cd /home/daytona/workspace && python -m markitdown /home/daytona/workspace/attac…

cd /home/daytona/workspace && pandoc /home/daytona/workspace/attachments/f69ea72…

cd /home/daytona/skills/pptx && python scripts/office/unpack.py /home/daytona/wo…

unzip -o /home/daytona/workspace/attachments/f69ea72b-4ae2-4b50-a1ca-0789d99d7d4…

ls /home/daytona/workspace/pptx_unpacked/ppt/slides/ 2>&1

for i in 1 2 3 4 5 6; do echo "=== SLIDE $i ==="; python3 -c " import xml.etree.…

for i in 7 8 9 10 11 12; do echo "=== SLIDE $i ==="; python3 -c " import xml.etr…

cat /home/daytona/workspace/pptx_unpacked/ppt/slides/slide1.xml | head -80

cat /home/daytona/workspace/pptx_unpacked/ppt/slides/slide2.xml | head -150

Create a PowerPoint presentation (.pptx) for a PG Synopsis on the topic "Role of HRCT in Interstitial Lung Disease" following the exact template format described below. ## Student Details - **Title**: Role of HRCT (High-Resolution Computed Tomography) in Interstitial Lung Disease - **Student**: Dr. Bhargav Gami - **Batch**: 2023-2026 - **Guide**: Dr. Nishant Patel, Associate Professor - **Department**: Radiodiagnosis - **Institution**: Nootan Medical College and Research Centre, Visnagar - **Date**: July 2026 ## Template Structure (from the original PPTX template) The template has 12 slides with: - **Formatting**: Times New Roman font, Title 36pt Bold, Headings 28pt Bold, Text 22pt, Line spacing 1.1, white background with dark blue headings - **Slide size**: Widescreen 16:9 ## Slides to Create (follow the exact same order as the template): **Slide 1**: Cover/Logo slide (blank with institution logo placeholder — leave blank background) **Slide 2**: Title Slide (centered, bold) - "Role of HRCT in Interstitial Lung Disease" - Dr. Bhargav Gami - Batch: 2023-2026 - Guide: Dr. Nishant Patel, Associate Professor - Department of Radiodiagnosis, NMCRC Visnagar - July 2026 **Slide 3**: Introduction / Background - HRCT (High-Resolution CT) uses thin slices (0.5–1.5 mm) with high spatial frequency reconstruction algorithms to provide superior detail of lung parenchyma - Interstitial Lung Disease (ILD) encompasses >200 disorders characterized by diffuse parenchymal lung abnormalities - Incidence of ILD is increasing globally, with IPF being most common (estimated 5 per 100,000 per year) - Chest X-ray has limited sensitivity for early ILD detection; HRCT has become the gold standard for ILD diagnosis and characterization - ILD leads to significant morbidity, mortality, and healthcare burden **Slide 4**: Review of Literature - **Müller et al. (1988)**: Established HRCT diagnostic criteria for UIP pattern — honeycombing, traction bronchiectasis, peripheral basal predominance - **ATS/ERS/JRS/ALAT (2011, 2018, 2022)**: Published guidelines recognizing HRCT patterns (UIP, probable UIP, indeterminate, alternative diagnosis) - **Walsh et al. (2016)**: Deep learning AI on HRCT showed comparable accuracy to radiologists for ILD classification - **Lynch et al. (2018)**: Fleischner Society White Paper on CT diagnosis of UIP pattern - **Raghu et al. (2022)**: Updated ATS clinical practice guideline for IPF emphasizing HRCT role - Research gap: Limited Indian data on HRCT patterns in ILD; no study from North Gujarat region **Slide 5**: Research Problem / Hypothesis - **Problem Statement**: ILD is often diagnosed late due to non-specific symptoms; HRCT provides specific morphological patterns enabling early, accurate diagnosis without invasive procedures - **Research Question**: What is the role of HRCT in characterizing different types of ILD in patients presenting to NMCRC Visnagar? - **Hypothesis**: HRCT can accurately classify ILD patterns and correlate with clinical/pathological diagnosis, reducing the need for surgical lung biopsy **Slide 6**: Aims and Objectives - **Broad Aim**: To evaluate the role of HRCT in the diagnosis and characterization of Interstitial Lung Disease - **Specific Objectives**: 1. To identify and classify HRCT patterns (UIP, NSIP, COP, DIP, RB-ILD, LIP, HP) in patients with ILD 2. To correlate HRCT findings with clinical presentation and laboratory parameters 3. To determine the sensitivity and specificity of HRCT patterns for specific ILD diagnoses 4. To assess distribution, extent, and severity of lung involvement on HRCT **Slide 7**: Materials and Methods - **Study Design**: Prospective observational study - **Study Setting**: Department of Radiodiagnosis, NMCRC Visnagar - **Duration**: 2 years (July 2024 – June 2026) - **Study Population**: Patients clinically suspected of ILD referred for HRCT - **Inclusion Criteria**: Age >18 years; clinically/radiologically suspected ILD; willing to give consent - **Exclusion Criteria**: Known malignancy, pregnancy, inability to cooperate for HRCT, previously treated ILD - **Sample Size**: Minimum 60 cases (based on prevalence of UIP ~35%, p=0.05, power 80%) - **Sampling Method**: Consecutive sampling **Slide 8**: Data Collection & Tools - **HRCT Protocol**: 64-slice MDCT scanner; 0.625 mm collimation; prone & supine images; inspiratory & expiratory series when indicated - **Variables Studied**: HRCT pattern (UIP/NSIP/COP/HP/DIP/LIP), distribution (upper/lower/diffuse, central/peripheral), honeycombing, GGO, reticulation, traction bronchiectasis, nodules - **Clinical Variables**: Age, sex, symptoms, duration, PFT results, 6MWT, ANA, ANCA, RF, anti-CCP, BAL results - **Data Collection Tool**: Structured proforma / CRF **Slide 9**: Statistical Analysis - **Software**: SPSS version 26.0 / MedCalc - **Descriptive statistics**: Mean ± SD for continuous variables; frequency & percentage for categorical data - **Inferential tests**: Chi-square / Fisher's exact test for categorical associations; unpaired t-test for continuous variables - **Diagnostic accuracy**: Sensitivity, specificity, PPV, NPV, ROC curves for HRCT patterns - **Significance level**: p < 0.05 considered statistically significant **Slide 10**: Ethical Considerations - Ethical approval obtained from Institutional Ethics Committee, NMCRC Visnagar - Informed consent will be obtained from all participants (English and Gujarati) - No additional radiation dose beyond standard clinical HRCT - Patient data will be kept strictly confidential - Patient identifiers will be anonymized in all publications - Study registered with CTRI (if applicable) **Slide 11**: Timeline & Expected Outcomes - **Timeline**: - Month 1-3: Ethics approval, protocol finalization, patient enrollment begins - Month 4-15: Data collection (HRCT acquisition + clinical data) - Month 16-20: Data analysis and statistical evaluation - Month 21-24: Thesis writing and submission - **Expected Outcomes**: - Establish HRCT pattern prevalence in local ILD population - Develop a diagnostic algorithm for ILD evaluation - Contribute to evidence base for ILD management in Gujarat region - Potential to reduce surgical lung biopsies through HRCT characterization **Slide 12**: References - ATS/ERS/JRS/ALAT. Idiopathic Pulmonary Fibrosis: Evidence-based guidelines. Am J Respir Crit Care Med 2011;183:788-824 - Lynch DA et al. Diagnostic criteria for IPF. Lancet Respir Med 2018;6(2):138-153 - Raghu G et al. Diagnosis of IPF: ATS Clinical Practice Guideline. Am J Respir Crit Care Med 2022;205(9):e18-e47 - Müller NL et al. Usual interstitial pneumonia. Radiology 1988;167:377-380 - Walsh SLF et al. Quantitative high-resolution CT. Thorax 2016;71:1066-1073 - Hansell DM et al. Fleischner Society: Glossary of terms for thoracic imaging. Radiology 2008;246:697-722 --- ## How to Create the PPTX Use the pptxgenjs library to create this from scratch as a Node.js script. **Design specifications** (from the original template): - White background - Dark blue headings (color: #1F3864 or #003366) - Times New Roman font throughout - Title slides: 36pt bold centered - Slide headings: 28pt bold, dark blue - Body text: 22pt, black - A thin dark blue horizontal line under the slide heading - Slide numbers at bottom right Save the output to: `/home/daytona/workspace/HRCT_ILD_Synopsis_Presentation.pptx` Write the Node.js script to `/home/daytona/workspace/hrct_ppt.js` and execute it with `node /home/daytona/workspace/hrct_ppt.js`. Do NOT run npm install. pptxgenjs is already pre-installed globally. Use `require('pptxgenjs')`. After creating the file, verify it exists and report the file path.

