genital tract normal flora male female urethra vagina microbiology 2024

ls /home/daytona/workspace/ 2>/dev/null || echo "workspace empty or not found"

mkdir -p /home/daytona/workspace/genital-flora-ppt && echo "done"

~/genital-flora-ppt/create_ppt.js

const pptxgen = require("pptxgenjs");

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Genital Flora - A Comprehensive Seminar";
pres.author = "Medical Microbiology Seminar";

// ─── COLOR PALETTE ───────────────────────────────────────────────────────────
const C = {
  navy:      "0D2B4E",   // dominant dark bg
  teal:      "1A7A8A",   // accent heading blocks
  tealLight: "2EABB C",  // lighter teal (unused placeholder)
  mint:      "D6F0EE",   // soft bg for content cards
  white:     "FFFFFF",
  offWhite:  "F4F9FA",
  gold:      "E8A020",   // accent highlights
  lightGold: "FFF3DC",
  coral:     "E05050",   // danger/warning accent
  gray:      "546E7A",
  lightGray: "ECF2F4",
  textDark:  "1C2B36",
  textMid:   "3D5565",
};

// ─── HELPERS ─────────────────────────────────────────────────────────────────

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

function addHeaderBar(slide, color) {
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: 10, h: 0.9,
    fill: { color: color || C.teal }, line: { color: color || C.teal }
  });
}

function addFooter(slide, text) {
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 5.3, w: 10, h: 0.325,
    fill: { color: C.navy }, line: { color: C.navy }
  });
  slide.addText(text || "Genital Flora | Medical Microbiology Seminar", {
    x: 0, y: 5.3, w: 10, h: 0.325,
    fontSize: 8, color: "AABBCC", align: "center", valign: "middle"
  });
}

function slideTitle(slide, title, subtitle) {
  slide.addText(title, {
    x: 0.3, y: 0.05, w: 9.4, h: 0.8,
    fontSize: 20, bold: true, color: C.white,
    valign: "middle", margin: 4
  });
  if (subtitle) {
    slide.addText(subtitle, {
      x: 0.3, y: 0.85, w: 9.4, h: 0.35,
      fontSize: 11, color: C.mint, italic: true, valign: "top", margin: 0
    });
  }
}

function card(slide, x, y, w, h, color) {
  slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
    x, y, w, h,
    fill: { color: color || C.white },
    line: { color: "D0E8ED", width: 0.5 },
    shadow: { type: "outer", color: "000000", blur: 5, offset: 2, angle: 135, opacity: 0.1 },
    rectRadius: 0.08
  });
}

function accentLine(slide, x, y, w, color) {
  slide.addShape(pres.shapes.RECTANGLE, {
    x, y, w, h: 0.04,
    fill: { color: color || C.gold }, line: { color: color || C.gold }
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 1 - TITLE SLIDE
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  darkSlide(s);

  // Decorative teal block left
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: 0.18, h: 5.625,
    fill: { color: C.teal }, line: { color: C.teal }
  });
  // Decorative teal block right small
  s.addShape(pres.shapes.RECTANGLE, {
    x: 9.82, y: 0, w: 0.18, h: 5.625,
    fill: { color: C.gold }, line: { color: C.gold }
  });

  // Top badge
  s.addShape(pres.shapes.ROUNDED_RECTANGLE, {
    x: 3.2, y: 0.4, w: 3.6, h: 0.4,
    fill: { color: C.teal }, line: { color: C.teal }, rectRadius: 0.12
  });
  s.addText("MEDICAL MICROBIOLOGY SEMINAR", {
    x: 3.2, y: 0.4, w: 3.6, h: 0.4,
    fontSize: 8, bold: true, color: C.white, align: "center", valign: "middle", charSpacing: 1.5
  });

  // Main title
  s.addText("GENITAL FLORA", {
    x: 0.5, y: 1.1, w: 9, h: 1.3,
    fontSize: 52, bold: true, color: C.white, align: "center", valign: "middle",
    fontFace: "Calibri"
  });

  // Gold accent under title
  s.addShape(pres.shapes.RECTANGLE, {
    x: 2.5, y: 2.45, w: 5, h: 0.07,
    fill: { color: C.gold }, line: { color: C.gold }
  });

  // Subtitle
  s.addText("Normal Microbiota of the Urogenital Tract", {
    x: 1, y: 2.6, w: 8, h: 0.5,
    fontSize: 18, color: "A0C8D0", align: "center", italic: true
  });

  // Info row
  s.addText("Composition  •  Functions  •  Lifecycle  •  Clinical Significance  •  Dysbiosis", {
    x: 1, y: 3.2, w: 8, h: 0.4,
    fontSize: 11, color: "607D8B", align: "center"
  });

  // Bottom source note
  s.addText("Sources: Jawetz Medical Microbiology 28e  |  Sherris & Ryan 8e  |  Murray Medical Microbiology 9e", {
    x: 1, y: 5.1, w: 8, h: 0.3,
    fontSize: 8, color: "455A64", align: "center"
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 2 - OVERVIEW / CONTENTS
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.shapes.RECTANGLE, { x:0, y:0, w:10, h:5.625, fill:{color:C.offWhite}, line:{color:C.offWhite} });
  addHeaderBar(s, C.navy);
  slideTitle(s, "📋  Seminar Outline");
  addFooter(s);

  const topics = [
    ["01", "What is Genital Flora?", "Definition, scope and symbiotic relationship"],
    ["02", "Urethral Flora (Both Sexes)", "Organisms, density and significance"],
    ["03", "Vaginal Flora – Age-Lifecycle", "Changes from birth to menopause"],
    ["04", "Vaginal Flora – Organisms", "Complete organism list & roles"],
    ["05", "Protective Mechanisms", "How Lactobacillus protects the host"],
    ["06", "Male Genital Microbiota", "Penis, urethra, semen, foreskin"],
    ["07", "Bacterial Vaginosis (BV)", "Dysbiosis, clue cells, organisms"],
    ["08", "Placenta & Uterine Flora", "Sterile myth debunked"],
    ["09", "Neonatal Significance", "Transmission at birth & risks"],
    ["10", "Factors Altering Genital Flora", "Antibiotics, hormones, lifestyle"],
    ["11", "Clinical Relevance", "Opportunistic infections & STIs"],
    ["12", "Summary & Key Takeaways", ""],
  ];

  const cols = 2;
  const perCol = Math.ceil(topics.length / cols);
  topics.forEach(([num, title, sub], i) => {
    const col = Math.floor(i / perCol);
    const row = i % perCol;
    const x = 0.35 + col * 4.85;
    const y = 1.1 + row * 0.72;

    s.addShape(pres.shapes.ROUNDED_RECTANGLE, {
      x, y, w: 4.6, h: 0.62,
      fill: { color: C.white },
      line: { color: "D5E8ED", width: 0.5 },
      rectRadius: 0.06,
      shadow: { type: "outer", color: "000000", blur: 3, offset: 1, angle: 135, opacity: 0.08 }
    });
    // Number badge
    s.addShape(pres.shapes.ROUNDED_RECTANGLE, {
      x: x + 0.06, y: y + 0.1, w: 0.36, h: 0.36,
      fill: { color: C.teal }, line: { color: C.teal }, rectRadius: 0.06
    });
    s.addText(num, { x: x+0.06, y: y+0.1, w: 0.36, h: 0.36, fontSize: 9, bold: true, color: C.white, align:"center", valign:"middle" });
    s.addText(title, { x: x+0.5, y: y+0.06, w: 4.0, h: 0.28, fontSize: 10, bold: true, color: C.textDark, valign:"middle", margin:0 });
    if (sub) {
      s.addText(sub, { x: x+0.5, y: y+0.33, w: 4.0, h: 0.22, fontSize: 8, color: C.gray, valign:"middle", margin:0 });
    }
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 3 - WHAT IS GENITAL FLORA?
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.shapes.RECTANGLE, { x:0, y:0, w:10, h:5.625, fill:{color:C.offWhite}, line:{color:C.offWhite} });
  addHeaderBar(s, C.teal);
  slideTitle(s, "What is Genital Flora?", "Slide 01");
  addFooter(s);

  // Definition card
  card(s, 0.3, 1.05, 9.4, 1.1, C.white);
  s.addText([
    { text: "Definition: ", options: { bold: true, color: C.teal } },
    { text: "Genital flora refers to the community of microorganisms (bacteria, fungi, occasionally protozoa) that normally inhabit the genital and lower urogenital tracts of healthy individuals. These organisms exist in a balanced, symbiotic relationship with the host.", options: { color: C.textDark } }
  ], { x: 0.55, y: 1.1, w: 8.9, h: 1.0, fontSize: 11.5, valign: "middle", margin: 6 });

  // Three concept boxes
  const concepts = [
    { icon: "🏠", head: "HOST PROVIDES", items: ["Place to colonize", "Nutrients & warmth", "Protection via innate immunity"] },
    { icon: "🦠", head: "MICROBES PROVIDE", items: ["Metabolic functions", "Immune stimulation", "Pathogen exclusion"] },
    { icon: "⚖️", head: "KEY PRINCIPLE", items: ["Symbiotic balance", "Core vs secondary microbiota", "Disruption → Disease"] },
  ];
  concepts.forEach((c, i) => {
    const x = 0.3 + i * 3.15;
    card(s, x, 2.3, 3.0, 2.75, C.white);
    s.addShape(pres.shapes.RECTANGLE, {
      x, y: 2.3, w: 3.0, h: 0.5,
      fill: { color: C.navy }, line: { color: C.navy }
    });
    s.addText(c.icon + " " + c.head, {
      x, y: 2.3, w: 3.0, h: 0.5,
      fontSize: 10, bold: true, color: C.white, align: "center", valign: "middle"
    });
    s.addText(c.items.map(t => "• " + t).join("\n"), {
      x: x + 0.15, y: 2.87, w: 2.7, h: 2.0,
      fontSize: 10.5, color: C.textDark, valign: "top", lineSpacingMultiple: 1.3
    });
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 4 - URETHRAL FLORA
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.shapes.RECTANGLE, { x:0, y:0, w:10, h:5.625, fill:{color:C.offWhite}, line:{color:C.offWhite} });
  addHeaderBar(s, C.teal);
  slideTitle(s, "Normal Microbiota of the Urethra", "Slide 02  |  Both Sexes");
  addFooter(s);

  // Key fact banner
  card(s, 0.3, 1.05, 9.4, 0.7, C.lightGold);
  s.addShape(pres.shapes.RECTANGLE, { x:0.3, y:1.05, w:0.08, h:0.7, fill:{color:C.gold}, line:{color:C.gold} });
  s.addText("Key Fact: The anterior urethra of both sexes contains small numbers of organisms derived from surrounding skin and perineum. Normal voided urine contains 10² – 10⁴ organisms/mL.", {
    x: 0.55, y: 1.05, w: 9.0, h: 0.7, fontSize: 11, color: C.textDark, valign: "middle"
  });

