, PRP, viscosupplements"]
    },
    {
      label: "STEP 3",
      title: "Surgical",
      color: C.red,
      items: ["Total joint replacement (end-stage)", "When pain disrupts sleep / ADLs", "After all conservative options exhausted", "Projected 50% ↑ in knee replacements by 2050"]
    }
  ];

  steps.forEach((st, i) => {
    const x = 0.3 + i * 3.18;
    card(s, x, 1.0, 2.95, 4.15, { fill: C.card });
    s.addShape(pres.ShapeType.rect, {
      x, y: 1.0, w: 2.95, h: 0.45,
      fill: { color: st.color }, line: { color: st.color }
    });
    s.addText(st.label + "  —  " + st.title, {
      x: x + 0.1, y: 1.0, w: 2.75, h: 0.45,
      fontSize: 10.5, bold: true, color: C.navy, valign: "middle", margin: 0
    });
    st.items.forEach((item, j) => {
      s.addText("• " + item, {
        x: x + 0.12, y: 1.52 + j * 0.55, w: 2.7, h: 0.5,
        fontSize: 10.5, color: C.offWhite, margin: 0
      });
    });
  });
}

// ══════════════════════════════════════════════════════════════
// SLIDE 9 — Key Numbers & Prognosis
// ══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  darkBg(s);
  sectionStrip(s, "Key Numbers & Prognosis");
  accentBar(s);

  const nums = [
    { val: "500M+", label: "Worldwide prevalence" },
    { val: "40%",   label: "People >70 affected" },
    { val: "<30 min", label: "Morning stiffness (OA)" },
    { val: "<2000",  label: "Synovial WBC/µL in OA" },
    { val: "85%",    label: "Stable disease trajectory" },
    { val: "5 kg",   label: "Weight loss: risk 21% → 7%" },
    { val: "20-25%", label: "Premature mortality ↑ (knee)" },
    { val: "50%",    label: "↑ Knee replacements by 2050" },
  ];

  nums.forEach((n, i) => {
    const col = i % 4;
    const row = Math.floor(i / 4);
    const x = 0.25 + col * 2.38;
    const y = 1.1 + row * 1.75;
    card(s, x, y, 2.18, 1.5, { fill: C.card });
    s.addShape(pres.ShapeType.rect, {
      x, y, w: 2.18, h: 0.06,
      fill: { color: C.amber }, line: { color: C.amber }
    });
    s.addText(n.val, {
      x: x + 0.08, y: y + 0.1, w: 2.02, h: 0.75,
      fontSize: 26, bold: true, color: C.amber, align: "center", margin: 0
    });
    s.addText(n.label, {
      x: x + 0.08, y: y + 0.88, w: 2.02, h: 0.52,
      fontSize: 9.5, color: C.grey, align: "center", margin: 0
    });
  });
}

// ══════════════════════════════════════════════════════════════
// SLIDE 10 — Summary / Closing
// ══════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  darkBg(s);

  s.addShape(pres.ShapeType.rect, {
    x: 0, y: 0, w: 0.18, h: 5.625,
    fill: { color: C.amber }, line: { color: C.amber }
  });
  s.addShape(pres.ShapeType.rect, {
    x: 9.82, y: 0, w: 0.18, h: 5.625,
    fill: { color: C.amber }, line: { color: C.amber }
  });

  s.addText("SUMMARY", {
    x: 1.0, y: 0.4, w: 8, h: 0.55,
    fontSize: 10, bold: true, color: C.amber, charSpacing: 5, align: "center", margin: 0
  });
  s.addText("Osteoarthritis", {
    x: 1.0, y: 0.95, w: 8, h: 0.7,
    fontSize: 30, bold: true, color: C.white, align: "center", margin: 0
  });

  const summPoints = [
    ["Mechanism", "Failed synovial joint repair → cartilage & bone breakdown"],
    ["3-Stage Path.", "Chondrocyte injury → Early (MMPs, cytokines) → Late (eburnation, osteophytes)"],
    ["Vs RA", "OA = mechanical/degenerative; RA = autoimmune/inflammatory; stiffness <30 min vs >1 hr"],
    ["Diagnosis", "Clinical (pain + stiffness + function); X-ray: JSN, sclerosis, cysts, osteophytes"],
    ["Treatment", "Core: exercise + weight loss first; then NSAIDs; surgery for end-stage disease"],
  ];

  summPoints.forEach((pt, i) => {
    const y = 1.85 + i * 0.67;
    s.addShape(pres.ShapeType.rect, {
      x: 0.9, y: y + 0.08, w: 1.3, h: 0.38,
      fill: { color: C.amber }, line: { color: C.amber }
    });
    s.addText(pt[0], {
      x: 0.9, y: y + 0.08, w: 1.3, h: 0.38,
      fontSize: 9, bold: true, color: C.navy, align: "center", valign: "middle", margin: 0
    });
    s.addText(pt[1], {
      x: 2.35, y: y + 0.08, w: 6.9, h: 0.38,
      fontSize: 11, color: C.offWhite, valign: "middle", margin: 0
    });
  });

  s.addText("Sources: Goldman-Cecil Medicine • Robbins & Kumar Basic Pathology • Firestein & Kelley's Rheumatology", {
    x: 1.0, y: 5.22, w: 8, h: 0.3,
    fontSize: 8, color: C.grey, italic: true, align: "center", margin: 0
  });
}

// ── Write file ─────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/osteoarthritis-ppt/Osteoarthritis.pptx" })
  .then(() => console.log("✅ Saved: Osteoarthritis.pptx"))
  .catch(err => console.error("❌ Error:", err));

cd /home/daytona/workspace/osteoarthritis-ppt && node make_ppt.js