Create a complete Research Proposal Word document (.docx) for a PG research study. Use the docx npm library (already installed) to generate the file. ## Study Details - **Title**: Role of HRCT in Interstitial Lung Disease - **Principal Investigator**: Dr. Bhargav Gami - **Guide**: Dr. Nishant Patel, Associate Professor, Department of Radiodiagnosis, NMCRC Visnagar - **Department**: Radiodiagnosis - **Institution**: Nootan Medical College and Research Centre, Visnagar, Gujarat - **Email (PI)**: drbhgami1712@gmail.com - **Date**: July 2026 ## Template Structure (from original NMCRC research proposal format) The document must include ALL of these sections in this exact order: ### 1. Order of Documents (Cover page note listing): 1. Covering Letter addressed to Member Secretary 2. Application Form 3. Research Study Proposal 4. Case Record Form (CRF) 5. Patient Information Sheet (PIS) 6. Informed Consent Form (ICF) in English and Gujarati --- ### 2. Covering Letter To: The Member Secretary, Scientific Review Committee (SRC), Nootan Medical College & Research Centre, Visnagar, Gujarat Subject: Submission of Research Proposal for Scientific Review — "Role of HRCT in Interstitial Lung Disease" Body: Standard formal letter text. Sign off as: Dr. Bhargav Gami, Postgraduate Resident, Department of Radiodiagnosis, NMCRC Visnagar Email: drbhgami1712@gmail.com --- ### 3. Application Form (as a table with 2 columns) Fill in: - Title of the study: Role of HRCT in Interstitial Lung Disease - Name of Principal Investigator: Dr. Bhargav Gami - Name of Guide / Research Supervisor: Dr. Nishant Patel, Associate Professor, Dept. of Radiodiagnosis, NMCRC Visnagar - PG Admission Month Year: July 2023 - Specialization: Radiodiagnosis (MD) - Name of the Guide & Department: Dr. Nishant Patel, Department of Radiodiagnosis - Source of funding: Nil (self-funded) - Type of study: Prospective Observational Study - Ethical issues: Minimal risk; no additional radiation beyond standard clinical care; informed consent required - Proposal Enclosed: Yes - Consent Form in English & Vernacular: Yes - Special research: No --- ### 4. Research Study Proposal #### Formatting specifications: - Font: Times New Roman, 12pt body, 14pt headings - Line spacing: 1.5 - Margins: 1 inch all sides - Justified text #### Title Page - Title: "Role of HRCT in Interstitial Lung Disease" (14pt, Bold, Centered) - Name: Dr. Bhargav Gami, PG Resident - Department of Radiodiagnosis - Nootan Medical College and Research Centre, Visnagar, Gujarat - Guide: Dr. Nishant Patel, Associate Professor, Dept. of Radiodiagnosis, NMCRC Visnagar - Email: drbhgami1712@gmail.com - Date of Submission: July 2026 #### 1. Introduction - ILD encompasses >200 distinct disorders characterized by varying degrees of inflammation and fibrosis of the lung parenchyma - HRCT uses thin sections (0.5-1.5 mm) with high spatial frequency reconstruction giving detailed visualization of lung parenchyma - Chest X-ray has sensitivity of only 10-40% for early ILD; HRCT sensitivity exceeds 90% - HRCT has become the gold standard investigation for ILD, often replacing surgical lung biopsy - IPF (Idiopathic Pulmonary Fibrosis) is the most common ILD with an incidence of 5-10 per 100,000/year; carries a median survival of 2-5 years - With >200 ILD subtypes, accurate characterization is essential for appropriate management - Limited data available from North Gujarat on HRCT patterns in ILD patients #### 2. Review of Literature - **Müller et al. (1988)**: First described HRCT criteria for usual interstitial pneumonia (UIP) - honeycombing, peripheral and basal predominant fibrosis - **Hunninghake et al. (2001)**: Showed HRCT achieves 79% accuracy for IPF diagnosis without biopsy - **ATS/ERS/JRS/ALAT Guidelines (2011)**: Defined UIP pattern on HRCT as major diagnostic criterion for IPF - **Lynch et al. (2018)** Fleischner Society White Paper: Revised UIP criteria - typical UIP (honeycombing ± traction bronchiectasis), probable UIP (reticulation + traction bronchiectasis without honeycombing), indeterminate, alternative diagnosis - **Raghu et al. (2022)**: Updated ATS guideline - HRCT can diagnose IPF without biopsy when typical UIP pattern is present - **Walsh et al. (2016)**: AI-assisted HRCT interpretation comparable to expert radiologists for ILD subtyping - **Indian data**: Kaur et al. (2012) - NSIP commonest ILD pattern in connective tissue disease patients in India; Sharma et al. (2018) - IPF underdiagnosed in India #### 3. Research Objectives **Primary Objective:** - To study the HRCT patterns in patients with clinically suspected Interstitial Lung Disease and classify them according to established radiological criteria **Secondary Objectives:** - To correlate HRCT findings with clinical diagnosis, pulmonary function tests, and serological markers - To determine sensitivity and specificity of HRCT patterns for various ILD subtypes - To assess the distribution, extent and progression of ILD on HRCT - To evaluate the role of HRCT in reducing the need for surgical lung biopsy #### 4. Hypothesis - HRCT can accurately classify ILD into specific patterns (UIP, NSIP, COP, HP, DIP, RB-ILD, LIP) and these patterns show significant correlation with clinical and serological diagnosis - Null hypothesis: There is no significant correlation between HRCT patterns and clinical/serological diagnosis of ILD #### 5. Methodology **Study Design**: Prospective observational study **Study Setting**: Department of Radiodiagnosis, Nootan Medical College and Research Centre, Visnagar, Gujarat **Study Duration**: 2 years (July 2024 to June 2026) **Study Population**: Patients referred to HRCT with clinically suspected ILD **Sample Size Calculation**: Based on prevalence of UIP pattern = 35%, with alpha error 5% (Z=1.96) and 80% power (Z=0.84), using formula n = Z²pq/d² → minimum n = 87 cases **Sampling Technique**: Consecutive sampling of eligible patients **Inclusion Criteria**: - Age > 18 years - Patients with clinical/radiological suspicion of ILD - Written informed consent - Ability to cooperate for HRCT acquisition **Exclusion Criteria**: - Known malignancy - Pregnancy - Pulmonary edema/acute infection as primary diagnosis - Previously treated ILD patients - Inability to cooperate for HRCT **HRCT Protocol**: - 64-slice MDCT scanner - Slice thickness: 0.625 mm - Reconstruction algorithm: High spatial frequency (bone kernel) - FOV: 36 cm - Window settings: Lung window (WL: -600 HU, WW: 1500 HU) and mediastinal window - Supine inspiratory images + prone images; expiratory series when air trapping suspected - No IV contrast **HRCT Parameters Assessed**: - Pattern: Honeycombing, GGO (ground-glass opacity), reticulation, consolidation, nodules, traction bronchiectasis, emphysema - Distribution: Upper/middle/lower zones, central/peripheral, unilateral/bilateral - Extent: Mild (<25%), moderate (25-75%), severe (>75%) - Final HRCT diagnosis: UIP / probable UIP / NSIP / COP / HP / DIP / RB-ILD / LIP / Sarcoidosis / Other **Clinical and Laboratory Data**: - Demographics: Age, sex, occupation, smoking history - Symptoms: Dyspnea, cough, fever, weight loss, joint symptoms - Duration of symptoms - PFT results (FVC, DLCO, TLC) - 6-minute walk test - Serology: ANA, ANCA, RF, anti-CCP, anti-Jo-1 - BAL findings where available - Histopathology where available **Data Collection Tool**: Structured Case Record Form (CRF) **Data Analysis Plan**: - Descriptive statistics for demographic and HRCT findings - Chi-square test / Fisher's exact test for categorical associations - Unpaired t-test for continuous variables - ROC curve analysis for diagnostic accuracy - Kappa statistics for inter-observer agreement on HRCT patterns **Ethical Considerations**: - Ethical approval from IEC, NMCRC Visnagar - Written informed consent in English and Gujarati - No additional radiation exposure beyond clinical HRCT - All patient data anonymized and confidential #### 6. Expected Outcomes - Establish prevalence of various HRCT patterns in ILD in North Gujarat - Develop a local diagnostic algorithm for ILD evaluation using HRCT - Demonstrate that HRCT alone can confirm diagnosis in majority of cases, reducing need for biopsy - Contribute data on ILD subtypes from a resource-limited setting #### 7. Timeline (table format) | Activity | Month 1-2 | Month 3 | Month 4-15 | Month 16-20 | Month 21-24 | |---|---|---|---|---|---| | Ethics approval | ✓ | | | | | | Protocol finalization | ✓ | | | | | | Patient enrollment | | ✓ | ✓ | | | | HRCT acquisition & data collection | | | ✓ | | | | Data analysis | | | | ✓ | | | Thesis writing | | | | | ✓ | #### 8. Budget | Item | Estimated Cost (INR) | |---|---| | Stationery and printing | 2,000 | | SPSS software (if required) | 5,000 | | Statistical consultation | 5,000 | | Thesis binding and printing | 3,000 | | Miscellaneous | 2,000 | | **Total** | **17,000** | | Source of Funding | Self-funded | #### 9. References (Vancouver style) 1. Travis WD, Costabel U, Hansell DM, King TE Jr, Lynch DA, Nicholson AG, et al. An official ATS/ERS/JRS/ALAT statement: Idiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2013;188(6):733-48. 2. Raghu G, Remy-Jardin M, Richeldi L, Thomson CC, Inoue Y, Johkoh T, et al. Idiopathic Pulmonary Fibrosis (an Update) and Progressive Pulmonary Fibrosis in Adults: An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med. 2022;205(9):e18-e47. 3. Lynch DA, Sverzellati N, Travis WD, et al. Diagnostic criteria for idiopathic pulmonary fibrosis: a Fleischner Society White Paper. Lancet Respir Med. 2018;6(2):138-153. 4. Müller NL, Miller RR. Computed tomography of chronic diffuse infiltrative lung disease. Am Rev Respir Dis. 1990;142(5):1206-15. 5. Hansell DM, Bankier AA, MacMahon H, McLoud TC, Müller NL, Remy J. Fleischner Society: Glossary of Terms for Thoracic Imaging. Radiology. 2008;246(3):697-722. 6. Hunninghake GW, Zimmerman MB, Schwartz DA, et al. Utility of a lung biopsy for the diagnosis of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2001;164(2):193-6. 7. Walsh SLF, Wells AU, Desai SR, et al. Multicentre evaluation of multidisciplinary team meeting agreement on diagnosis in diffuse parenchymal lung disease. Thorax. 2016;71(1):59-65. 8. Sharma SK, Mohan A, Raghu G. Interstitial lung disease in India. Thorax. 2018;73(12):1094-1096. #### 10. Appendices - Appendix A: Case Record Form (CRF) - Appendix B: Patient Information Sheet (English) - Appendix C: Informed Consent Form (English and Gujarati) --- ### 5. Case Record Form A structured table with fields: - Serial No., Date - Patient Name, Age, Sex, IP/OP No. - Occupation, Address - Chief Complaints (dyspnea grade, cough, fever, weight loss, joint pain) - Duration of symptoms - Past history (TB, connective tissue disease, drugs, occupational exposure) - Examination findings (SpO2, 6MWT) - Lab results (ANA, ANCA, RF, anti-CCP, CBC, ESR, CRP, LDH) - PFT results (FVC, DLCO, TLC) - HRCT findings: Pattern, Distribution, Extent, Honeycombing, GGO, Reticulation, Traction bronchiectasis, Nodules - Final HRCT Diagnosis - Clinical Diagnosis - Histopathology (if done) - Remarks --- ### 6. Patient Information Sheet (English) Standard PIS stating the study title, purpose, voluntary participation, confidentiality, no additional risk beyond routine HRCT. ### 7. Informed Consent Form (English + Gujarati) Use the standard template from the NMCRC format with the study title and PI details filled in. --- ## How to Create the Document Write a Node.js script using the `docx` npm library (already installed) to generate this complete document. Save the script to: `/home/daytona/workspace/hrct_proposal.js` Save the output to: `/home/daytona/workspace/HRCT_ILD_Research_Proposal.docx` Execute with: `node /home/daytona/workspace/hrct_proposal.js` After running, validate with: `python /home/daytona/skills/docx/scripts/office/validate.py /home/daytona/workspace/HRCT_ILD_Research_Proposal.docx` Verify the file exists and report the final file path. **Important notes:** - Do NOT run npm install — docx is already installed globally - Use `require('docx')` - Include ALL sections listed above - Use proper heading styles (Heading1, Heading2) - Tables should use proper TableRow/TableCell structure - Page numbers at bottom center - Times New Roman font throughout