  // Organisms list
  const orgs = [
    ["Staphylococcus epidermidis", "Coagulase-negative; most common"],
    ["Diphtheroids (Corynebacterium spp.)", "Gram-positive rods; skin origin"],
    ["Streptococcus viridans group", "Alpha-hemolytic streptococci"],
    ["Enterococcus spp.", "Facultative anaerobes from perineum"],
    ["Mycobacterium smegmatis", "Non-pathogenic; periurethral smegma"],
    ["Coliforms (E. coli, Klebsiella)", "In small numbers; perineal origin"],
  ];

  card(s, 0.3, 1.9, 9.4, 3.1, C.white);
  s.addText("Organisms Found in the Anterior Urethra", {
    x: 0.5, y: 1.98, w: 9.0, h: 0.35,
    fontSize: 12, bold: true, color: C.navy
  });

  orgs.forEach(([name, desc], i) => {
    const col = Math.floor(i / 3);
    const row = i % 3;
    const x = 0.5 + col * 4.7;
    const y = 2.42 + row * 0.72;
    s.addShape(pres.shapes.ROUNDED_RECTANGLE, {
      x, y, w: 4.5, h: 0.6, fill:{color:C.lightGray}, line:{color:"D0DDE5", width:0.5}, rectRadius:0.05
    });
    s.addShape(pres.shapes.RECTANGLE, { x, y, w:0.07, h:0.6, fill:{color:C.teal}, line:{color:C.teal} });
    s.addText(name, { x:x+0.15, y:y+0.04, w:4.3, h:0.28, fontSize:10.5, bold:true, color:C.textDark, margin:0 });
    s.addText(desc,  { x:x+0.15, y:y+0.32, w:4.3, h:0.22, fontSize:9,    color:C.gray,    margin:0 });
  });

  s.addText("⚠  The posterior urethra and urinary bladder are normally STERILE", {
    x: 0.5, y: 4.95, w: 9.0, h: 0.25,
    fontSize: 9.5, bold: true, color: C.coral, align: "center"
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 5 - VAGINAL FLORA LIFECYCLE
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.shapes.RECTANGLE, { x:0, y:0, w:10, h:5.625, fill:{color:C.offWhite}, line:{color:C.offWhite} });
  addHeaderBar(s, C.teal);
  slideTitle(s, "Vaginal Flora – Changes Across Lifecycle", "Slide 03");
  addFooter(s);

  const stages = [
    { phase: "AT BIRTH", pH: "Acidic", flora: "Aerobic Lactobacillus spp.", reason: "Maternal estrogen effect (transient)", col: C.teal },
    { phase: "INFANCY →\nPRE-PUBERTY", pH: "Neutral 6–7", flora: "Mixed cocci & bacilli", reason: "No estrogen; low glycogen", col: "6B8E9F" },
    { phase: "PUBERTY &\nREPRODUCTIVE AGE", pH: "Acidic 3.8–4.5", flora: "Lactobacillus dominant", reason: "Estrogen ↑ glycogen → lactic acid + H₂O₂", col: C.navy },
    { phase: "POST-\nMENOPAUSE", pH: "Rising → Neutral", flora: "Mixed flora returns", reason: "Estrogen ↓ → glycogen ↓ → lactobacilli ↓", col: "8D6E63" },
  ];

  // Arrow bar
  s.addShape(pres.shapes.RECTANGLE, { x:0.3, y:2.22, w:9.4, h:0.08, fill:{color:"C5D5DA"}, line:{color:"C5D5DA"} });

  stages.forEach((st, i) => {
    const x = 0.3 + i * 2.35;
    // connector dot
    s.addShape(pres.shapes.OVAL, { x: x+0.9, y: 2.17, w:0.18, h:0.18, fill:{color:st.col}, line:{color:st.col} });

    // upper box (phase)
    s.addShape(pres.shapes.ROUNDED_RECTANGLE, {
      x, y:1.0, w:2.2, h:1.1,
      fill:{color:st.col}, line:{color:st.col}, rectRadius:0.08
    });
    s.addText(st.phase, { x, y:1.0, w:2.2, h:1.1, fontSize:11, bold:true, color:C.white, align:"center", valign:"middle" });

    // lower card
    card(s, x, 2.45, 2.2, 2.8, C.white);
    s.addText("pH: " + st.pH, { x:x+0.1, y:2.52, w:2.0, h:0.3, fontSize:10, bold:true, color:C.teal, margin:0 });
    accentLine(s, x+0.1, 2.83, 1.8, C.gold);
    s.addText(st.flora, { x:x+0.1, y:2.9, w:2.0, h:0.6, fontSize:9.5, bold:true, color:C.textDark, lineSpacingMultiple:1.2 });
    s.addText(st.reason, { x:x+0.1, y:3.55, w:2.0, h:1.5, fontSize:8.5, color:C.gray, lineSpacingMultiple:1.2, valign:"top" });
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 6 - VAGINAL FLORA ORGANISMS (Full List)
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.shapes.RECTANGLE, { x:0, y:0, w:10, h:5.625, fill:{color:C.offWhite}, line:{color:C.offWhite} });
  addHeaderBar(s, C.teal);
  slideTitle(s, "Normal Vaginal Flora – Complete Organism List", "Slide 04  |  Reproductive-Age Women");
  addFooter(s);

  const groups = [
    {
      label: "GRAM-POSITIVE", color: C.teal,
      items: ["Lactobacillus spp. (dominant – crispatus, iners, jensenii)", "Group B Streptococcus – 25% of women ⚠", "Alpha-hemolytic Streptococci (viridans)", "Peptostreptococcus / Peptoniphilus spp.", "Corynebacterium spp. (Diphtheroids)", "Staphylococcus epidermidis", "Mobiluncus spp. (curved anaerobic rods)"]
    },
    {
      label: "GRAM-NEGATIVE / ANAEROBES", color: C.navy,
      items: ["Prevotella spp.", "Gardnerella vaginalis (Gram-variable)", "Fusobacterium spp.", "Bacteroides spp.", "Clostridium spp. (occasionally)", "E. coli (in small numbers near introitus)"]
    },
    {
      label: "FUNGI / MYCOPLASMA", color: "7B5EA7",
      items: ["Candida albicans (~20% healthy women)", "Ureaplasma urealyticum", "Mycoplasma hominis", "Listeria monocytogenes (rare)"]
    },
  ];

  groups.forEach((g, i) => {
    const x = 0.22 + i * 3.27;
    card(s, x, 1.05, 3.1, 4.3, C.white);
    s.addShape(pres.shapes.RECTANGLE, {
      x, y:1.05, w:3.1, h:0.45,
      fill:{color:g.color}, line:{color:g.color}
    });
    s.addText(g.label, { x, y:1.05, w:3.1, h:0.45, fontSize:9.5, bold:true, color:C.white, align:"center", valign:"middle", charSpacing:1 });
    s.addText(g.items.map(t => "• " + t).join("\n"), {
      x: x+0.12, y:1.58, w:2.86, h:3.6,
      fontSize: 9.2, color: C.textDark, valign:"top", lineSpacingMultiple:1.4
    });
  });

  s.addText("⚠ Group B Streptococcus present in 25% of childbearing-age women — major neonatal risk factor", {
    x: 0.3, y: 5.28, w: 9.4, h: 0.22,
    fontSize: 8.5, color: C.coral, align: "center", bold: true
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 7 - PROTECTIVE MECHANISMS OF LACTOBACILLUS
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  darkSlide(s);
  addFooter(s, "Genital Flora | Slide 05 – Protective Mechanisms");

  // Header
  s.addShape(pres.shapes.RECTANGLE, {x:0, y:0, w:10, h:0.9, fill:{color:C.teal}, line:{color:C.teal}});
  s.addText("Protective Mechanisms of Lactobacillus (Döderlein's Bacilli)", {
    x:0.3, y:0.05, w:9.4, h:0.8, fontSize:18, bold:true, color:C.white, valign:"middle"
  });

  // Central concept
  s.addShape(pres.shapes.OVAL, {
    x:3.8, y:1.9, w:2.4, h:1.5,
    fill:{color:C.teal}, line:{color:C.gold, width:2}
  });
  s.addText("Lactobacillus\nDominance\n(Core Flora)", {
    x:3.8, y:1.9, w:2.4, h:1.5,
    fontSize:11, bold:true, color:C.white, align:"center", valign:"middle"
  });

  const mechanisms = [
    { x:0.2,  y:1.1,  label:"🧪 Lactic Acid Production", body:"Metabolizes glycogen → lactic acid\nMaintains pH 3.8–4.5" },
    { x:7.1,  y:1.1,  label:"⚗️ H₂O₂ Production", body:"Hydrogen peroxide kills\nanaerobes & pathogens" },
    { x:0.2,  y:3.1,  label:"🛡️ Bacteriocins", body:"Antimicrobial peptides\ninhibit competing organisms" },
    { x:7.1,  y:3.1,  label:"🔒 Competitive Exclusion", body:"Occupy attachment sites\nBlock pathogen colonization" },
    { x:3.6,  y:4.55, label:"🧬 Immune Modulation", body:"Stimulate innate & regulatory immunity; reduce inflammatory response" },
  ];

  mechanisms.forEach((m) => {
    card(s, m.x, m.y, 2.7, 1.1, "0D3D54");
    s.addText(m.label, { x:m.x+0.12, y:m.y+0.05, w:2.46, h:0.38, fontSize:10, bold:true, color:C.gold, margin:0 });
    s.addText(m.body,  { x:m.x+0.12, y:m.y+0.42, w:2.46, h:0.6,  fontSize:9,  color:"C8E0E8", lineSpacingMultiple:1.2, margin:0 });
  });

  // Connecting lines (decorative)
  s.addShape(pres.shapes.RECTANGLE, { x:2.9, y:1.65, w:0.9, h:0.04, fill:{color:C.gold}, line:{color:C.gold} });
  s.addShape(pres.shapes.RECTANGLE, { x:6.2, y:1.65, w:0.9, h:0.04, fill:{color:C.gold}, line:{color:C.gold} });
  s.addShape(pres.shapes.RECTANGLE, { x:2.9, y:3.65, w:0.9, h:0.04, fill:{color:C.gold}, line:{color:C.gold} });
  s.addShape(pres.shapes.RECTANGLE, { x:6.2, y:3.65, w:0.9, h:0.04, fill:{color:C.gold}, line:{color:C.gold} });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 8 - MALE GENITAL MICROBIOTA
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.shapes.RECTANGLE, { x:0, y:0, w:10, h:5.625, fill:{color:C.offWhite}, line:{color:C.offWhite} });
  addHeaderBar(s, C.navy);
  slideTitle(s, "Male Genital Microbiota (MUGT)", "Slide 06  |  Male Urogenital Tract");
  addFooter(s);

  const sites = [
    { site:"Penile Skin", color:C.teal, orgs:["Staphylococcus spp.", "Corynebacterium spp.", "Streptococcus spp."] },
    { site:"Foreskin / Balanopreputial Sulcus\n(Uncircumcised)", color:"8D5524", orgs:["Anaerococcus spp.", "Peptoniphilus spp.", "Finegoldia spp.", "Prevotella spp. ⚠ BV-overlap"] },
    { site:"Urethra", color:C.navy, orgs:["Coagulase-negative Staph", "Diphtheroids", "Occasional coliforms"] },
    { site:"Semen", color:"546E7A", orgs:["Low diversity", "Variable composition", "Lactobacillus (variable)"] },
  ];

  sites.forEach((site, i) => {
    const col = i % 2;
    const row = Math.floor(i / 2);
    const x = 0.3 + col * 4.85;
    const y = 1.05 + row * 2.15;
    card(s, x, y, 4.6, 1.95, C.white);
    s.addShape(pres.shapes.RECTANGLE, { x, y, w:4.6, h:0.42, fill:{color:site.color}, line:{color:site.color} });
    s.addText(site.site, { x, y, w:4.6, h:0.42, fontSize:10.5, bold:true, color:C.white, align:"center", valign:"middle" });
    s.addText(site.orgs.map(o => "• " + o).join("\n"), {
      x:x+0.15, y:y+0.5, w:4.3, h:1.3,
      fontSize:9.5, color:C.textDark, valign:"top", lineSpacingMultiple:1.3
    });
  });

  // Key point box
  s.addShape(pres.shapes.ROUNDED_RECTANGLE, {
    x:0.3, y:5.18, w:9.4, h:0.22,
    fill:{color:"FFF0F0"}, line:{color:C.coral, width:0.5}, rectRadius:0.04
  });
  s.addText("⚠  Uncircumcised men harbor BV-associated anaerobes (Prevotella, Anaerococcus) — supporting sexual transmission of BV to female partners", {
    x:0.4, y:5.18, w:9.2, h:0.22,
    fontSize:8.5, color:C.coral, align:"center", valign:"middle"
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 9 - BACTERIAL VAGINOSIS
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  darkSlide(s);
  s.addShape(pres.shapes.RECTANGLE, {x:0, y:0, w:10, h:0.9, fill:{color:C.coral}, line:{color:C.coral}});
  s.addText("Bacterial Vaginosis (BV) – Vaginal Flora Dysbiosis", {
    x:0.3, y:0.05, w:9.4, h:0.8, fontSize:18, bold:true, color:C.white, valign:"middle"
  });
  s.addText("Slide 07", { x:0.3, y:0.72, w:9, h:0.22, fontSize:9, color:"FFCCCC", italic:true });
  addFooter(s, "Genital Flora | Slide 07 – Bacterial Vaginosis");