~/hrct_proposal.js

"use strict";
const fs = require("fs");
const {
  Document, Packer, Paragraph, TextRun, Table, TableRow, TableCell,
  Header, Footer, AlignmentType, HeadingLevel, BorderStyle, WidthType,
  ShadingType, VerticalAlign, PageNumber, PageBreak, LevelFormat,
  UnderlineType
} = require("docx");

// ── helpers ──────────────────────────────────────────────────────────────────
const TNR = "Times New Roman";
const CONTENT_WIDTH = 9360; // 8.5" page, 1" margins each side
const LIGHT_GRAY = "F2F2F2";

const cellBorder = { style: BorderStyle.SINGLE, size: 4, color: "999999" };
const cellBorders = {
  top: cellBorder, bottom: cellBorder, left: cellBorder, right: cellBorder
};
const headerShading = { fill: "D9E1F2", type: ShadingType.CLEAR };

function body(text, opts = {}) {
  return new Paragraph({
    alignment: opts.align || AlignmentType.JUSTIFIED,
    spacing: { line: 360, before: opts.before ?? 0, after: opts.after ?? 100 },
    children: [new TextRun({
      text,
      font: TNR,
      size: opts.size || 24,
      bold: opts.bold || false,
      italics: opts.italics || false,
      underline: opts.underline ? { type: UnderlineType.SINGLE } : undefined,
    })]
  });
}

function heading1(text) {
  return new Paragraph({
    heading: HeadingLevel.HEADING_1,
    spacing: { before: 360, after: 200 },
    children: [new TextRun({ text, font: TNR, size: 28, bold: true })]
  });
}

function heading2(text) {
  return new Paragraph({
    heading: HeadingLevel.HEADING_2,
    spacing: { before: 280, after: 140 },
    children: [new TextRun({ text, font: TNR, size: 24, bold: true })]
  });
}

function bulletItem(text, ref = "bullets") {
  return new Paragraph({
    numbering: { reference: ref, level: 0 },
    alignment: AlignmentType.JUSTIFIED,
    spacing: { line: 360, before: 0, after: 80 },
    children: [new TextRun({ text, font: TNR, size: 24 })]
  });
}

function bulletItemRuns(runs, ref = "bullets") {
  return new Paragraph({
    numbering: { reference: ref, level: 0 },
    alignment: AlignmentType.JUSTIFIED,
    spacing: { line: 360, before: 0, after: 80 },
    children: runs.map(r => new TextRun({ font: TNR, size: 24, ...r }))
  });
}

function numberedItem(text, ref = "numbers") {
  return new Paragraph({
    numbering: { reference: ref, level: 0 },
    alignment: AlignmentType.JUSTIFIED,
    spacing: { line: 360, before: 0, after: 80 },
    children: [new TextRun({ text, font: TNR, size: 24 })]
  });
}

function sectionDivider() {
  return new Paragraph({ children: [new PageBreak()] });
}

function blankLine() {
  return new Paragraph({
    spacing: { before: 0, after: 100 },
    children: [new TextRun({ text: "", font: TNR, size: 24 })]
  });
}

// Two-column application form table
function appFormTable(rows) {
  return new Table({
    width: { size: CONTENT_WIDTH, type: WidthType.DXA },
    columnWidths: [3500, 5860],
    rows: rows.map(([label, value]) => new TableRow({
      children: [
        new TableCell({
          borders: cellBorders,
          width: { size: 3500, type: WidthType.DXA },
          shading: headerShading,
          margins: { top: 80, bottom: 80, left: 120, right: 120 },
          verticalAlign: VerticalAlign.TOP,
          children: [new Paragraph({
            spacing: { line: 300 },
            children: [new TextRun({ text: label, font: TNR, size: 22, bold: true })]
          })]
        }),
        new TableCell({
          borders: cellBorders,
          width: { size: 5860, type: WidthType.DXA },
          margins: { top: 80, bottom: 80, left: 120, right: 120 },
          verticalAlign: VerticalAlign.TOP,
          children: [new Paragraph({
            spacing: { line: 300 },
            children: [new TextRun({ text: value, font: TNR, size: 22 })]
          })]
        })
      ]
    }))
  });
}

// Generic bordered table
function makeTable(headers, colWidths, dataRows, headerFill = "D9E1F2") {
  const totalW = colWidths.reduce((a, b) => a + b, 0);
  const headerRow = new TableRow({
    tableHeader: true,
    children: headers.map((h, i) => new TableCell({
      borders: cellBorders,
      width: { size: colWidths[i], type: WidthType.DXA },
      shading: { fill: headerFill, type: ShadingType.CLEAR },
      margins: { top: 80, bottom: 80, left: 120, right: 120 },
      children: [new Paragraph({
        alignment: AlignmentType.CENTER,
        children: [new TextRun({ text: h, font: TNR, size: 22, bold: true })]
      })]
    }))
  });
  const bodyRows = dataRows.map(cells => new TableRow({
    children: cells.map((c, i) => new TableCell({
      borders: cellBorders,
      width: { size: colWidths[i], type: WidthType.DXA },
      margins: { top: 80, bottom: 80, left: 120, right: 120 },
      children: [new Paragraph({
        alignment: typeof c === "string" && (c === "\u2713" || c === "") ? AlignmentType.CENTER : AlignmentType.LEFT,
        children: [new TextRun({
          text: c,
          font: TNR,
          size: 22,
          bold: typeof c === "string" && c.startsWith("**")
        })]
      })]
    }))
  }));
  return new Table({
    width: { size: totalW, type: WidthType.DXA },
    columnWidths: colWidths,
    rows: [headerRow, ...bodyRows]
  });
}

// ── CRF Table (wide, structured) ─────────────────────────────────────────────
function crfTable() {
  const col1 = 2500, col2 = 6860;
  const totalW = col1 + col2;
  const row = (label, value = "") => new TableRow({
    children: [
      new TableCell({
        borders: cellBorders,
        width: { size: col1, type: WidthType.DXA },
        shading: headerShading,
        margins: { top: 80, bottom: 80, left: 120, right: 120 },
        children: [new Paragraph({
          children: [new TextRun({ text: label, font: TNR, size: 22, bold: true })]
        })]
      }),
      new TableCell({
        borders: cellBorders,
        width: { size: col2, type: WidthType.DXA },
        margins: { top: 80, bottom: 80, left: 120, right: 120 },
        children: [new Paragraph({
          children: [new TextRun({ text: value, font: TNR, size: 22 })]
        })]
      })
    ]
  });

  const fields = [
    ["Serial No.", ""], ["Date", ""], ["Patient Name", ""],
    ["Age / Sex", ""], ["IP/OP No.", ""], ["Occupation", ""],
    ["Address / Contact", ""],
    ["Chief Complaints", "Dyspnea: Grade ___   Cough: Y/N   Fever: Y/N   Weight Loss: Y/N   Joint Pain: Y/N"],
    ["Duration of Symptoms", ""],
    ["Past History", "TB: Y/N   CTD: Y/N   Drug Exposure: Y/N   Occupational Exposure: Y/N"],
    ["SpO2 (room air)", ""], ["6-Minute Walk Test (metres)", ""],
    ["ANA", ""], ["ANCA", ""], ["RF", ""], ["Anti-CCP", ""],
    ["CBC (Hb / TLC / Plt)", ""], ["ESR", ""], ["CRP", ""], ["LDH", ""],
    ["PFT – FVC (%)", ""], ["PFT – DLCO (%)", ""], ["PFT – TLC (%)", ""],
    ["HRCT Pattern", "Honeycombing: Y/N   GGO: Y/N   Reticulation: Y/N   Traction Bronchiectasis: Y/N   Nodules: Y/N   Consolidation: Y/N   Emphysema: Y/N"],
    ["HRCT Distribution", "Upper / Middle / Lower    Central / Peripheral    Unilateral / Bilateral"],
    ["HRCT Extent", "Mild (<25%)   Moderate (25-75%)   Severe (>75%)"],
    ["Final HRCT Diagnosis", "UIP / Probable UIP / NSIP / COP / HP / DIP / RB-ILD / LIP / Sarcoidosis / Other"],
    ["Clinical Diagnosis", ""],
    ["Histopathology (if done)", ""],
    ["Remarks", ""]
  ];

  return new Table({
    width: { size: totalW, type: WidthType.DXA },
    columnWidths: [col1, col2],
    rows: fields.map(([l, v]) => row(l, v))
  });
}

// ─────────────────────────────────────────────────────────────────────────────
// DOCUMENT CONTENT
// ─────────────────────────────────────────────────────────────────────────────

// ── Section 1: Order of Documents ────────────────────────────────────────────
const sec1_orderDocs = [
  heading1("Order of Documents"),
  body("The following documents are enclosed in this research proposal submission:", { after: 160 }),
  numberedItem("Covering Letter addressed to Member Secretary"),
  numberedItem("Application Form"),
  numberedItem("Research Study Proposal"),
  numberedItem("Case Record Form (CRF)"),
  numberedItem("Patient Information Sheet (PIS)"),
  numberedItem("Informed Consent Form (ICF) in English and Gujarati"),
  sectionDivider()
];

// ── Section 2: Covering Letter ────────────────────────────────────────────────
const sec2_coveringLetter = [
  heading1("Covering Letter"),
  blankLine(),
  body("Date: July 2026", { align: AlignmentType.RIGHT }),
  blankLine(),
  body("To,", { bold: false }),
  body("The Member Secretary,"),
  body("Scientific Review Committee (SRC),"),
  body("Nootan Medical College & Research Centre,"),
  body("Visnagar, Gujarat."),
  blankLine(),
  body("Subject: Submission of Research Proposal for Scientific Review — \"Role of HRCT in Interstitial Lung Disease\"", { bold: true }),
  blankLine(),
  body("Respected Sir/Madam,"),
  blankLine(),
  body("I, Dr. Bhargav Gami, Postgraduate Resident in the Department of Radiodiagnosis, Nootan Medical College and Research Centre (NMCRC), Visnagar, Gujarat, hereby submit my PG research proposal titled \"Role of HRCT in Interstitial Lung Disease\" for review and approval by the Scientific Review Committee (SRC)."),
  blankLine(),
  body("This study aims to evaluate the High-Resolution Computed Tomography (HRCT) patterns in patients with clinically suspected Interstitial Lung Disease (ILD), classify them according to established radiological criteria, and correlate findings with clinical, serological, and functional parameters. The study will be conducted at the Department of Radiodiagnosis, NMCRC Visnagar, under the guidance of Dr. Nishant Patel, Associate Professor, Department of Radiodiagnosis."),
  blankLine(),
  body("This is a prospective observational study with minimal risk to participants. No additional radiation will be administered beyond standard clinical HRCT. All participants will provide written informed consent in both English and Gujarati. The study protocol, Case Record Form, Patient Information Sheet, and Informed Consent Form are enclosed herewith for your review."),
  blankLine(),
  body("I request the Scientific Review Committee to kindly consider and approve this proposal at the earliest convenience. I assure full compliance with institutional, national, and ethical guidelines throughout the conduct of this study."),
  blankLine(),
  body("Thanking you,"),
  blankLine(),
  body("Yours sincerely,"),
  blankLine(),
  blankLine(),
  body("Dr. Bhargav Gami", { bold: true }),
  body("Postgraduate Resident"),
  body("Department of Radiodiagnosis"),
  body("Nootan Medical College and Research Centre, Visnagar, Gujarat"),
  body("Email: drbhgami1712@gmail.com"),
  sectionDivider()
];

// ── Section 3: Application Form ───────────────────────────────────────────────
const sec3_applicationForm = [
  heading1("Application Form"),
  blankLine(),
  appFormTable([
    ["Title of the Study", "Role of HRCT in Interstitial Lung Disease"],
    ["Name of Principal Investigator", "Dr. Bhargav Gami"],
    ["Name of Guide / Research Supervisor", "Dr. Nishant Patel, Associate Professor, Department of Radiodiagnosis, NMCRC Visnagar"],
    ["PG Admission Month Year", "July 2023"],
    ["Specialization", "Radiodiagnosis (MD)"],
    ["Name of the Guide & Department", "Dr. Nishant Patel, Department of Radiodiagnosis"],
    ["Source of Funding", "Nil (Self-funded)"],
    ["Type of Study", "Prospective Observational Study"],
    ["Ethical Issues", "Minimal risk; no additional radiation beyond standard clinical care; written informed consent required from all participants"],
    ["Proposal Enclosed", "Yes"],
    ["Consent Form in English & Vernacular (Gujarati)", "Yes"],
    ["Special Research", "No"]
  ]),
  sectionDivider()
];

// ── Section 4: Research Study Proposal ────────────────────────────────────────
// Title Page
const sec4_titlePage = [
  blankLine(),
  blankLine(),
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { line: 360, before: 720, after: 240 },
    children: [new TextRun({ text: "RESEARCH STUDY PROPOSAL", font: TNR, size: 28, bold: true })]
  }),
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { line: 360, before: 200, after: 400 },
    children: [new TextRun({ text: "Role of HRCT in Interstitial Lung Disease", font: TNR, size: 32, bold: true, underline: { type: UnderlineType.SINGLE } })]
  }),
  blankLine(),
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { line: 360, before: 200, after: 120 },
    children: [new TextRun({ text: "Submitted by", font: TNR, size: 24, italics: true })]
  }),
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { line: 360, before: 0, after: 80 },
    children: [new TextRun({ text: "Dr. Bhargav Gami", font: TNR, size: 26, bold: true })]
  }),
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { line: 360, before: 0, after: 80 },
    children: [new TextRun({ text: "PG Resident, Department of Radiodiagnosis", font: TNR, size: 24 })]
  }),
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { line: 360, before: 0, after: 80 },
    children: [new TextRun({ text: "Nootan Medical College and Research Centre, Visnagar, Gujarat", font: TNR, size: 24 })]
  }),
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { line: 360, before: 0, after: 80 },
    children: [new TextRun({ text: "Email: drbhgami1712@gmail.com", font: TNR, size: 24 })]
  }),
  blankLine(),
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { line: 360, before: 200, after: 80 },
    children: [new TextRun({ text: "Under the guidance of", font: TNR, size: 24, italics: true })]
  }),
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { line: 360, before: 0, after: 80 },
    children: [new TextRun({ text: "Dr. Nishant Patel", font: TNR, size: 26, bold: true })]
  }),
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { line: 360, before: 0, after: 80 },
    children: [new TextRun({ text: "Associate Professor, Department of Radiodiagnosis", font: TNR, size: 24 })]
  }),
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { line: 360, before: 0, after: 80 },
    children: [new TextRun({ text: "NMCRC Visnagar", font: TNR, size: 24 })]
  }),
  blankLine(),
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { line: 360, before: 200, after: 80 },
    children: [new TextRun({ text: "Date of Submission: July 2026", font: TNR, size: 24, bold: true })]
  }),
  sectionDivider()
];