  // Left: what happens
  card(s, 0.2, 1.0, 4.5, 4.1, "0D2B3E");
  s.addText("PATHOPHYSIOLOGY", { x:0.35, y:1.05, w:4.2, h:0.35, fontSize:11, bold:true, color:C.gold, charSpacing:1 });
  accentLine(s, 0.35, 1.42, 3.5, C.coral);
  s.addText([
    { text: "1. Unexplained disappearance of Lactobacillus\n", options:{ bold:true } },
    { text: "2. Vaginal pH rises above 4.5\n" },
    { text: "3. Anaerobes & facultative organisms overgrow\n" },
    { text: "4. Amine (fishy) odor produced\n" },
    { text: "5. Clue cells form — hallmark finding" },
  ], { x:0.35, y:1.5, w:4.2, h:2.1, fontSize:10, color:C.white, valign:"top", lineSpacingMultiple:1.5 });
  s.addText("BV Organisms:", { x:0.35, y:3.65, w:4.2, h:0.3, fontSize:10, bold:true, color:C.gold });
  s.addText("Gardnerella vaginalis • Prevotella spp. • Mobiluncus • Atopobium vaginae • Sneathia spp. • Leptotrichia • Megasphaera spp.", {
    x:0.35, y:3.95, w:4.1, h:0.95, fontSize:9.5, color:"C8D8E0", lineSpacingMultiple:1.3
  });

  // Right: Clinical features + Amsel criteria
  card(s, 4.85, 1.0, 4.9, 4.1, "0D2B3E");
  s.addText("CLINICAL FEATURES (Amsel Criteria)", { x:5.0, y:1.05, w:4.6, h:0.35, fontSize:11, bold:true, color:C.gold, charSpacing:1 });
  accentLine(s, 5.0, 1.42, 3.5, C.coral);
  const amsel = [
    ["1", "Homogeneous, thin grey-white discharge"],
    ["2", "Vaginal pH > 4.5"],
    ["3", "Positive Whiff test (fishy odor with 10% KOH)"],
    ["4", "Clue cells on wet mount (≥20% epithelial cells)"],
  ];
  amsel.forEach(([n, text], i) => {
    s.addShape(pres.shapes.OVAL, { x:5.0, y:1.58+i*0.55, w:0.28, h:0.28, fill:{color:C.coral}, line:{color:C.coral} });
    s.addText(n, { x:5.0, y:1.58+i*0.55, w:0.28, h:0.28, fontSize:9, bold:true, color:C.white, align:"center", valign:"middle" });
    s.addText(text, { x:5.35, y:1.6+i*0.55, w:4.3, h:0.25, fontSize:10, color:C.white, margin:0 });
  });
  s.addText("⚡  Diagnosis: ≥ 3 of 4 Amsel criteria", {
    x:5.0, y:3.82, w:4.6, h:0.3, fontSize:10, bold:true, color:C.gold
  });
  s.addText("Complications: PID risk ↑ • HIV susceptibility ↑ • Preterm birth risk ↑ • STI acquisition ↑", {
    x:5.0, y:4.15, w:4.6, h:0.75, fontSize:9.5, color:"FFAAAA", lineSpacingMultiple:1.4
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 10 - PLACENTA & UTERINE FLORA
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.shapes.RECTANGLE, { x:0, y:0, w:10, h:5.625, fill:{color:C.offWhite}, line:{color:C.offWhite} });
  addHeaderBar(s, C.teal);
  slideTitle(s, "Placenta & Uterine Microbiome", "Slide 08  |  Sterile Myth Debunked");
  addFooter(s);

  // Myth vs Reality
  s.addShape(pres.shapes.RECTANGLE, { x:0.3, y:1.05, w:4.55, h:3.8, fill:{color:"FFF0F0"}, line:{color:C.coral, width:1} });
  s.addShape(pres.shapes.RECTANGLE, { x:5.15, y:1.05, w:4.55, h:3.8, fill:{color:"EAF7F0"}, line:{color:"2E9E6A", width:1} });

  s.addText("❌  OLD BELIEF", { x:0.5, y:1.12, w:4.1, h:0.4, fontSize:13, bold:true, color:C.coral });
  s.addText("The placenta and uterus were considered STERILE environments. Any microorganism found was considered pathological contamination.", {
    x:0.5, y:1.6, w:4.1, h:1.3, fontSize:10.5, color:C.textDark, lineSpacingMultiple:1.4
  });

  s.addText("✅  CURRENT EVIDENCE", { x:5.35, y:1.12, w:4.1, h:0.4, fontSize:13, bold:true, color:"2E9E6A" });
  s.addText("Molecular (16S rRNA) sequencing revealed commensal, non-pathogenic bacteria in placental tissue and uterus of healthy, asymptomatic women.", {
    x:5.35, y:1.6, w:4.1, h:1.3, fontSize:10.5, color:C.textDark, lineSpacingMultiple:1.4
  });

  // Facts
  const facts = [
    { icon:"🔬", text:"Uterine microbiome differs significantly from vaginal and GI microbiomes" },
    { icon:"🧬", text:"Identified by 16S rRNA sequencing — organisms are unculturable by standard methods" },
    { icon:"❓", text:"Exact role and clinical significance is still under active investigation" },
    { icon:"⚠️",  text:"Disruption of uterine microbiome may affect implantation, pregnancy outcome" },
  ];
  facts.forEach((f, i) => {
    const y = 3.1 + i * 0.6;
    s.addShape(pres.shapes.RECTANGLE, { x:0.3, y, w:9.4, h:0.5, fill:{color: i%2===0 ? C.white : C.lightGray}, line:{color:"D5E0E8", width:0.3} });
    s.addText(f.icon, { x:0.4, y, w:0.5, h:0.5, fontSize:14, align:"center", valign:"middle" });
    s.addText(f.text, { x:1.0, y, w:8.5, h:0.5, fontSize:10.5, color:C.textDark, valign:"middle" });
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 11 - NEONATAL SIGNIFICANCE
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.shapes.RECTANGLE, { x:0, y:0, w:10, h:5.625, fill:{color:C.offWhite}, line:{color:C.offWhite} });
  addHeaderBar(s, C.navy);
  slideTitle(s, "Neonatal Significance of Maternal Genital Flora", "Slide 09");
  addFooter(s);

  s.addText("Organisms colonizing the maternal vagina at delivery can be transmitted to the newborn during birth", {
    x:0.3, y:1.0, w:9.4, h:0.4, fontSize:11, color:C.gray, italic:true
  });

  const rows = [
    ["Organism", "Transmission Route", "Neonatal Disease", "header"],
    ["Group B Streptococcus\n(S. agalactiae)", "Vaginal colonization", "Neonatal SEPSIS & MENINGITIS\n(~25% of mothers colonized)", "high"],
    ["Neisseria gonorrhoeae", "Contact during delivery", "Ophthalmia neonatorum\n(gonococcal eye infection)", "high"],
    ["Chlamydia trachomatis", "Birth canal exposure", "Neonatal conjunctivitis\nChlamydial pneumonia", "med"],
    ["Candida albicans", "Birth canal", "Oral thrush\nNeonatal skin candidiasis", "low"],
    ["Herpes simplex virus", "Primary HSV lesions", "Neonatal herpes encephalitis\n(high mortality)", "high"],
    ["Listeria monocytogenes", "Rare vaginal colonizer", "Neonatal listeriosis\nEarly-onset sepsis", "med"],
  ];

  const colW = [2.5, 2.3, 3.7, 0.9];
  const colX = [0.3, 2.8, 5.1, 8.8];
  const rowH = 0.62;

  rows.forEach((row, ri) => {
    const y = 1.45 + ri * rowH;
    const bgColor = row[3]==="header" ? C.navy : row[3]==="high" ? "FFF0F0" : row[3]==="med" ? "FFF8E8" : C.white;
    const txtColor = row[3]==="header" ? C.white : C.textDark;
    s.addShape(pres.shapes.RECTANGLE, { x:0.3, y, w:9.4, h:rowH, fill:{color:bgColor}, line:{color:"D5E0E8", width:0.5} });
    row.slice(0,3).forEach((cell, ci) => {
      s.addText(cell, {
        x:colX[ci]+0.08, y:y+0.04, w:colW[ci]-0.12, h:rowH-0.08,
        fontSize: ri===0 ? 10 : 9.5,
        bold: ri===0,
        color: row[3]==="high" && ci===2 ? C.coral : ri===0 ? C.white : txtColor,
        valign:"middle"
      });
    });
    if (row[3]==="high") {
      s.addText("⚠", { x:colX[3], y, w:0.7, h:rowH, fontSize:14, align:"center", valign:"middle" });
    }
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 12 - FACTORS ALTERING GENITAL FLORA
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.shapes.RECTANGLE, { x:0, y:0, w:10, h:5.625, fill:{color:C.offWhite}, line:{color:C.offWhite} });
  addHeaderBar(s, C.teal);
  slideTitle(s, "Factors That Alter Genital Flora", "Slide 10");
  addFooter(s);

  const factors = [
    { icon:"💊", label:"Antibiotics", effect:"Suppress Lactobacillus\n→ BV or Candida vaginitis" },
    { icon:"🌡️", label:"Hormonal Changes", effect:"Pregnancy / menopause\nalter glycogen & pH" },
    { icon:"💑",  label:"Sexual Activity", effect:"New organisms introduced;\nBV sexually transmissible" },
    { icon:"🚿", label:"Vaginal Douching", effect:"Disrupts normal flora\nMajor BV risk factor" },
    { icon:"🩺", label:"IUDs / Devices", effect:"Alter uterine microenvironment" },
    { icon:"🧪", label:"Spermicides", effect:"Kill beneficial organisms\nalong with pathogens" },
    { icon:"🍬", label:"Diabetes Mellitus", effect:"High glucose → Candida\novergrowth" },
    { icon:"🛡️", label:"Immunosuppression", effect:"Opportunistic organisms\nproliferate" },
    { icon:"🥗", label:"Diet & Hygiene", effect:"Fiber, soap, deodorants\nalter pH and microbiome" },
  ];

  const perRow = 3;
  factors.forEach((f, i) => {
    const col = i % perRow;
    const row = Math.floor(i / perRow);
    const x = 0.28 + col * 3.22;
    const y = 1.1 + row * 1.48;
    card(s, x, y, 3.05, 1.32, C.white);
    s.addShape(pres.shapes.RECTANGLE, { x, y, w:3.05, h:0.08, fill:{color:C.gold}, line:{color:C.gold} });
    s.addText(f.icon + "  " + f.label, { x:x+0.1, y:y+0.14, w:2.85, h:0.35, fontSize:11, bold:true, color:C.navy, margin:0 });
    s.addText(f.effect, { x:x+0.1, y:y+0.5, w:2.85, h:0.72, fontSize:9.5, color:C.gray, lineSpacingMultiple:1.25, valign:"top" });
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 13 - CLINICAL RELEVANCE
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  darkSlide(s);
  s.addShape(pres.shapes.RECTANGLE, {x:0, y:0, w:10, h:0.9, fill:{color:"1A6B3C"}, line:{color:"1A6B3C"}});
  s.addText("Clinical Relevance – Opportunistic Infections & STI Interactions", {
    x:0.3, y:0.05, w:9.4, h:0.8, fontSize:17, bold:true, color:C.white, valign:"middle"
  });
  addFooter(s, "Genital Flora | Slide 11 – Clinical Relevance");

  const clinPoints = [
    { icon:"🦠", head:"Urinary Tract Infection (UTI)", body:"E. coli from vaginal introitus/perineum ascends to bladder. Heavy introital flora resembling perineal flora is a predisposing factor for recurrent UTIs." },
    { icon:"🤱", head:"Chorioamnionitis", body:"Ascending genital flora through cervix contaminates amniotic cavity → intrauterine infection, preterm birth, fetal damage, postpartum endometritis." },
    { icon:"🔬", head:"Pelvic Inflammatory Disease (PID)", body:"BV organisms (Gardnerella, anaerobes) ascend from vagina to upper genital tract → salpingitis, infertility, ectopic pregnancy risk." },
    { icon:"🔴", head:"HIV Acquisition", body:"BV (disrupted vaginal flora) significantly increases susceptibility to HIV acquisition. Lactobacillus-dominant flora provides protection against HIV." },
    { icon:"🧫", head:"Gonorrhoea Enhancement", body:"Cervicovaginal microbiota enzymes unmask receptors on cervical cells that enhance attachment of Neisseria gonorrhoeae — microbiota can facilitate STI pathogenesis." },
    { icon:"💉", head:"Surgical Site Infections", body:"Post-hysterectomy, post-cesarean infections often due to vaginal flora organisms (anaerobes, GBS, Prevotella) entering surgical sites." },
  ];