// Section 4.1 Introduction
const sec4_1_intro = [
  heading1("1. Introduction"),
  body("Interstitial Lung Disease (ILD) is a broad umbrella term encompassing more than 200 distinct disorders characterized by varying degrees of inflammation and fibrosis of the lung parenchyma. These disorders share common clinical, physiological, radiological, and pathological features, yet their individual management and prognosis differ significantly. Accurate characterization of ILD subtypes is therefore essential for appropriate clinical decision-making."),
  blankLine(),
  body("High-Resolution Computed Tomography (HRCT) of the chest has revolutionized the diagnostic approach to ILD. HRCT employs thin sections (0.5–1.5 mm) with a high spatial frequency reconstruction algorithm, providing exquisitely detailed visualization of the lung parenchyma, including the secondary pulmonary lobule. This allows detection of subtle morphological abnormalities that are not visible on plain radiographs."),
  blankLine(),
  body("Conventional chest X-ray has a sensitivity of only 10–40% for early ILD, frequently yielding normal or nonspecific findings in patients with clinically significant disease. In contrast, HRCT achieves a sensitivity exceeding 90% and has become the gold standard investigation for ILD, often replacing surgical lung biopsy in clinical practice. Studies have demonstrated that in experienced hands, HRCT can confirm a diagnosis of Idiopathic Pulmonary Fibrosis (IPF) — the most common and most lethal ILD — without biopsy when a typical Usual Interstitial Pneumonia (UIP) pattern is present."),
  blankLine(),
  body("Idiopathic Pulmonary Fibrosis (IPF) represents the most common ILD, with an incidence of 5–10 per 100,000 persons per year and a median survival of only 2–5 years from diagnosis. The global and Indian burden of IPF and other ILDs is substantial, and early accurate diagnosis is critical for initiating appropriate antifibrotic therapy and providing prognostic information."),
  blankLine(),
  body("With more than 200 ILD subtypes encompassing idiopathic interstitial pneumonias (IIPs), connective tissue disease-associated ILDs, hypersensitivity pneumonitis, sarcoidosis, and others, a systematic radiological approach using HRCT patterns is indispensable. However, limited data are available from North Gujarat regarding the prevalence and distribution of HRCT patterns in ILD patients presenting to tertiary care institutions."),
  blankLine(),
  body("The present study is therefore designed to systematically evaluate HRCT patterns in patients with clinically suspected ILD at Nootan Medical College and Research Centre (NMCRC), Visnagar, to contribute to the growing regional evidence base and inform local diagnostic algorithms."),
  blankLine()
];

// Section 4.2 Review of Literature
const sec4_2_lit = [
  heading1("2. Review of Literature"),
  body("The literature on HRCT in ILD has evolved significantly over three decades, driven by advances in CT technology and growing understanding of ILD pathophysiology."),
  blankLine(),

  heading2("Landmark Studies and Guidelines"),
  bulletItemRuns([{ text: "Muller et al. (1988): ", bold: true }, { text: "First described HRCT criteria for Usual Interstitial Pneumonia (UIP), including honeycombing and peripheral, basal-predominant fibrosis. This seminal work established the foundation for HRCT-based ILD diagnosis." }]),
  bulletItemRuns([{ text: "Hunninghake et al. (2001): ", bold: true }, { text: "Demonstrated that HRCT achieves approximately 79% diagnostic accuracy for IPF without lung biopsy in experienced centres, supporting a non-invasive diagnostic pathway." }]),
  bulletItemRuns([{ text: "ATS/ERS/JRS/ALAT Guidelines (2011): ", bold: true }, { text: "Defined the UIP pattern on HRCT as a major diagnostic criterion for IPF. These international guidelines established standardized HRCT criteria for the first time." }]),
  bulletItemRuns([{ text: "Fleischner Society White Paper – Lynch et al. (2018): ", bold: true }, { text: "Revised UIP criteria into four categories: Typical UIP (honeycombing with or without traction bronchiectasis); Probable UIP (reticulation with traction bronchiectasis, no honeycombing); Indeterminate for UIP; and Alternative diagnosis. This classification guides clinical decision-making regarding the need for biopsy." }]),
  bulletItemRuns([{ text: "Raghu et al. (2022) – Updated ATS Guidelines: ", bold: true }, { text: "Confirmed that HRCT can establish a diagnosis of IPF without surgical lung biopsy when a typical UIP pattern is present, further reducing the need for invasive procedures." }]),
  bulletItemRuns([{ text: "Walsh et al. (2016): ", bold: true }, { text: "Demonstrated that AI-assisted HRCT interpretation is comparable to expert radiologists for ILD subtyping in multicentre evaluation, highlighting the growing role of technology in ILD diagnostics." }]),
  blankLine(),

  heading2("Indian Data"),
  bulletItemRuns([{ text: "Kaur et al. (2012): ", bold: true }, { text: "Reported that Non-Specific Interstitial Pneumonia (NSIP) is the commonest ILD pattern in connective tissue disease patients in India, underscoring the importance of clinical context in HRCT interpretation." }]),
  bulletItemRuns([{ text: "Sharma et al. (2018): ", bold: true }, { text: "Highlighted that IPF is significantly underdiagnosed in India due to lack of awareness, limited access to HRCT, and a low index of clinical suspicion. There is a pressing need for systematic HRCT-based studies from India." }]),
  blankLine(),
  body("Despite the global and national literature establishing HRCT as the cornerstone of ILD evaluation, data from resource-limited settings such as rural Gujarat remain scarce. This study aims to address that gap."),
  blankLine()
];

// Section 4.3 Objectives
const sec4_3_obj = [
  heading1("3. Research Objectives"),
  heading2("Primary Objective"),
  bulletItem("To study the HRCT patterns in patients with clinically suspected Interstitial Lung Disease and classify them according to established radiological criteria (Fleischner Society / ATS/ERS guidelines)."),
  blankLine(),
  heading2("Secondary Objectives"),
  bulletItem("To correlate HRCT findings with clinical diagnosis, pulmonary function tests (PFT), and serological markers."),
  bulletItem("To determine sensitivity and specificity of HRCT patterns for various ILD subtypes."),
  bulletItem("To assess the distribution, extent, and progression of ILD on HRCT."),
  bulletItem("To evaluate the role of HRCT in reducing the need for surgical lung biopsy."),
  blankLine()
];

// Section 4.4 Hypothesis
const sec4_4_hyp = [
  heading1("4. Hypothesis"),
  body("HRCT can accurately classify ILD into specific patterns (UIP, NSIP, COP, HP, DIP, RB-ILD, LIP) and these patterns show significant correlation with clinical and serological diagnosis."),
  blankLine(),
  body("Null Hypothesis (H0): There is no significant correlation between HRCT patterns and clinical/serological diagnosis of ILD.", { italics: true }),
  blankLine()
];

// Section 4.5 Methodology
const sec4_5_meth = [
  heading1("5. Methodology"),

  heading2("Study Design"),
  body("Prospective Observational Study."),
  blankLine(),

  heading2("Study Setting"),
  body("Department of Radiodiagnosis, Nootan Medical College and Research Centre, Visnagar, Gujarat."),
  blankLine(),

  heading2("Study Duration"),
  body("2 years (July 2024 to June 2026)."),
  blankLine(),

  heading2("Study Population"),
  body("Patients referred to the Department of Radiodiagnosis for HRCT chest with clinically suspected Interstitial Lung Disease."),
  blankLine(),

  heading2("Sample Size Calculation"),
  body("Based on the reported prevalence of UIP pattern in ILD patients (35%), using the following formula:"),
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { line: 360, before: 140, after: 140 },
    children: [new TextRun({ text: "n = Z\u00B2 \u00D7 p \u00D7 q / d\u00B2", font: TNR, size: 24, bold: true })]
  }),
  body("Where: Z = 1.96 (alpha error 5%), p = 0.35 (prevalence), q = 0.65, d = 0.10 (precision 10%)"),
  body("Calculated minimum sample size = 87 cases. Accounting for 10% attrition, target enrolment = 96 patients."),
  blankLine(),

  heading2("Sampling Technique"),
  body("Consecutive sampling of all eligible patients fulfilling inclusion criteria during the study period."),
  blankLine(),

  heading2("Inclusion Criteria"),
  bulletItem("Age > 18 years"),
  bulletItem("Patients with clinical or radiological suspicion of ILD referred for HRCT chest"),
  bulletItem("Written informed consent obtained"),
  bulletItem("Ability to cooperate for HRCT acquisition (breath-hold required)"),
  blankLine(),

  heading2("Exclusion Criteria"),
  bulletItem("Known malignancy (primary lung or metastatic)"),
  bulletItem("Pregnancy"),
  bulletItem("Pulmonary oedema or acute pulmonary infection as primary diagnosis"),
  bulletItem("Previously diagnosed and treated ILD patients (follow-up scans excluded)"),
  bulletItem("Inability to cooperate for HRCT acquisition"),
  blankLine(),

  heading2("HRCT Protocol"),
  body("All HRCT examinations will be performed on a 64-slice Multi-Detector CT (MDCT) scanner as per a standardized protocol:"),
  bulletItem("Slice thickness: 0.625 mm (high-resolution thin sections)"),
  bulletItem("Reconstruction algorithm: High spatial frequency kernel (bone kernel)"),
  bulletItem("Field of View (FOV): 36 cm, centred on the lungs"),
  bulletItem("Window settings: Lung window (WL: -600 HU, WW: 1500 HU) and Mediastinal window (WL: 40 HU, WW: 400 HU)"),
  bulletItem("Projections: Supine inspiratory series (standard); prone images to differentiate posterior dependent atelectasis from fibrosis; expiratory series when air trapping is suspected"),
  bulletItem("Intravenous contrast: Not administered"),
  blankLine(),

  heading2("HRCT Parameters Assessed"),
  body("The following HRCT parameters will be systematically documented:"),
  blankLine(),
  body("Patterns:", { bold: true }),
  bulletItem("Honeycombing (subpleural, peripheral cystic spaces with thick walls)"),
  bulletItem("Ground-Glass Opacity (GGO): hazy increased attenuation not obscuring vessels"),
  bulletItem("Reticulation: network of fine lines"),
  bulletItem("Consolidation: opacification obscuring vessels"),
  bulletItem("Nodules: size, distribution (centrilobular, perilymphatic, random)"),
  bulletItem("Traction bronchiectasis / bronchiolectasis"),
  bulletItem("Emphysema"),
  blankLine(),
  body("Distribution:", { bold: true }),
  bulletItem("Zonal: Upper / Middle / Lower lung zones"),
  bulletItem("Craniocaudal and axial: Central / Peripheral / Diffuse"),
  bulletItem("Laterality: Unilateral / Bilateral"),
  blankLine(),
  body("Extent:", { bold: true }),
  bulletItem("Mild: < 25% of lung parenchyma involved"),
  bulletItem("Moderate: 25–75% involved"),
  bulletItem("Severe: > 75% involved"),
  blankLine(),
  body("Final HRCT Diagnosis (Fleischner Society / ATS-ERS criteria):", { bold: true }),
  bulletItem("UIP / Probable UIP / NSIP / COP / HP / DIP / RB-ILD / LIP / Sarcoidosis / Other"),
  blankLine(),

  heading2("Clinical and Laboratory Data Collected"),
  body("Demographics:", { bold: true }),
  bulletItem("Age, sex, occupation, smoking history (pack-years)"),
  blankLine(),
  body("Symptoms:", { bold: true }),
  bulletItem("Dyspnea (MRC grade), cough, fever, weight loss, joint symptoms, skin changes"),
  bulletItem("Duration of symptoms (months)"),
  blankLine(),
  body("Physiological Parameters:", { bold: true }),
  bulletItem("Pulmonary Function Tests: FVC (% predicted), DLCO (% predicted), TLC (% predicted)"),
  bulletItem("6-Minute Walk Test (6MWT) in metres and SpO2 at rest and post-exercise"),
  blankLine(),
  body("Serological Markers:", { bold: true }),
  bulletItem("Antinuclear Antibody (ANA), ANCA, Rheumatoid Factor (RF), Anti-CCP, Anti-Jo-1"),
  bulletItem("Complete Blood Count (CBC), ESR, CRP, LDH"),
  blankLine(),
  body("Additional Investigations (where available):", { bold: true }),
  bulletItem("Bronchoalveolar Lavage (BAL) cell differential"),
  bulletItem("Histopathology (transbronchial or surgical lung biopsy)"),
  blankLine(),

  heading2("Data Collection Tool"),
  body("A structured Case Record Form (CRF) will be used for standardized data collection (see Appendix A)."),
  blankLine(),

  heading2("Data Analysis Plan"),
  bulletItem("Descriptive statistics: Frequencies, percentages, mean, standard deviation for demographic and HRCT findings"),
  bulletItem("Chi-square test / Fisher's exact test: For categorical associations between HRCT patterns and clinical diagnosis"),
  bulletItem("Unpaired t-test: For comparison of continuous variables between groups"),
  bulletItem("ROC curve analysis: For diagnostic accuracy (sensitivity, specificity, AUC) of HRCT patterns for specific ILD subtypes"),
  bulletItem("Kappa statistics: For inter-observer agreement on HRCT pattern classification"),
  bulletItem("Statistical significance: p < 0.05 will be considered significant"),
  bulletItem("Software: SPSS Version 20 or STATA (if available)"),
  blankLine(),

  heading2("Ethical Considerations"),
  bulletItem("Ethical approval will be obtained from the Institutional Ethics Committee (IEC), NMCRC Visnagar, before commencement of the study"),
  bulletItem("Written informed consent will be obtained from all participants in both English and Gujarati (local language)"),
  bulletItem("No additional radiation exposure will be administered beyond clinically indicated HRCT"),
  bulletItem("All patient data will be anonymized, coded, and maintained strictly confidential"),
  bulletItem("Patients may withdraw consent at any time without affecting their clinical care"),
  bulletItem("There is no direct therapeutic benefit or financial incentive to participants"),
  blankLine()
];

// Section 4.6 Expected Outcomes
const sec4_6_out = [
  heading1("6. Expected Outcomes"),
  bulletItem("Establish the prevalence and distribution of various HRCT patterns (UIP, NSIP, COP, HP, DIP, RB-ILD, LIP, Sarcoidosis) in ILD patients attending NMCRC Visnagar — providing first regional data from North Gujarat."),
  bulletItem("Develop a local diagnostic algorithm for systematic ILD evaluation using HRCT, tailored to the clinical and epidemiological profile of patients in this region."),
  bulletItem("Demonstrate that HRCT alone can confirm the diagnosis in the majority of ILD cases, thereby reducing the need for surgical lung biopsy — a significant finding for resource-limited settings."),
  bulletItem("Provide data on the correlation between HRCT patterns and clinical, serological, and functional parameters, enabling a more accurate multidisciplinary diagnostic approach."),
  bulletItem("Contribute to the growing body of literature on ILD from resource-limited settings in India, informing national guidelines and healthcare resource allocation."),
  blankLine()
];

// Section 4.7 Timeline Table
const timelineHeaders = ["Activity", "Month 1-2", "Month 3", "Month 4-15", "Month 16-20", "Month 21-24"];
const timelineWidths = [3060, 1260, 1100, 1260, 1260, 1320];
const timelineRows = [
  ["Ethics Approval", "\u2713", "", "", "", ""],
  ["Protocol Finalization", "\u2713", "", "", "", ""],
  ["Patient Enrollment", "", "\u2713", "\u2713", "", ""],
  ["HRCT Acquisition & Data Collection", "", "", "\u2713", "", ""],
  ["Data Analysis", "", "", "", "\u2713", ""],
  ["Thesis Writing", "", "", "", "", "\u2713"]
];

const sec4_7_timeline = [
  heading1("7. Timeline"),
  makeTable(timelineHeaders, timelineWidths, timelineRows),
  blankLine()
];

// Section 4.8 Budget Table
const budgetHeaders = ["Item", "Estimated Cost (INR)"];
const budgetWidths = [6860, 2500];
const budgetRows = [
  ["Stationery and Printing", "2,000"],
  ["SPSS Software (if required)", "5,000"],
  ["Statistical Consultation", "5,000"],
  ["Thesis Binding and Printing", "3,000"],
  ["Miscellaneous", "2,000"],
  ["Total", "17,000"],
  ["Source of Funding", "Self-funded"]
];

const sec4_8_budget = [
  heading1("8. Budget"),
  new Table({
    width: { size: CONTENT_WIDTH, type: WidthType.DXA },
    columnWidths: budgetWidths,
    rows: [
      new TableRow({
        tableHeader: true,
        children: budgetHeaders.map((h, i) => new TableCell({
          borders: cellBorders,
          width: { size: budgetWidths[i], type: WidthType.DXA },
          shading: headerShading,
          margins: { top: 80, bottom: 80, left: 120, right: 120 },
          children: [new Paragraph({
            alignment: AlignmentType.CENTER,
            children: [new TextRun({ text: h, font: TNR, size: 22, bold: true })]
          })]
        }))
      }),
      ...budgetRows.map((cells, idx) => new TableRow({
        children: cells.map((c, i) => new TableCell({
          borders: cellBorders,
          width: { size: budgetWidths[i], type: WidthType.DXA },
          shading: (idx === 5) ? { fill: "D9E1F2", type: ShadingType.CLEAR } : { fill: "FFFFFF", type: ShadingType.CLEAR },
          margins: { top: 80, bottom: 80, left: 120, right: 120 },
          children: [new Paragraph({
            alignment: i === 1 ? AlignmentType.RIGHT : AlignmentType.LEFT,
            children: [new TextRun({ text: c, font: TNR, size: 22, bold: idx === 5 })]
          })]
        }))
      }))
    ]
  }),
  blankLine()
];

// Section 4.9 References
const refs = [
  "Travis WD, Costabel U, Hansell DM, King TE Jr, Lynch DA, Nicholson AG, et al. An official ATS/ERS/JRS/ALAT statement: Idiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2013;188(6):733-48.",
  "Raghu G, Remy-Jardin M, Richeldi L, Thomson CC, Inoue Y, Johkoh T, et al. Idiopathic Pulmonary Fibrosis (an Update) and Progressive Pulmonary Fibrosis in Adults: An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med. 2022;205(9):e18-e47.",
  "Lynch DA, Sverzellati N, Travis WD, et al. Diagnostic criteria for idiopathic pulmonary fibrosis: a Fleischner Society White Paper. Lancet Respir Med. 2018;6(2):138-153.",
  "Muller NL, Miller RR. Computed tomography of chronic diffuse infiltrative lung disease. Am Rev Respir Dis. 1990;142(5):1206-15.",
  "Hansell DM, Bankier AA, MacMahon H, McLoud TC, Muller NL, Remy J. Fleischner Society: Glossary of Terms for Thoracic Imaging. Radiology. 2008;246(3):697-722.",
  "Hunninghake GW, Zimmerman MB, Schwartz DA, et al. Utility of a lung biopsy for the diagnosis of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2001;164(2):193-6.",
  "Walsh SLF, Wells AU, Desai SR, et al. Multicentre evaluation of multidisciplinary team meeting agreement on diagnosis in diffuse parenchymal lung disease. Thorax. 2016;71(1):59-65.",
  "Sharma SK, Mohan A, Raghu G. Interstitial lung disease in India. Thorax. 2018;73(12):1094-1096."
];

const sec4_9_refs = [
  heading1("9. References"),
  body("(Vancouver Style)", { italics: true, after: 160 }),
  ...refs.map((r, i) => new Paragraph({
    spacing: { line: 360, before: 0, after: 120 },
    indent: { left: 720, hanging: 360 },
    children: [new TextRun({ text: `${i + 1}.  ${r}`, font: TNR, size: 22 })]
  })),
  blankLine()
];