  clinPoints.forEach((p, i) => {
    const col = i % 2;
    const row = Math.floor(i / 2);
    const x = 0.2 + col * 4.9;
    const y = 1.05 + row * 1.5;
    card(s, x, y, 4.65, 1.35, "0D3045");
    s.addShape(pres.shapes.RECTANGLE, { x, y, w:0.07, h:1.35, fill:{color:"2E9E6A"}, line:{color:"2E9E6A"} });
    s.addText(p.icon + " " + p.head, { x:x+0.18, y:y+0.08, w:4.3, h:0.35, fontSize:11, bold:true, color:C.gold, margin:0 });
    s.addText(p.body, { x:x+0.18, y:y+0.45, w:4.3, h:0.82, fontSize:9, color:"C0D8E0", lineSpacingMultiple:1.3, valign:"top" });
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 14 - SUMMARY TABLE
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.shapes.RECTANGLE, { x:0, y:0, w:10, h:5.625, fill:{color:C.offWhite}, line:{color:C.offWhite} });
  addHeaderBar(s, C.navy);
  slideTitle(s, "Quick Reference Summary Table", "Slide 12");
  addFooter(s);

  const tableData = [
    ["Organism", "Site", "Role / Significance"],
    ["Lactobacillus spp.", "Vagina (dominant)", "Core protective flora; lactic acid + H₂O₂ producer"],
    ["Group B Streptococcus", "Vagina (25% women)", "Normal commensal; neonatal sepsis/meningitis risk"],
    ["Gardnerella vaginalis", "Vagina (minor)", "Overgrows in BV; key diagnostic marker"],
    ["Prevotella spp.", "Vagina / foreskin", "Normal anaerobe; dominant in BV"],
    ["Ureaplasma urealyticum", "Vagina / urethra", "Normal commensal; can cause NGU"],
    ["Candida albicans", "Vagina (~20%)", "Minor commensal; vaginitis when flora disrupted"],
    ["CoNS (S. epidermidis)", "Urethra (both sexes)", "Normal contaminant of voided urine"],
    ["Mycobacterium smegmatis", "Male genitalia", "Non-pathogenic; periurethral smegma"],
    ["Anaerococcus / Finegoldia", "Male foreskin", "BV-overlap anaerobes; sexually transmissible"],
  ];

  const colWidths = [2.4, 2.2, 4.6];
  const colXs = [0.3, 2.7, 4.9];
  const rowH = 0.46;

  tableData.forEach((row, ri) => {
    const y = 1.0 + ri * rowH;
    const isHeader = ri === 0;
    const bg = isHeader ? C.navy : ri%2===0 ? C.white : C.lightGray;
    s.addShape(pres.shapes.RECTANGLE, { x:0.3, y, w:9.2, h:rowH, fill:{color:bg}, line:{color:"C8D5DA", width:0.3} });
    row.forEach((cell, ci) => {
      s.addText(cell, {
        x:colXs[ci]+0.08, y:y+0.03, w:colWidths[ci]-0.12, h:rowH-0.06,
        fontSize: isHeader ? 10 : 9.2,
        bold: isHeader || ci===0,
        color: isHeader ? C.white : ci===0 ? C.teal : C.textDark,
        valign:"middle"
      });
    });
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 15 - KEY TAKEAWAYS
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  darkSlide(s);
  s.addShape(pres.shapes.RECTANGLE, {x:0, y:0, w:10, h:0.9, fill:{color:C.gold}, line:{color:C.gold}});
  s.addText("Key Takeaways", { x:0.3, y:0.05, w:9.4, h:0.8, fontSize:24, bold:true, color:C.navy, valign:"middle" });
  addFooter(s, "Genital Flora | Key Takeaways");

  const takeaways = [
    { n:"01", t:"Vaginal flora is hormonally driven", b:"Estrogen → glycogen → Lactobacillus → lactic acid + H₂O₂ → protection. This cycle defines reproductive-age vaginal health." },
    { n:"02", t:"Lactobacillus is the guardian of vaginal health", b:"Its dominance is not just about pH — it provides competitive exclusion, immune modulation, and bacteriocin production." },
    { n:"03", t:"BV is flora dysbiosis, not a simple infection", b:"It is a polymicrobial syndrome with complex microbiome shifts. No single organism causes BV — it requires ecological collapse." },
    { n:"04", t:"Genital flora has critical obstetric implications", b:"Group B Streptococcus (25% of women) causes neonatal meningitis/sepsis. Neonates acquire flora from the birth canal." },
    { n:"05", t:"Male genital flora interacts with female flora", b:"Uncircumcised men carry BV-associated anaerobes. Sexual transmission of BV is evidenced by partner concordance studies." },
    { n:"06", t:"Antibiotics disrupt flora — with consequences", b:"Broad-spectrum antibiotics suppress Lactobacillus, creating an ecologic vacuum filled by Candida or BV organisms." },
  ];

  takeaways.forEach((t, i) => {
    const col = i % 2;
    const row = Math.floor(i / 2);
    const x = 0.2 + col * 4.9;
    const y = 1.0 + row * 1.5;
    card(s, x, y, 4.65, 1.35, "0D2B3E");
    s.addShape(pres.shapes.ROUNDED_RECTANGLE, { x:x+0.1, y:y+0.1, w:0.42, h:0.42, fill:{color:C.gold}, line:{color:C.gold}, rectRadius:0.05 });
    s.addText(t.n, { x:x+0.1, y:y+0.1, w:0.42, h:0.42, fontSize:11, bold:true, color:C.navy, align:"center", valign:"middle" });
    s.addText(t.t, { x:x+0.62, y:y+0.1, w:3.88, h:0.38, fontSize:10.5, bold:true, color:C.gold, margin:0, valign:"middle" });
    s.addText(t.b, { x:x+0.1, y:y+0.58, w:4.4, h:0.7, fontSize:8.8, color:"BFCDD4", lineSpacingMultiple:1.3, valign:"top" });
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 16 - THANK YOU / REFERENCES
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  darkSlide(s);
  s.addShape(pres.shapes.RECTANGLE, { x:0, y:0, w:0.22, h:5.625, fill:{color:C.teal}, line:{color:C.teal} });
  s.addShape(pres.shapes.RECTANGLE, { x:9.78, y:0, w:0.22, h:5.625, fill:{color:C.gold}, line:{color:C.gold} });

  s.addText("Thank You", { x:1, y:0.6, w:8, h:1.1, fontSize:48, bold:true, color:C.white, align:"center", fontFace:"Calibri" });
  s.addShape(pres.shapes.RECTANGLE, { x:2.5, y:1.75, w:5, h:0.07, fill:{color:C.gold}, line:{color:C.gold} });
  s.addText("Questions & Discussion Welcome", { x:1, y:1.9, w:8, h:0.5, fontSize:16, color:"A0C8D0", align:"center", italic:true });

  // References
  s.addShape(pres.shapes.ROUNDED_RECTANGLE, {
    x:0.5, y:2.55, w:9, h:2.7,
    fill:{color:"0D1F30"}, line:{color:C.teal, width:1}, rectRadius:0.08
  });
  s.addText("References", { x:0.8, y:2.62, w:8.4, h:0.38, fontSize:12, bold:true, color:C.gold });
  s.addText([
    { text: "1.  Jawetz, Melnick & Adelberg's Medical Microbiology, 28th Edition — Normal Microbiota of the Urethra & Vagina, pp.182–184\n", options:{} },
    { text: "2.  Sherris & Ryan's Medical Microbiology, 8th Edition — Vaginal Flora, BV, Exclusionary Effect, pp.37–39\n", options:{} },
    { text: "3.  Murray PR et al. Medical Microbiology, 9th Edition — Evolution of the Microbiome & Normal Flora, pp.22–26\n", options:{} },
    { text: "4.  Donders GGG et al. Pathogenesis of abnormal vaginal bacterial flora. Am J Obstet Gynecol. 2000\n", options:{} },
    { text: "5.  Ravel J et al. Vaginal microbiome of reproductive-age women. PNAS. 2011;108 Suppl 1:4680–4687", options:{} },
  ], { x:0.8, y:3.05, w:8.4, h:2.05, fontSize:9, color:"A0B8C0", lineSpacingMultiple:1.4, valign:"top" });
}

// ─── WRITE FILE ───────────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/genital-flora-ppt/Genital_Flora_Seminar.pptx" })
  .then(() => console.log("✅  Presentation saved successfully!"))
  .catch(err => console.error("❌  Error:", err));

cd /home/daytona/workspace/genital-flora-ppt && node create_ppt.js 2>&1

ls -lh /home/daytona/workspace/genital-flora-ppt/

~/genital-flora-ppt/dept_ppt.js

const pptxgen = require("pptxgenjs");

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Genital Flora – Department Seminar Presentation";
pres.author = "Department of Microbiology";

// ─── PALETTE ─────────────────────────────────────────────────────────────────
const C = {
  bg:        "F7F9FC",
  navy:      "0A2540",
  deepTeal:  "0B6E72",
  teal:      "1A8A8E",
  tealLight: "D0EEF0",
  gold:      "C8860A",
  goldLight: "FDF3DC",
  coral:     "C0392B",
  coralLight:"FDE8E6",
  green:     "1B7A4A",
  greenLight:"E2F5EC",
  white:     "FFFFFF",
  gray1:     "E8EEF3",
  gray2:     "90A4AE",
  textDark:  "0D1B2A",
  textMid:   "3A4F5C",
};

// ─── UTILITY FUNCTIONS ───────────────────────────────────────────────────────
function fillBg(s, color) {
  s.addShape(pres.shapes.RECTANGLE, { x:0,y:0,w:10,h:5.625, fill:{color:color||C.bg}, line:{color:color||C.bg} });
}
function fillDark(s) { fillBg(s, C.navy); }

function topBar(s, color, h) {
  s.addShape(pres.shapes.RECTANGLE, { x:0,y:0,w:10,h:h||0.85, fill:{color:color||C.navy}, line:{color:color||C.navy} });
}
function leftAccent(s, color, w) {
  s.addShape(pres.shapes.RECTANGLE, { x:0,y:0,w:w||0.15,h:5.625, fill:{color:color||C.teal}, line:{color:color||C.teal} });
}
function footer(s, right) {
  s.addShape(pres.shapes.RECTANGLE, { x:0,y:5.33,w:10,h:0.295, fill:{color:C.navy}, line:{color:C.navy} });
  s.addText("Department Seminar  •  Genital Flora  •  Medical Microbiology", {
    x:0.25,y:5.33,w:7,h:0.295, fontSize:7.5, color:"6B8BAD", valign:"middle"
  });
  if (right) s.addText(right, { x:8.5,y:5.33,w:1.4,h:0.295, fontSize:7.5, color:"6B8BAD", align:"right", valign:"middle" });
}
function hRule(s, x, y, w, color) {
  s.addShape(pres.shapes.RECTANGLE, { x,y,w,h:0.035, fill:{color:color||C.teal}, line:{color:color||C.teal} });
}
function sectionTag(s, text, x, y, color) {
  s.addShape(pres.shapes.ROUNDED_RECTANGLE, { x,y,w:1.55,h:0.3, fill:{color:color||C.teal}, line:{color:color||C.teal}, rectRadius:0.08 });
  s.addText(text, { x,y,w:1.55,h:0.3, fontSize:8, bold:true, color:C.white, align:"center", valign:"middle", charSpacing:0.8 });
}
function slideH(s, txt, sub) {
  s.addText(txt, { x:0.28,y:0.07,w:9.5,h:0.72, fontSize:19, bold:true, color:C.white, valign:"middle", margin:4, fontFace:"Calibri" });
  if (sub) s.addText(sub, { x:0.28,y:0.72,w:9.5,h:0.22, fontSize:9.5, color:"A0C8D0", italic:true, valign:"top", margin:0 });
}
function card(s, x, y, w, h, fill, lineColor) {
  s.addShape(pres.shapes.ROUNDED_RECTANGLE, {
    x,y,w,h, fill:{color:fill||C.white}, rectRadius:0.07,
    line:{color:lineColor||"D0DDE8", width:0.5},
    shadow:{type:"outer",color:"000000",blur:4,offset:2,angle:135,opacity:0.09}
  });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 1 — COVER
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  fillDark(s);

  // Decorative geometry
  s.addShape(pres.shapes.RECTANGLE, { x:0,y:0,w:0.22,h:5.625, fill:{color:C.teal}, line:{color:C.teal} });
  s.addShape(pres.shapes.RECTANGLE, { x:9.78,y:0,w:0.22,h:5.625, fill:{color:C.gold}, line:{color:C.gold} });
  s.addShape(pres.shapes.RECTANGLE, { x:0.22,y:4.6,w:9.56,h:0.08, fill:{color:C.teal}, line:{color:C.teal} });