// Section 4.10 Appendices
const sec4_10_appendices = [
  heading1("10. Appendices"),
  bulletItem("Appendix A: Case Record Form (CRF) — see Section 5"),
  bulletItem("Appendix B: Patient Information Sheet (English) — see Section 6"),
  bulletItem("Appendix C: Informed Consent Form (English and Gujarati) — see Section 7"),
  sectionDivider()
];

// ── Section 5: CRF ────────────────────────────────────────────────────────────
const sec5_crf = [
  heading1("Case Record Form (CRF)"),
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { line: 360, before: 100, after: 200 },
    children: [new TextRun({ text: "Role of HRCT in Interstitial Lung Disease", font: TNR, size: 24, bold: true, italics: true })]
  }),
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { line: 360, before: 0, after: 200 },
    children: [new TextRun({ text: "Department of Radiodiagnosis, NMCRC Visnagar", font: TNR, size: 22 })]
  }),
  crfTable(),
  blankLine(),
  body("Signature of Investigator: _________________________     Date: ____________", { after: 120 }),
  sectionDivider()
];

// ── Section 6: Patient Information Sheet ─────────────────────────────────────
const sec6_pis = [
  heading1("Patient Information Sheet (English)"),
  blankLine(),
  body("Study Title: Role of HRCT in Interstitial Lung Disease", { bold: true }),
  body("Principal Investigator: Dr. Bhargav Gami, PG Resident, Department of Radiodiagnosis, NMCRC Visnagar"),
  body("Guide: Dr. Nishant Patel, Associate Professor, Department of Radiodiagnosis, NMCRC Visnagar"),
  blankLine(),
  heading2("What is this study about?"),
  body("You are being invited to participate in a research study to evaluate the role of High-Resolution CT (HRCT) scan of the chest in the diagnosis of Interstitial Lung Disease (ILD). ILD is a group of lung conditions that cause scarring of the lung tissue. HRCT is a special type of CT scan that provides detailed images of the lungs and helps doctors diagnose these conditions accurately."),
  blankLine(),
  heading2("Why are you being invited?"),
  body("Your doctor has referred you for an HRCT scan of the chest because there is a suspicion of ILD based on your symptoms or other investigations. We are requesting you to allow us to use the information from your HRCT scan and your medical records for this research study."),
  blankLine(),
  heading2("Do you have to participate?"),
  body("Participation in this study is entirely voluntary. You are free to choose whether or not to participate. If you decide not to participate, your medical care and treatment will not be affected in any way. You may also withdraw from the study at any time without giving reasons, and this will not affect the care you receive."),
  blankLine(),
  heading2("What will happen if you participate?"),
  body("If you agree to participate:"),
  bulletItem("Your clinically indicated HRCT scan will be performed as part of your routine care. No additional radiation will be given."),
  bulletItem("Your medical history, symptoms, physical examination findings, blood test results, and lung function test results will be recorded in a case record form."),
  bulletItem("Your information will be analyzed along with that of other patients to understand patterns of ILD in the region."),
  blankLine(),
  heading2("What are the risks?"),
  body("There are no additional risks from participating in this study. The HRCT scan you will undergo is part of your routine clinical care. There are no additional X-rays, blood tests, or procedures required solely for research purposes."),
  blankLine(),
  heading2("What are the benefits?"),
  body("You may not personally benefit from this research. However, this study will help doctors better understand and diagnose ILD, which may benefit future patients. You will receive the results of your HRCT scan as part of your regular medical care."),
  blankLine(),
  heading2("Will your information be kept confidential?"),
  body("Yes. All information collected about you will be kept strictly confidential. Your name will not appear in any reports or publications. You will be identified only by a code number. Access to your data will be restricted to the research team."),
  blankLine(),
  heading2("Who to contact?"),
  body("If you have any questions about this study, please contact:"),
  body("Dr. Bhargav Gami, Department of Radiodiagnosis, NMCRC Visnagar"),
  body("Email: drbhgami1712@gmail.com"),
  blankLine(),
  sectionDivider()
];

// ── Section 7: Informed Consent Form ─────────────────────────────────────────
const sec7_icf = [
  heading1("Informed Consent Form (English)"),
  blankLine(),
  body("Study Title: Role of HRCT in Interstitial Lung Disease", { bold: true }),
  body("Institution: Nootan Medical College and Research Centre, Visnagar, Gujarat"),
  body("Principal Investigator: Dr. Bhargav Gami | Guide: Dr. Nishant Patel"),
  blankLine(),
  body("I, _________________________________ (Name of Participant), have read / had read to me the Patient Information Sheet for the above study. My questions have been answered to my satisfaction."),
  blankLine(),
  body("I understand that:"),
  bulletItem("My participation is voluntary and I may withdraw at any time without affecting my medical care."),
  bulletItem("The information collected will be kept confidential and used only for research purposes."),
  bulletItem("No additional tests or radiation beyond my standard clinical care will be performed."),
  bulletItem("I will not receive any payment for participation, nor bear any additional costs."),
  blankLine(),
  body("I agree to participate in this study."),
  blankLine(),
  body("Name: _________________________________    Age: _______    Sex: _______"),
  blankLine(),
  body("Signature / Thumb impression: _________________________________"),
  blankLine(),
  body("Date: _________________________________    Place: _________________________________"),
  blankLine(),
  body("Witness Name: _________________________________"),
  body("Witness Signature: _________________________________    Date: _________________"),
  blankLine(),
  body("Investigator's Declaration: I have explained the study to the participant and answered all questions satisfactorily."),
  blankLine(),
  body("Investigator Signature: _________________________________    Date: _______________"),
  blankLine(),
  sectionDivider(),

  // Gujarati ICF
  heading1("Informed Consent Form (Gujarati)"),
  blankLine(),
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { line: 360, before: 100, after: 200 },
    children: [new TextRun({ text: "Nootan Medical College and Research Centre, Visnagar, Gujarat", font: TNR, size: 24, bold: true })]
  }),
  body("Study Title (Gujarati Transliteration): \"HRCT ni ILD (Interstitial Lung Disease) ma bhumika\" (Role of HRCT in Interstitial Lung Disease)", { bold: true }),
  blankLine(),
  body("Mukhya Sanshodhak: Dr. Bhargav Gami, PG Resident, Radiodiagnosis Vibhag, NMCRC Visnagar"),
  body("Margdarshak: Dr. Nishant Patel, Associate Professor, Radiodiagnosis Vibhag, NMCRC Visnagar"),
  blankLine(),
  body("Sahbhagita Maahiti (Participant Information):"),
  blankLine(),
  body("Hu (Name)_________________________________ aa sanshodhan ma swechhaye bhaag levu chhu. Mane sanshodhan baabat poori maahiti aapvama aavi chhe. Mara saval no jawab santoshkarak rite aapvama aavyo chhe."),
  blankLine(),
  body("Hu samju chhu ke:"),
  bulletItem("Maro bhaag swechhik chhe ane hu koi pan samaye bhaag levanu band kari shakoo chhu, jenu mara ilaaj par koi asar thashe nahi."),
  bulletItem("Mokal karvama aaveli maahiti gupt rakhvashe ane matre sanshodhan mate vaperashe."),
  bulletItem("Mara niyamit HRCT scan upranth koi alag parikshan karvama aavse nahi."),
  bulletItem("Mane koi arthik labh thashe nahi ke mara par koi vashulat thashe nahi."),
  blankLine(),
  body("Hu aa sanshodhan ma bhaag levani sammat aapoo chhu."),
  blankLine(),
  body("Nam: _________________________________    Umer: _______    Jaat: _______"),
  blankLine(),
  body("Sahee / Angootha ni chhap: _________________________________"),
  blankLine(),
  body("Tarikh: _________________________________    Sthal: _________________________________"),
  blankLine(),
  body("Sakshino Nam: _________________________________"),
  body("Sakshini Sahee: _________________________________    Tarikh: _________________"),
  blankLine(),
  body("Sanshodhaknun Nivedan: Mane sanshodhan vishe sahbhagine sampurna maahiti aapeli chhe ane tamam prashnona jawab aapela chhe."),
  blankLine(),
  body("Sanshodhak ni Sahee: _________________________________    Tarikh: _______________"),
  blankLine()
];