  // Institution / department tag
  s.addShape(pres.shapes.ROUNDED_RECTANGLE, { x:3.0,y:0.3,w:4.0,h:0.38, fill:{color:C.deepTeal}, line:{color:C.deepTeal}, rectRadius:0.1 });
  s.addText("DEPARTMENT OF MICROBIOLOGY  •  SEMINAR", { x:3.0,y:0.3,w:4.0,h:0.38, fontSize:8, bold:true, color:C.white, align:"center", valign:"middle", charSpacing:1 });

  // Main title
  s.addText("GENITAL FLORA", { x:0.4,y:0.85,w:9.2,h:1.45, fontSize:58, bold:true, color:C.white, align:"center", fontFace:"Calibri" });
  hRule(s, 2.0, 2.35, 6.0, C.gold);

  // Subtitle
  s.addText("Normal Microbiota of the Urogenital Tract:\nComposition, Function, Dysbiosis & Clinical Significance", {
    x:0.6,y:2.48,w:8.8,h:0.9, fontSize:15, color:"9AC8D2", align:"center", italic:true, lineSpacingMultiple:1.5
  });

  // Presenter line
  s.addShape(pres.shapes.RECTANGLE, { x:2.8,y:3.55,w:4.4,h:0.5, fill:{color:"102038"}, line:{color:C.teal, width:0.8} });
  s.addText("Presenter: [Your Name]   |   Moderator: [Faculty Name]", {
    x:2.8,y:3.55,w:4.4,h:0.5, fontSize:10, color:"A8C8D8", align:"center", valign:"middle"
  });

  // Date
  s.addText("Date: ___________   |   Venue: Department Seminar Hall", {
    x:1,y:4.18,w:8,h:0.3, fontSize:10, color:"607890", align:"center"
  });

  // Keywords strip
  s.addText("LACTOBACILLUS  •  VAGINAL MICROBIOME  •  BACTERIAL VAGINOSIS  •  NEONATAL FLORA  •  DYSBIOSIS", {
    x:0.25,y:4.7,w:9.5,h:0.28, fontSize:8, color:"456070", align:"center", charSpacing:0.5
  });

  // Source note
  s.addText("Sources: Jawetz Medical Microbiology 28e  |  Sherris & Ryan 8e  |  Murray Medical Microbiology 9e  |  Ravel et al. PNAS 2011", {
    x:0.25,y:5.28,w:9.5,h:0.22, fontSize:7.5, color:"3A5060", align:"center"
  });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 2 — TABLE OF CONTENTS
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  fillBg(s);
  topBar(s, C.navy);
  slideH(s, "Contents at a Glance");
  footer(s, "Slide 2");

  const sections = [
    { num:"A", title:"Introduction & Definitions",        sub:"Scope, symbiosis, microbiome basics" },
    { num:"B", title:"Urethral Flora (Both Sexes)",        sub:"Organisms, density, sterile zones" },
    { num:"C", title:"Vaginal Flora – Lifecycle Changes",  sub:"Birth → puberty → menopause" },
    { num:"D", title:"Vaginal Flora – Organism Inventory", sub:"Complete list by Gram category" },
    { num:"E", title:"Protective Mechanisms",              sub:"Lactobacillus as guardian flora" },
    { num:"F", title:"Male Genital Microbiota",            sub:"Foreskin, urethra, semen, circumcision" },
    { num:"G", title:"Bacterial Vaginosis (BV)",           sub:"Dysbiosis, Amsel criteria, organisms" },
    { num:"H", title:"Placenta & Uterine Microbiome",      sub:"Sterile myth vs. molecular evidence" },
    { num:"I", title:"Neonatal Significance",              sub:"Vertical transmission & disease" },
    { num:"J", title:"Altering Factors & Clinical Impact", sub:"Drugs, hormones, opportunistic infections" },
    { num:"K", title:"Summary & Key Takeaways",            sub:"Core learning points" },
  ];

  const COLS = 2, perCol = Math.ceil(sections.length / COLS);
  sections.forEach((sec, i) => {
    const col = Math.floor(i / perCol);
    const row = i % perCol;
    const x = 0.28 + col * 4.87;
    const y = 0.95 + row * 0.42;

    s.addShape(pres.shapes.RECTANGLE, { x,y,w:4.65,h:0.38,
      fill:{color: i%2===0?C.white:C.gray1}, line:{color:"D5E2E8",width:0.4} });
    // Letter badge
    s.addShape(pres.shapes.RECTANGLE, { x,y,w:0.35,h:0.38, fill:{color:C.deepTeal}, line:{color:C.deepTeal} });
    s.addText(sec.num, { x,y,w:0.35,h:0.38, fontSize:11, bold:true, color:C.white, align:"center", valign:"middle" });
    s.addText(sec.title, { x:x+0.42,y:y+0.02,w:3.8,h:0.2, fontSize:10, bold:true, color:C.textDark, margin:0 });
    s.addText(sec.sub,   { x:x+0.42,y:y+0.22,w:3.8,h:0.15, fontSize:8,  color:C.gray2, margin:0 });
  });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 3 — INTRODUCTION
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  fillBg(s);
  topBar(s, C.deepTeal);
  leftAccent(s, C.deepTeal);
  slideH(s, "Introduction – What Is Genital Flora?", "Section A");
  footer(s, "Slide 3");

  // Definition box
  card(s, 0.28,0.95,9.44,1.15,C.tealLight);
  s.addShape(pres.shapes.RECTANGLE, { x:0.28,y:0.95,w:0.09,h:1.15, fill:{color:C.teal}, line:{color:C.teal} });
  s.addText([
    { text:"Definition: ", options:{bold:true, color:C.deepTeal} },
    { text:"Genital flora comprises the community of microorganisms — predominantly bacteria, with fungi and occasionally protozoa — that normally inhabit the genital and lower urogenital tracts of healthy individuals. These form a dynamic, symbiotic ecosystem with the host that evolves with age, hormonal status, and environment.", options:{color:C.textDark} }
  ], { x:0.5,y:1.0,w:9.1,h:1.05, fontSize:11, valign:"middle" });

  // Three pillars
  const pillars = [
    { head:"HOST PROVIDES", color:C.teal, items:["Site of colonization","Nutrients & warmth","Innate immune protection","Hormonal environment"] },
    { head:"MICROBES PROVIDE", color:C.navy, items:["Metabolic functions","Immune priming","Pathogen exclusion","Bacteriocin production"] },
    { head:"RESULT", color:C.green, items:["Symbiotic homeostasis","Protection from pathogens","Optimal pH maintenance","Reproductive health support"] },
  ];
  pillars.forEach((p, i) => {
    const x = 0.28 + i * 3.2;
    card(s, x, 2.22, 3.05, 2.9, C.white);
    s.addShape(pres.shapes.RECTANGLE, { x,y:2.22,w:3.05,h:0.45, fill:{color:p.color}, line:{color:p.color} });
    s.addText(p.head, { x,y:2.22,w:3.05,h:0.45, fontSize:10.5, bold:true, color:C.white, align:"center", valign:"middle", charSpacing:0.8 });
    p.items.forEach((item, j) => {
      s.addShape(pres.shapes.RECTANGLE, { x:x+0.14,y:2.82+j*0.52,w:2.77,h:0.44,
        fill:{color:j%2===0?C.gray1:C.white}, line:{color:"D8E5EA",width:0.3} });
      s.addText("→  "+item, { x:x+0.22,y:2.82+j*0.52,w:2.65,h:0.44, fontSize:10, color:C.textDark, valign:"middle" });
    });
  });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 4 — URETHRAL FLORA
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  fillBg(s);
  topBar(s, C.navy);
  leftAccent(s, C.teal);
  slideH(s, "Normal Microbiota of the Urethra", "Section B  |  Both Sexes");
  footer(s, "Slide 4");

  // Key fact
  card(s, 0.28,0.95,9.44,0.65,C.goldLight);
  s.addShape(pres.shapes.RECTANGLE, { x:0.28,y:0.95,w:0.09,h:0.65, fill:{color:C.gold}, line:{color:C.gold} });
  s.addText("Key Point: The anterior urethra of BOTH sexes harbors small numbers of organisms from surrounding skin and perineum. Normal voided urine contains 10² – 10⁴ organisms/mL. The posterior urethra and bladder are STERILE.", {
    x:0.5,y:0.97,w:9.1,h:0.62, fontSize:10.5, color:C.textDark, valign:"middle"
  });

  // Organisms table
  const orgs = [
    ["Organism","Gram Stain","Notes","Risk"],
    ["Staphylococcus epidermidis","Gram +ve cocci","Most common; skin origin","Low"],
    ["Diphtheroids (Corynebacterium spp.)","Gram +ve rods","Aerobic skin commensal","Low"],
    ["Streptococcus viridans group","Gram +ve cocci","Alpha-hemolytic","Low"],
    ["Enterococcus faecalis","Gram +ve cocci","From perineum","Mod"],
    ["Mycobacterium smegmatis","Acid-fast rods","Periurethral smegma; non-pathogenic","Low"],
    ["E. coli / Klebsiella (coliforms)","Gram -ve rods","Small numbers; perineal origin","Mod"],
    ["Anaerobic cocci (occasional)","Gram +ve","From perineal skin","Low"],
  ];

  const cw = [3.0,2.0,3.4,0.85];
  const cx = [0.28,3.28,5.28,8.68];
  orgs.forEach(([c0,c1,c2,c3], ri) => {
    const y = 1.7 + ri * 0.48;
    const isH = ri===0;
    const bg = isH?C.navy: ri%2===0?C.white:C.gray1;
    s.addShape(pres.shapes.RECTANGLE, { x:0.28,y,w:9.25,h:0.46, fill:{color:bg}, line:{color:"C8D8E0",width:0.35} });
    [[c0,0],[c1,1],[c2,2],[c3,3]].forEach(([txt,ci]) => {
      const riskColor = txt==="Mod"?C.gold:txt==="Low"?"2E9E6A":C.textDark;
      s.addText(txt, { x:cx[ci]+0.07,y:y+0.04,w:cw[ci]-0.1,h:0.38,
        fontSize:isH?9.5:9.2, bold:isH, color:isH?C.white:ci===3?riskColor:C.textDark, valign:"middle" });
    });
  });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 5 — VAGINAL FLORA LIFECYCLE
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  fillBg(s);
  topBar(s, C.deepTeal);
  leftAccent(s, C.deepTeal);
  slideH(s, "Vaginal Flora – Changes Across the Lifespan", "Section C");
  footer(s, "Slide 5");

  const phases = [
    { label:"NEONATAL\n(Birth–Weeks)", pH:"Acidic", dominant:"Aerobic\nLactobacillus spp.", mechanism:"Maternal estrogen\ntransferred in utero", color:C.teal, note:"Transient" },
    { label:"CHILDHOOD\n(Weeks–Puberty)", pH:"Neutral\n6.0–7.0", dominant:"Mixed cocci\n& bacilli", mechanism:"No estrogen,\nlow glycogen", color:"607D8B", note:"Mixed flora" },
    { label:"REPRODUCTIVE\nAGE (Puberty–)", pH:"Acidic\n3.8–4.5", dominant:"Lactobacillus\n(dominant)", mechanism:"Estrogen → glycogen\n→ lactic acid + H₂O₂", color:C.navy, note:"Protective state" },
    { label:"PREGNANCY", pH:"pH ↓ further\n(more acidic)", dominant:"Lactobacillus\n(↑ further)", mechanism:"High estrogen &\nprogesterone", color:C.deepTeal, note:"Max protection" },
    { label:"POST-\nMENOPAUSE", pH:"Rising\n→ Neutral", dominant:"Mixed flora\nreturns", mechanism:"Estrogen ↓,\nglycogens ↓", color:"8D6E63", note:"Vulnerable" },
  ];

  // Horizontal timeline bar
  s.addShape(pres.shapes.RECTANGLE, { x:0.3,y:2.26,w:9.4,h:0.07, fill:{color:"C5D5DC"}, line:{color:"C5D5DC"} });

  phases.forEach((ph, i) => {
    const x = 0.28 + i * 1.9;
    // Top phase box
    s.addShape(pres.shapes.ROUNDED_RECTANGLE, { x,y:1.0,w:1.78,h:1.18, fill:{color:ph.color}, line:{color:ph.color}, rectRadius:0.07 });
    s.addText(ph.label, { x,y:1.0,w:1.78,h:1.18, fontSize:10.5, bold:true, color:C.white, align:"center", valign:"middle", lineSpacingMultiple:1.3 });
    // Timeline dot
    s.addShape(pres.shapes.OVAL, { x:x+0.65,y:2.2,w:0.2,h:0.2, fill:{color:ph.color}, line:{color:ph.color} });
    // Bottom card
    card(s, x, 2.48, 1.78, 2.85, C.white);
    s.addText("pH: "+ph.pH, { x:x+0.1,y:2.56,w:1.6,h:0.38, fontSize:10, bold:true, color:ph.color, lineSpacingMultiple:1.1 });
    hRule(s, x+0.08, 2.96, 1.45, C.gold);
    s.addText(ph.dominant, { x:x+0.1,y:3.03,w:1.6,h:0.55, fontSize:9.5, bold:true, color:C.textDark, lineSpacingMultiple:1.2 });
    s.addText(ph.mechanism, { x:x+0.1,y:3.62,w:1.6,h:0.62, fontSize:8.8, color:C.textMid, lineSpacingMultiple:1.2 });
    // Note badge
    s.addShape(pres.shapes.ROUNDED_RECTANGLE, { x:x+0.1,y:5.05,w:1.55,h:0.22, fill:{color:ph.color}, line:{color:ph.color}, rectRadius:0.04 });
    s.addText(ph.note, { x:x+0.1,y:5.05,w:1.55,h:0.22, fontSize:8, bold:true, color:C.white, align:"center", valign:"middle" });
  });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 6 — ORGANISM INVENTORY (two-column detailed)
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  fillBg(s);
  topBar(s, C.navy);
  leftAccent(s, C.teal);
  slideH(s, "Normal Vaginal Flora – Organism Inventory", "Section D  |  Reproductive-Age Women");
  footer(s, "Slide 6");

  // Left column: Gram-positive
  card(s, 0.24, 0.95, 4.55, 4.4, C.white);
  s.addShape(pres.shapes.RECTANGLE, { x:0.24,y:0.95,w:4.55,h:0.42, fill:{color:C.teal}, line:{color:C.teal} });
  s.addText("GRAM-POSITIVE ORGANISMS", { x:0.24,y:0.95,w:4.55,h:0.42, fontSize:10.5, bold:true, color:C.white, align:"center", valign:"middle", charSpacing:0.8 });

  const gpOrgs = [
    ["Lactobacillus spp.", "DOMINANT", C.teal, "L. crispatus, iners, jensenii, gasseri — core protective flora"],
    ["Group B Streptococcus", "⚠ 25%", C.coral, "S. agalactiae; present in 25% of childbearing women"],
    ["Streptococcus viridans", "Common", C.teal, "Alpha-hemolytic; low virulence"],
    ["Peptostreptococcus", "Anaerobe", C.gray2, "Anaerobic streptococci; normal minority flora"],
    ["Corynebacterium spp.", "Common", C.gray2, "Diphtheroids; skin-derived commensals"],
    ["Staphylococcus epidermidis", "Common", C.gray2, "Coagulase-negative; low pathogenicity"],
    ["Mobiluncus spp.", "Minor", C.gold, "Curved anaerobic rods; associated with BV if dominant"],
  ];
  gpOrgs.forEach(([name, badge, bc, desc], i) => {
    const y = 1.47 + i * 0.56;
    s.addShape(pres.shapes.RECTANGLE, { x:0.28,y,w:4.47,h:0.5, fill:{color:i%2===0?C.gray1:C.white}, line:{color:"D5E2E8",width:0.3} });
    s.addShape(pres.shapes.ROUNDED_RECTANGLE, { x:0.34,y:y+0.1,w:0.82,h:0.28, fill:{color:bc}, line:{color:bc}, rectRadius:0.04 });
    s.addText(badge, { x:0.34,y:y+0.1,w:0.82,h:0.28, fontSize:7.5, bold:true, color:C.white, align:"center", valign:"middle" });
    s.addText(name, { x:1.24,y:y+0.02,w:3.38,h:0.22, fontSize:10, bold:true, color:C.textDark, margin:0 });
    s.addText(desc, { x:1.24,y:y+0.24,w:3.38,h:0.22, fontSize:8.2, color:C.gray2, margin:0 });
  });

  // Right column: GN + Fungi/Other
  card(s, 5.03, 0.95, 4.73, 4.4, C.white);
  s.addShape(pres.shapes.RECTANGLE, { x:5.03,y:0.95,w:4.73,h:0.42, fill:{color:C.navy}, line:{color:C.navy} });
  s.addText("GRAM-NEGATIVE  /  FUNGI  /  MYCOPLASMA", { x:5.03,y:0.95,w:4.73,h:0.42, fontSize:10.5, bold:true, color:C.white, align:"center", valign:"middle", charSpacing:0.8 });

  const gnOrgs = [
    ["Prevotella spp.", "Anaerobe", C.gold, "Normal anaerobe; key BV organism when dominant"],
    ["Gardnerella vaginalis", "Gram-variable", C.coral, "Minor commensal; overgrows in BV → clue cells"],
    ["Fusobacterium spp.", "Anaerobe", C.gray2, "Obligate anaerobe; minor commensal"],
    ["Bacteroides spp.", "Anaerobe", C.gray2, "Part of normal anaerobic flora"],
    ["Candida albicans", "Fungus", "7B5EA7", "~20% healthy women; vaginitis when Lactobacillus lost"],
    ["Ureaplasma urealyticum", "Mycoplasma", C.deepTeal, "No cell wall; normal commensal; can cause NGU"],
    ["Mycoplasma hominis", "Mycoplasma", C.deepTeal, "Normal commensal; associated with BV occasionally"],
    ["Listeria monocytogenes", "Rare", C.coral, "Rare colonizer; neonatal listeriosis risk if present"],
  ];
  gnOrgs.forEach(([name, badge, bc, desc], i) => {
    const y = 1.47 + i * 0.485;
    s.addShape(pres.shapes.RECTANGLE, { x:5.07,y,w:4.65,h:0.44, fill:{color:i%2===0?C.gray1:C.white}, line:{color:"D5E2E8",width:0.3} });
    s.addShape(pres.shapes.ROUNDED_RECTANGLE, { x:5.12,y:y+0.08,w:0.92,h:0.26, fill:{color:bc}, line:{color:bc}, rectRadius:0.04 });
    s.addText(badge, { x:5.12,y:y+0.08,w:0.92,h:0.26, fontSize:7, bold:true, color:C.white, align:"center", valign:"middle" });
    s.addText(name, { x:6.12,y:y+0.01,w:3.5,h:0.2,  fontSize:9.8, bold:true, color:C.textDark, margin:0 });
    s.addText(desc, { x:6.12,y:y+0.22,w:3.5,h:0.2,  fontSize:7.8, color:C.gray2, margin:0 });
  });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 7 — PROTECTIVE MECHANISMS
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  fillDark(s);
  s.addShape(pres.shapes.RECTANGLE, { x:0,y:0,w:10,h:0.85, fill:{color:C.teal}, line:{color:C.teal} });
  s.addText("Protective Mechanisms of Vaginal Flora", { x:0.25,y:0.05,w:9.5,h:0.76, fontSize:19, bold:true, color:C.white, valign:"middle" });
  s.addText("Section E  |  Döderlein's Bacilli & the Vaginal Defence System", { x:0.25,y:0.68,w:9.5,h:0.2, fontSize:9, color:"A0D0D8", italic:true, margin:0 });
  footer(s, "Slide 7");

  // Mechanism cards (6 mechanisms in 2x3 grid)
  const mechs = [
    { icon:"🧪", title:"Lactic Acid Production", body:"Lactobacillus ferments glycogen (from estrogen-primed epithelium) → lactic acid → pH 3.8–4.5. Most vaginal pathogens cannot survive below pH 4.5.", color:C.teal },
    { icon:"⚗️", title:"Hydrogen Peroxide (H₂O₂)", body:"H₂O₂-producing Lactobacillus strains (esp. L. crispatus) generate H₂O₂ that is directly toxic to anaerobes, Gardnerella, Trichomonas, and HIV.", color:C.deepTeal },
    { icon:"🛡️", title:"Bacteriocins", body:"Low-molecular-weight antimicrobial peptides (lactocins, acidocins) produced by Lactobacillus inhibit competing Gram-positive and some Gram-negative bacteria.", color:"1B5E8C" },
    { icon:"🔒", title:"Competitive Exclusion", body:"Lactobacillus occupies epithelial adhesion sites, preventing pathogen attachment. A Lactobacillus-dominated flora is an environment hostile to enteric pathogens.", color:"1A6B3C" },
    { icon:"🧬", title:"Immune Modulation", body:"Vaginal flora stimulates innate immunity (TLRs, defensins) and induces regulatory T-cell responses that maintain tolerance while enabling pathogen responses.", color:"6B3C7A" },
    { icon:"🦠", title:"Biosurfactants & Coaggregation", body:"Lactobacillus produces biosurfactants that reduce pathogen biofilm formation and coaggregation proteins that cluster pathogens away from epithelial surfaces.", color:"7A5030" },
  ];

  mechs.forEach((m, i) => {
    const col = i % 3;
    const row = Math.floor(i / 3);
    const x = 0.2 + col * 3.25;
    const y = 1.0 + row * 2.18;
    card(s, x, y, 3.1, 2.08, "0C2234");
    s.addShape(pres.shapes.RECTANGLE, { x,y,w:3.1,h:0.44, fill:{color:m.color}, line:{color:m.color} });
    s.addText(m.icon+"  "+m.title, { x,y,w:3.1,h:0.44, fontSize:10.5, bold:true, color:C.white, align:"center", valign:"middle" });
    s.addText(m.body, { x:x+0.14,y:y+0.52,w:2.82,h:1.48, fontSize:9.5, color:"BDD4E0", lineSpacingMultiple:1.4, valign:"top" });
  });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 8 — MALE GENITAL MICROBIOTA
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  fillBg(s);
  topBar(s, C.navy);
  leftAccent(s, C.gold);
  slideH(s, "Male Urogenital Tract Microbiota (MUGT)", "Section F");
  footer(s, "Slide 8");

  // Intro line
  s.addText("The MUGT includes several distinct microbial environments: penile skin, balanopreputial sulcus (foreskin), urethra, and semen. Circumcision status, sexual behaviour, and female partner's flora all influence composition.", {
    x:0.3,y:0.92,w:9.4,h:0.5, fontSize:10.5, color:C.textMid, italic:true
  });

  // 4 site cards top row
  const sites = [
    { site:"Penile Skin", icon:"🩺", color:C.teal, orgs:["Staphylococcus spp.","Corynebacterium spp.","Streptococcus spp.","Malassezia (fungi)"] },
    { site:"Foreskin (Uncircumcised)", icon:"⚠️", color:C.coral, orgs:["Anaerococcus spp.","Peptoniphilus spp.","Finegoldia spp.","Prevotella spp. (BV-overlap)"] },
    { site:"Urethra", icon:"🔬", color:C.navy, orgs:["CoNS (S. epidermidis)","Corynebacterium spp.","Occasional coliforms","Mycobacterium smegmatis"] },
    { site:"Semen", icon:"🧫", color:"546E7A", orgs:["Variable, low diversity","Lactobacillus (variable)","Prevotella, Finegoldia","Streptococcus (occasional)"] },
  ];
  sites.forEach((st, i) => {
    const x = 0.24 + i * 2.4;
    card(s, x, 1.52, 2.25, 2.65, C.white);
    s.addShape(pres.shapes.RECTANGLE, { x,y:1.52,w:2.25,h:0.44, fill:{color:st.color}, line:{color:st.color} });
    s.addText(st.icon+" "+st.site, { x,y:1.52,w:2.25,h:0.44, fontSize:10, bold:true, color:C.white, align:"center", valign:"middle" });
    st.orgs.forEach((org, j) => {
      s.addText("• "+org, { x:x+0.1,y:2.06+j*0.52,w:2.05,h:0.46, fontSize:9.5, color:C.textDark, valign:"middle" });
    });
  });

  // Circumcision insight
  card(s, 0.24, 4.28, 9.52, 0.88, C.goldLight);
  s.addShape(pres.shapes.RECTANGLE, { x:0.24,y:4.28,w:0.09,h:0.88, fill:{color:C.gold}, line:{color:C.gold} });
  s.addText([
    { text:"Circumcision Effect: ", options:{bold:true, color:C.gold} },
    { text:"Circumcision significantly reduces anaerobic load (Prevotella, Anaerococcus, Peptoniphilus) in the balanopreputial sulcus. These organisms overlap with BV-associated bacteria. Concordance studies show sexual transmission of BV strains between partners, supporting the role of male genital flora in female vaginal health.", options:{color:C.textDark} }
  ], { x:0.45,y:4.3,w:9.15,h:0.82, fontSize:10, valign:"middle" });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 9 — BACTERIAL VAGINOSIS (2-column detail)
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  fillDark(s);
  s.addShape(pres.shapes.RECTANGLE, { x:0,y:0,w:10,h:0.85, fill:{color:C.coral}, line:{color:C.coral} });
  s.addText("Bacterial Vaginosis (BV) – Vaginal Dysbiosis", { x:0.25,y:0.05,w:9.5,h:0.76, fontSize:19, bold:true, color:C.white, valign:"middle" });
  s.addText("Section G  |  Most Common Cause of Vaginal Discharge in Reproductive-Age Women", { x:0.25,y:0.68,w:9.5,h:0.2, fontSize:9, color:"FFBBBB", italic:true, margin:0 });
  footer(s, "Slide 9");

  // Col 1: Pathophysiology
  card(s, 0.2,0.95,4.7,4.35,"0D1E2C");
  s.addText("PATHOPHYSIOLOGY", { x:0.35,y:1.0,w:4.4,h:0.32, fontSize:11, bold:true, color:C.gold, charSpacing:1.2 });
  hRule(s, 0.35, 1.34, 3.8, C.coral);
  const path = [
    "1.  Unexplained disappearance of Lactobacillus",
    "2.  Vaginal pH rises above 4.5",
    "3.  Anaerobic bacterial overgrowth",
    "4.  Amines (putrescine, cadaverine) produced → fishy odor",
    "5.  Epithelial cells coated with bacteria → Clue cells",
  ];
  path.forEach((p, i) => {
    s.addText(p, { x:0.35,y:1.42+i*0.46,w:4.4,h:0.42, fontSize:10, color:C.white, valign:"middle" });
  });
  s.addText("BV-ASSOCIATED ORGANISMS:", { x:0.35,y:3.76,w:4.4,h:0.28, fontSize:10, bold:true, color:C.gold });
  s.addText("Gardnerella vaginalis (hallmark)  •  Prevotella spp.  •  Mobiluncus spp.  •  Atopobium vaginae  •  Sneathia spp.  •  Leptotrichia spp.  •  Megasphaera spp.", {
    x:0.35,y:4.05,w:4.4,h:1.1, fontSize:9.5, color:"FFBBAA", lineSpacingMultiple:1.4
  });

  // Col 2: Clinical + complications
  card(s, 5.1,0.95,4.7,4.35,"0D1E2C");
  s.addText("AMSEL DIAGNOSTIC CRITERIA", { x:5.25,y:1.0,w:4.4,h:0.32, fontSize:11, bold:true, color:C.gold, charSpacing:1.2 });
  hRule(s, 5.25, 1.34, 3.8, C.coral);
  s.addText("Diagnosis requires ≥ 3 of 4:", { x:5.25,y:1.4,w:4.4,h:0.28, fontSize:9.5, color:"FFDDDD", italic:true });
  const amsel = [
    ["1","Homogeneous, thin grey-white discharge"],
    ["2","Vaginal pH > 4.5"],
    ["3","Positive Whiff test (10% KOH → fishy odor)"],
    ["4","Clue cells ≥20% on wet mount (pathognomonic)"],
  ];
  amsel.forEach(([n, t], i) => {
    s.addShape(pres.shapes.OVAL, { x:5.25,y:1.78+i*0.5,w:0.3,h:0.3, fill:{color:C.coral}, line:{color:C.coral} });
    s.addText(n, { x:5.25,y:1.78+i*0.5,w:0.3,h:0.3, fontSize:9.5, bold:true, color:C.white, align:"center", valign:"middle" });
    s.addText(t, { x:5.65,y:1.8+i*0.5,w:4.0,h:0.27, fontSize:10, color:C.white, margin:0 });
  });
  s.addText("COMPLICATIONS OF BV:", { x:5.25,y:3.82,w:4.4,h:0.28, fontSize:10, bold:true, color:C.gold });
  const comps = ["PID & upper genital tract infection","HIV acquisition risk ↑ 2–3x","Preterm birth & PPROM in pregnancy","Post-surgical infections","Increased STI susceptibility","Neonatal complications"];
  comps.forEach((c, i) => {
    const col = i<3?0:1;
    const row = i%3;
    s.addText("⚠ "+c, { x:5.25+col*2.3,y:4.12+row*0.35,w:2.2,h:0.32, fontSize:9, color:"FFCCAA", margin:0 });
  });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 10 — PLACENTA & UTERINE MICROBIOME
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  fillBg(s);
  topBar(s, C.deepTeal);
  leftAccent(s, C.deepTeal);
  slideH(s, "Placenta & Uterine Microbiome", "Section H  |  The 'Sterile Womb' Hypothesis Revisited");
  footer(s, "Slide 10");

  // Split design
  card(s, 0.24,0.95,4.6,4.4,"FFF0F0");
  s.addShape(pres.shapes.RECTANGLE, { x:0.24,y:0.95,w:4.6,h:0.42, fill:{color:C.coral}, line:{color:C.coral} });
  s.addText("❌  HISTORICAL VIEW (Pre-2012)", { x:0.24,y:0.95,w:4.6,h:0.42, fontSize:11, bold:true, color:C.white, align:"center", valign:"middle" });
  s.addText("• Placenta = sterile\n• Uterus = sterile\n• Any microorganism found = contamination or infection\n• Basis: Culture-based studies (detection limit issue)\n• Used to justify aggressive antibiotic use in pregnancy", {
    x:0.38,y:1.47,w:4.3,h:2.5, fontSize:10.5, color:C.textDark, lineSpacingMultiple:1.55
  });

  card(s, 5.16,0.95,4.6,4.4,"E8F7F0");
  s.addShape(pres.shapes.RECTANGLE, { x:5.16,y:0.95,w:4.6,h:0.42, fill:{color:C.green}, line:{color:C.green} });
  s.addText("✅  CURRENT EVIDENCE (Post-2012)", { x:5.16,y:0.95,w:4.6,h:0.42, fontSize:11, bold:true, color:C.white, align:"center", valign:"middle" });
  s.addText("• 16S rRNA sequencing identified commensal bacteria in placenta\n• Uterus harbors microorganisms in healthy asymptomatic women\n• Uterine microbiome differs from vagina and gut\n• May influence implantation, pregnancy outcome\n• Role in preterm birth under active investigation", {
    x:5.3,y:1.47,w:4.3,h:2.5, fontSize:10.5, color:C.textDark, lineSpacingMultiple:1.55
  });

  // Key message
  card(s, 0.24,5.1,9.52,0.3,C.goldLight);
  s.addShape(pres.shapes.RECTANGLE, { x:0.24,y:5.1,w:0.09,h:0.3, fill:{color:C.gold}, line:{color:C.gold} });
  s.addText("Clinical Significance: Disruption of the uterine microbiome may impair implantation and predispose to recurrent pregnancy loss — an area of active research.", {
    x:0.45,y:5.1,w:9.15,h:0.3, fontSize:9.5, color:C.textDark, valign:"middle", italic:true
  });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 11 — NEONATAL SIGNIFICANCE
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  fillBg(s);
  topBar(s, C.navy);
  leftAccent(s, C.coral);
  slideH(s, "Neonatal Significance of Maternal Genital Flora", "Section I  |  Vertical Transmission");
  footer(s, "Slide 11");

  s.addText("Organisms colonizing the maternal vagina/cervix at delivery are transmitted to the neonate during passage through the birth canal:", {
    x:0.28,y:0.9,w:9.4,h:0.36, fontSize:10.5, color:C.textMid, italic:true
  });

  const rows = [
    { org:"Organism", route:"Transmission", disease:"Neonatal Disease / Manifestation", timing:"Timing", hdr:true },
    { org:"Group B Streptococcus", route:"Vaginal colonization", disease:"Sepsis, Meningitis, Pneumonia (25% of mothers colonized)", timing:"Early-onset", hdr:false },
    { org:"Neisseria gonorrhoeae", route:"Direct mucosal contact", disease:"Ophthalmia neonatorum — purulent conjunctivitis (may → blindness)", timing:"1–4 days", hdr:false },
    { org:"Chlamydia trachomatis", route:"Birth canal secretions", disease:"Neonatal conjunctivitis; Chlamydial pneumonia at 2–12 weeks", timing:"5–14 days", hdr:false },
    { org:"Herpes simplex virus", route:"Active genital HSV lesions", disease:"Neonatal herpes — encephalitis, disseminated (high mortality)", timing:"0–4 days", hdr:false },
    { org:"Candida albicans", route:"Vaginal colonization", disease:"Oral thrush, cutaneous candidiasis, rarely systemic", timing:"Days–weeks", hdr:false },
    { org:"Listeria monocytogenes", route:"Rare vaginal colonizer", disease:"Early-onset neonatal sepsis, meningitis, granulomatosis infantiseptica", timing:"Hours–days", hdr:false },
  ];

  const CW = [2.2, 2.1, 3.9, 1.0];
  const CX = [0.28, 2.48, 4.58, 8.48];
  rows.forEach((row, ri) => {
    const y = 1.32 + ri * 0.58;
    const isH = row.hdr;
    const isHigh = ["Group B Streptococcus","Herpes simplex virus"].includes(row.org);
    const bg = isH?C.navy: isHigh?"FFF0F0": ri%2===0?C.white:C.gray1;
    s.addShape(pres.shapes.RECTANGLE, { x:0.28,y,w:9.25,h:0.53, fill:{color:bg}, line:{color:"C8D8E0",width:0.35} });
    [[row.org,0],[row.route,1],[row.disease,2],[row.timing,3]].forEach(([txt,ci]) => {
      s.addText(txt, { x:CX[ci]+0.07,y:y+0.03,w:CW[ci]-0.1,h:0.47,
        fontSize:isH?9.5:9.2, bold:isH||ci===0, color:isH?C.white:ci===0?C.teal:C.textDark, valign:"middle" });
    });
    if (isHigh) {
      s.addText("⚠", { x:9.52,y,w:0.22,h:0.53, fontSize:12, align:"center", valign:"middle" });
    }
  });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 12 — ALTERING FACTORS + CLINICAL IMPACT
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  fillBg(s);
  topBar(s, C.navy);
  leftAccent(s, C.teal);
  slideH(s, "Factors Altering Genital Flora & Clinical Impact", "Section J");
  footer(s, "Slide 12");

  // Left: factors
  card(s, 0.22,0.95,5.1,4.5,C.white);
  s.addShape(pres.shapes.RECTANGLE, { x:0.22,y:0.95,w:5.1,h:0.4, fill:{color:C.deepTeal}, line:{color:C.deepTeal} });
  s.addText("FACTORS THAT ALTER FLORA", { x:0.22,y:0.95,w:5.1,h:0.4, fontSize:10.5, bold:true, color:C.white, align:"center", valign:"middle", charSpacing:0.8 });

  const factors = [
    { icon:"💊", label:"Broad-spectrum antibiotics",  effect:"Suppress Lactobacillus → BV or Candida vaginitis" },
    { icon:"🌡️", label:"Hormonal changes",            effect:"Pregnancy, menopause alter glycogen & Lactobacillus" },
    { icon:"🚿", label:"Vaginal douching",             effect:"Disrupts normal flora; major BV risk factor" },
    { icon:"💑", label:"Sexual activity / new partner",effect:"New organisms; BV sexually transmissible" },
    { icon:"🩺", label:"IUD / Contraceptive devices",  effect:"Alter uterine and cervical microenvironment" },
    { icon:"🍬", label:"Diabetes mellitus",            effect:"Elevated glucose → Candida overgrowth" },
    { icon:"🛡️", label:"Immunosuppression",           effect:"Opportunistic organisms flourish" },
    { icon:"🧪", label:"Spermicides",                  effect:"Nonoxynol-9 kills Lactobacillus as well as sperm" },
  ];
  factors.forEach((f, i) => {
    const y = 1.44 + i * 0.48;
    s.addShape(pres.shapes.RECTANGLE, { x:0.26,y,w:5.02,h:0.44, fill:{color:i%2===0?C.gray1:C.white}, line:{color:"D5E2E8",width:0.3} });
    s.addText(f.icon, { x:0.3,y,w:0.38,h:0.44, fontSize:13, align:"center", valign:"middle" });
    s.addText(f.label, { x:0.72,y:y+0.01,w:2.5,h:0.2, fontSize:9.8, bold:true, color:C.textDark, margin:0 });
    s.addText(f.effect, { x:0.72,y:y+0.22,w:4.4,h:0.2, fontSize:8.5, color:C.gray2, margin:0 });
  });

  // Right: opportunistic infections
  card(s, 5.55,0.95,4.25,4.5,C.white);
  s.addShape(pres.shapes.RECTANGLE, { x:5.55,y:0.95,w:4.25,h:0.4, fill:{color:C.navy}, line:{color:C.navy} });
  s.addText("OPPORTUNISTIC INFECTIONS", { x:5.55,y:0.95,w:4.25,h:0.4, fontSize:10.5, bold:true, color:C.white, align:"center", valign:"middle", charSpacing:0.8 });

  const opps = [
    { icon:"💧", name:"Urinary Tract Infection", detail:"E. coli from vaginal introitus ascends urethra; heavy introital flora = recurrent UTI risk", color:C.teal },
    { icon:"🔥", name:"Pelvic Inflammatory Disease", detail:"BV organisms ascend to uterus/tubes → salpingitis, infertility, ectopic pregnancy", color:C.coral },
    { icon:"🤱", name:"Chorioamnionitis", detail:"Ascending vaginal flora infects amniotic cavity → preterm birth, fetal damage", color:"C0761B" },
    { icon:"🔴", name:"HIV Susceptibility ↑↑", detail:"BV disrupts mucosal barrier; HIV risk 2–3x higher with BV vs. Lactobacillus-dominated flora", color:C.coral },
    { icon:"🧫", name:"Gonorrhoea Enhancement", detail:"Cervicovaginal microbiota unmask receptors on cervical cells, enhancing N. gonorrhoeae attachment", color:C.deepTeal },
    { icon:"🏥", name:"Surgical Site Infections", detail:"Post-hysterectomy/cesarean infections from ascending vaginal flora (anaerobes, GBS)", color:C.navy },
  ];
  opps.forEach((op, i) => {
    const y = 1.44 + i * 0.67;
    s.addShape(pres.shapes.RECTANGLE, { x:5.6,y,w:4.15,h:0.6, fill:{color:i%2===0?C.gray1:C.white}, line:{color:"D5E2E8",width:0.3} });
    s.addShape(pres.shapes.RECTANGLE, { x:5.6,y,w:0.06,h:0.6, fill:{color:op.color}, line:{color:op.color} });
    s.addText(op.icon+" "+op.name, { x:5.72,y:y+0.02,w:4.0,h:0.24, fontSize:9.8, bold:true, color:op.color, margin:0 });
    s.addText(op.detail, { x:5.72,y:y+0.28,w:4.0,h:0.26, fontSize:8.2, color:C.textMid, margin:0 });
  });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 13 — ETHNIC VARIATION & SPECIAL POPULATIONS
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  fillBg(s);
  topBar(s, C.deepTeal);
  leftAccent(s, C.deepTeal);
  slideH(s, "Ethnic Variation & Special Populations", "Section D (continued)  |  Ravel et al., PNAS 2011");
  footer(s, "Slide 13");

  // Study card
  card(s, 0.24,0.95,9.52,1.0,C.tealLight);
  s.addShape(pres.shapes.RECTANGLE, { x:0.24,y:0.95,w:0.09,h:1.0, fill:{color:C.teal}, line:{color:C.teal} });
  s.addText([
    { text:"Landmark Study: ", options:{bold:true, color:C.deepTeal} },
    { text:"Ravel et al. (PNAS 2011) analyzed the vaginal microbiome of ", options:{color:C.textDark} },
    { text:"396 asymptomatic reproductive-age women ", options:{bold:true, color:C.textDark} },
    { text:"across four ethnic groups and found significant variation in both vaginal pH and microbiome composition. This challenged the uniform definition of 'normal' vaginal flora.", options:{color:C.textDark} }
  ], { x:0.45,y:0.97,w:9.15,h:0.96, fontSize:11, valign:"middle" });

  // Ethnic comparison cards
  const groups = [
    { eth:"White Women",    color:C.teal,    dominant:"L. crispatus (dominant)", pH:"3.8–4.2", notes:"Most consistently Lactobacillus-dominant; lowest BV prevalence" },
    { eth:"Asian Women",    color:C.navy,    dominant:"L. crispatus or iners",    pH:"3.8–4.4", notes:"High Lactobacillus dominance; similar to White women pattern" },
    { eth:"Hispanic Women", color:"8B6914",  dominant:"L. iners dominant",       pH:"4.0–4.6", notes:"More L. iners (less protective than L. crispatus); moderate BV risk" },
    { eth:"Black Women",    color:C.coral,   dominant:"Mixed anaerobic flora",   pH:"4.5–5.5", notes:"Higher proportion with Lactobacillus-deficient microbiome; highest BV prevalence" },
  ];

  groups.forEach((g, i) => {
    const x = 0.24 + i * 2.4;
    card(s, x, 2.08, 2.28, 2.95, C.white);
    s.addShape(pres.shapes.RECTANGLE, { x,y:2.08,w:2.28,h:0.44, fill:{color:g.color}, line:{color:g.color} });
    s.addText(g.eth, { x,y:2.08,w:2.28,h:0.44, fontSize:11, bold:true, color:C.white, align:"center", valign:"middle" });
    s.addText("Dominant Flora:", { x:x+0.1,y:2.6,w:2.08,h:0.22, fontSize:9, bold:true, color:g.color, margin:0 });
    s.addText(g.dominant, { x:x+0.1,y:2.82,w:2.08,h:0.24, fontSize:10, color:C.textDark, margin:0 });
    s.addText("Typical pH: "+g.pH, { x:x+0.1,y:3.1,w:2.08,h:0.24, fontSize:10, bold:true, color:C.textMid, margin:0 });
    hRule(s, x+0.1, 3.36, 1.8, g.color);
    s.addText(g.notes, { x:x+0.1,y:3.45,w:2.08,h:1.42, fontSize:8.8, color:C.textMid, lineSpacingMultiple:1.35, valign:"top" });
  });

  card(s, 0.24,5.12,9.52,0.3,C.goldLight);
  s.addShape(pres.shapes.RECTANGLE, { x:0.24,y:5.12,w:0.09,h:0.3, fill:{color:C.gold}, line:{color:C.gold} });
  s.addText("Clinical Implication: Ethnicity must be considered when defining 'normal' vs. 'abnormal' vaginal flora. Black women have higher BV rates not solely due to risk behavior, but due to underlying microbiome differences.", {
    x:0.45,y:5.12,w:9.15,h:0.3, fontSize:9, color:C.textDark, valign:"middle", italic:true
  });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 14 — KEY TAKEAWAYS
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  fillDark(s);
  s.addShape(pres.shapes.RECTANGLE, { x:0,y:0,w:10,h:0.85, fill:{color:C.gold}, line:{color:C.gold} });
  s.addText("Key Takeaways", { x:0.25,y:0.06,w:9.5,h:0.76, fontSize:22, bold:true, color:C.navy, valign:"middle", fontFace:"Calibri" });
  footer(s, "Slide 14");

  const kts = [
    { n:"01", title:"Vaginal flora is estrogen-driven", body:"Estrogen → glycogen deposition → Lactobacillus dominance → lactic acid + H₂O₂ → pH 3.8–4.5. This entire cascade collapses at menopause and before puberty." },
    { n:"02", title:"Lactobacillus = multifactorial guardian", body:"Protection is not just from pH. Bacteriocins, H₂O₂, competitive exclusion, immune modulation and biosurfactants all contribute to its defensive role." },
    { n:"03", title:"BV is ecological collapse, not infection", body:"No single pathogen causes BV. It is a polymicrobial dysbiosis — a loss of Lactobacillus dominance and takeover by a mixed anaerobic community." },
    { n:"04", title:"GBS colonization is a silent neonatal threat", body:"25% of childbearing women carry GBS. Without intrapartum prophylaxis, neonatal sepsis and meningitis can result — one of the most preventable neonatal tragedies." },
    { n:"05", title:"Male flora affects female vaginal health", body:"Uncircumcised men harbor BV-associated anaerobes (Prevotella, Anaerococcus). Sexual partners share microbial strains — BV has a sexual transmission component." },
    { n:"06", title:"Antibiotic stewardship matters here too", body:"Broad-spectrum antibiotics do not just create resistance. They strip the vaginal microbiome, creating an ecological vacuum filled by Candida or BV organisms." },
  ];

  kts.forEach((k, i) => {
    const col = i % 2;
    const row = Math.floor(i / 2);
    const x = 0.2 + col * 4.95;
    const y = 0.95 + row * 1.55;
    card(s, x, y, 4.7, 1.45, "0C1F30");
    s.addShape(pres.shapes.ROUNDED_RECTANGLE, { x:x+0.1,y:y+0.12,w:0.44,h:0.44, fill:{color:C.gold}, line:{color:C.gold}, rectRadius:0.06 });
    s.addText(k.n, { x:x+0.1,y:y+0.12,w:0.44,h:0.44, fontSize:12, bold:true, color:C.navy, align:"center", valign:"middle" });
    s.addText(k.title, { x:x+0.65,y:y+0.12,w:3.95,h:0.38, fontSize:11, bold:true, color:C.gold, margin:0, valign:"middle" });
    s.addText(k.body, { x:x+0.14,y:y+0.62,w:4.42,h:0.76, fontSize:9, color:"B8CED8", lineSpacingMultiple:1.35, valign:"top" });
  });
}

// ═════════════════════════════════════════════════════════════════════════════
// SLIDE 15 — REFERENCES & THANK YOU
// ═════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  fillDark(s);
  s.addShape(pres.shapes.RECTANGLE, { x:0,y:0,w:0.22,h:5.625, fill:{color:C.teal}, line:{color:C.teal} });
  s.addShape(pres.shapes.RECTANGLE, { x:9.78,y:0,w:0.22,h:5.625, fill:{color:C.gold}, line:{color:C.gold} });
  s.addShape(pres.shapes.RECTANGLE, { x:0.22,y:4.65,w:9.56,h:0.07, fill:{color:C.teal}, line:{color:C.teal} });

  s.addText("Thank You", { x:0.5,y:0.35,w:9,h:1.1, fontSize:52, bold:true, color:C.white, align:"center", fontFace:"Calibri" });
  hRule(s, 2.5, 1.5, 5.0, C.gold);
  s.addText("Open for Discussion & Questions", { x:0.5,y:1.62,w:9,h:0.48, fontSize:16, color:"8EC8D2", align:"center", italic:true });

  // References box
  card(s, 0.5,2.22,9.0,2.55,"0D1E2C");
  s.addText("References", { x:0.7,y:2.3,w:8.6,h:0.36, fontSize:13, bold:true, color:C.gold });
  hRule(s, 0.7, 2.68, 6.0, C.teal);
  const refs = [
    "1.  Jawetz E, Melnick JL, Adelberg EA. Medical Microbiology, 28th Ed. McGraw-Hill; 2019. Ch. 11 — Normal Human Microbiota, pp. 180–186.",
    "2.  Ryan KJ, Ray CG. Sherris & Ryan's Medical Microbiology, 8th Ed. McGraw-Hill; 2022. pp. 37–39.",
    "3.  Murray PR, Rosenthal KS, Pfaller MA. Medical Microbiology, 9th Ed. Elsevier; 2021. Ch. 2 — Normal Flora, pp. 19–30.",
    "4.  Ravel J et al. Vaginal microbiome of reproductive-age women. Proc Natl Acad Sci USA. 2011;108 Suppl 1:4680–4687.",
    "5.  Amsel R et al. Nonspecific vaginitis: Diagnostic criteria and microbial and epidemiologic associations. Am J Med. 1983;74(1):14–22.",
  ];
  refs.forEach((r, i) => {
    s.addText(r, { x:0.7,y:2.78+i*0.38,w:8.6,h:0.36, fontSize:8.8, color:"90B8C8", lineSpacingMultiple:1.1, valign:"middle" });
  });
}

// ─── WRITE ────────────────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/genital-flora-ppt/Genital_Flora_Department_Seminar.pptx" })
  .then(() => console.log("✅  Department PPT saved!"))
  .catch(err => console.error("❌  Error:", err));

cd /home/daytona/workspace/genital-flora-ppt && node dept_ppt.js 2>&1

ls -lh /home/daytona/workspace/genital-flora-ppt/