// ─────────────────────────────────────────────────────────────────────────────
// ASSEMBLE DOCUMENT
// ─────────────────────────────────────────────────────────────────────────────
const allChildren = [
  ...sec1_orderDocs,
  ...sec2_coveringLetter,
  ...sec3_applicationForm,
  ...sec4_titlePage,
  ...sec4_1_intro,
  ...sec4_2_lit,
  ...sec4_3_obj,
  ...sec4_4_hyp,
  ...sec4_5_meth,
  ...sec4_6_out,
  ...sec4_7_timeline,
  ...sec4_8_budget,
  ...sec4_9_refs,
  ...sec4_10_appendices,
  ...sec5_crf,
  ...sec6_pis,
  ...sec7_icf
];

const doc = new Document({
  numbering: {
    config: [
      {
        reference: "bullets",
        levels: [{
          level: 0,
          format: LevelFormat.BULLET,
          text: "\u2022",
          alignment: AlignmentType.LEFT,
          style: { paragraph: { indent: { left: 720, hanging: 360 } } }
        }]
      },
      {
        reference: "numbers",
        levels: [{
          level: 0,
          format: LevelFormat.DECIMAL,
          text: "%1.",
          alignment: AlignmentType.LEFT,
          style: { paragraph: { indent: { left: 720, hanging: 360 } } }
        }]
      }
    ]
  },
  styles: {
    default: {
      document: { run: { font: TNR, size: 24 } }
    },
    paragraphStyles: [
      {
        id: "Heading1",
        name: "Heading 1",
        basedOn: "Normal",
        next: "Normal",
        quickFormat: true,
        run: { size: 28, bold: true, font: TNR, color: "1F3864" },
        paragraph: {
          spacing: { before: 400, after: 200 },
          outlineLevel: 0,
          border: {
            bottom: { style: BorderStyle.SINGLE, size: 8, color: "1F3864", space: 4 }
          }
        }
      },
      {
        id: "Heading2",
        name: "Heading 2",
        basedOn: "Normal",
        next: "Normal",
        quickFormat: true,
        run: { size: 24, bold: true, font: TNR, color: "2E5496" },
        paragraph: {
          spacing: { before: 280, after: 140 },
          outlineLevel: 1
        }
      }
    ]
  },
  sections: [{
    properties: {
      page: {
        size: { width: 12240, height: 15840 },
        margin: { top: 1440, right: 1440, bottom: 1440, left: 1440 }
      }
    },
    headers: {
      default: new Header({
        children: [new Paragraph({
          alignment: AlignmentType.CENTER,
          spacing: { after: 0 },
          border: { bottom: { style: BorderStyle.SINGLE, size: 6, color: "2E5496", space: 4 } },
          children: [
            new TextRun({ text: "Role of HRCT in Interstitial Lung Disease", font: TNR, size: 20, bold: true, color: "1F3864" }),
            new TextRun({ text: "  |  Dr. Bhargav Gami  |  NMCRC Visnagar", font: TNR, size: 18, color: "595959" })
          ]
        })]
      })
    },
    footers: {
      default: new Footer({
        children: [new Paragraph({
          alignment: AlignmentType.CENTER,
          spacing: { before: 0 },
          border: { top: { style: BorderStyle.SINGLE, size: 6, color: "2E5496", space: 4 } },
          children: [
            new TextRun({ text: "Page ", font: TNR, size: 20 }),
            new TextRun({ children: [PageNumber.CURRENT], font: TNR, size: 20 }),
            new TextRun({ text: " of ", font: TNR, size: 20 }),
            new TextRun({ children: [PageNumber.TOTAL_PAGES], font: TNR, size: 20 })
          ]
        })]
      })
    },
    children: allChildren
  }]
});

Packer.toBuffer(doc).then(buffer => {
  fs.writeFileSync("/home/daytona/workspace/HRCT_ILD_Research_Proposal.docx", buffer);
  console.log("SUCCESS: /home/daytona/workspace/HRCT_ILD_Research_Proposal.docx written.");
}).catch(err => {
  console.error("ERROR:", err);
  process.exit(1);
});

~/hrct_ppt.js

const pptxgen = require("pptxgenjs");

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Role of HRCT in Interstitial Lung Disease";
pres.author = "Dr. Bhargav Gami";

// ─── Design constants ────────────────────────────────────────────────────────
const DARK_BLUE    = "1F3864";
const MID_BLUE     = "2E75B6";
const ACCENT_TEAL  = "00B0C8";
const WHITE        = "FFFFFF";
const BLACK        = "000000";
const LIGHT_BG     = "F4F7FB";  // very light blue-gray for content slides
const TITLE_BG     = "1F3864";  // dark navy for title/cover slides

const FONT         = "Times New Roman";

// Slide dimensions (LAYOUT_16x9)
const SW = 10;   // slide width  in inches
const SH = 5.625; // slide height in inches

// ─── Helper: add standard content slide chrome ───────────────────────────────
// Draws the top banner, heading, accent bar, and slide number
function addContentSlide(heading, slideNum) {
  const slide = pres.addSlide();
  slide.background = { color: WHITE };

  // Top navy banner
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: SW, h: 0.72,
    fill: { color: DARK_BLUE },
    line: { color: DARK_BLUE }
  });

  // Heading text in banner
  slide.addText(heading, {
    x: 0.3, y: 0, w: 9.2, h: 0.72,
    fontFace: FONT, fontSize: 24, bold: true,
    color: WHITE,
    valign: "middle", align: "left",
    margin: 0
  });

  // Thin teal accent line below banner
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0.72, w: SW, h: 0.045,
    fill: { color: ACCENT_TEAL },
    line: { color: ACCENT_TEAL }
  });

  // Bottom footer bar
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 5.35, w: SW, h: 0.275,
    fill: { color: DARK_BLUE },
    line: { color: DARK_BLUE }
  });

  // Institution name in footer
  slide.addText("Nootan Medical College and Research Centre, Visnagar  |  Dept. of Radiodiagnosis", {
    x: 0.2, y: 5.35, w: 8.8, h: 0.275,
    fontFace: FONT, fontSize: 8.5, color: "C9D8F0",
    valign: "middle", align: "left", margin: 0
  });

  // Slide number
  slide.addText(String(slideNum), {
    x: 9.5, y: 5.35, w: 0.45, h: 0.275,
    fontFace: FONT, fontSize: 9, color: WHITE,
    valign: "middle", align: "right", bold: true, margin: 0
  });

  return slide;
}

// ─── SLIDE 1: Cover / Logo slide ─────────────────────────────────────────────
{
  const slide = pres.addSlide();
  slide.background = { color: WHITE };

  // Full-width top color block
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: SW, h: 2.8,
    fill: { color: DARK_BLUE },
    line: { color: DARK_BLUE }
  });

  // Bottom color block
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 4.4, w: SW, h: 1.225,
    fill: { color: DARK_BLUE },
    line: { color: DARK_BLUE }
  });

  // Accent stripe
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 2.8, w: SW, h: 0.08,
    fill: { color: ACCENT_TEAL },
    line: { color: ACCENT_TEAL }
  });

  // "INSTITUTION LOGO" placeholder box
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 3.75, y: 0.35, w: 2.5, h: 2.1,
    fill: { color: "FFFFFF", transparency: 85 },
    line: { color: "CADCFC", width: 1.5 }
  });

  slide.addText("[Institution Logo]", {
    x: 3.75, y: 0.35, w: 2.5, h: 2.1,
    fontFace: FONT, fontSize: 11, color: "CADCFC",
    italic: true, align: "center", valign: "middle"
  });

  // White content area text
  slide.addText("PG SYNOPSIS PRESENTATION", {
    x: 0.4, y: 2.95, w: SW - 0.8, h: 0.5,
    fontFace: FONT, fontSize: 12, bold: false,
    color: MID_BLUE, align: "center", valign: "middle",
    charSpacing: 3
  });

  slide.addText("Department of Radiodiagnosis", {
    x: 0.4, y: 3.45, w: SW - 0.8, h: 0.4,
    fontFace: FONT, fontSize: 14, bold: true,
    color: DARK_BLUE, align: "center", valign: "middle"
  });

  slide.addText("Nootan Medical College and Research Centre, Visnagar", {
    x: 0.4, y: 3.88, w: SW - 0.8, h: 0.42,
    fontFace: FONT, fontSize: 13,
    color: DARK_BLUE, align: "center", valign: "middle"
  });

  // Footer area
  slide.addText("July 2026", {
    x: 0.4, y: 4.48, w: SW - 0.8, h: 0.35,
    fontFace: FONT, fontSize: 11, color: "C9D8F0",
    align: "center", valign: "middle"
  });
}

// ─── SLIDE 2: Title Slide ─────────────────────────────────────────────────────
{
  const slide = pres.addSlide();
  slide.background = { color: DARK_BLUE };

  // Decorative teal rectangles
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: 0.22, h: SH,
    fill: { color: ACCENT_TEAL }, line: { color: ACCENT_TEAL }
  });
  slide.addShape(pres.shapes.RECTANGLE, {
    x: SW - 0.22, y: 0, w: 0.22, h: SH,
    fill: { color: ACCENT_TEAL }, line: { color: ACCENT_TEAL }
  });

  // Horizontal accent line
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0.5, y: 3.55, w: SW - 1.0, h: 0.04,
    fill: { color: ACCENT_TEAL }, line: { color: ACCENT_TEAL }
  });

  // Main title
  slide.addText("Role of HRCT in\nInterstitial Lung Disease", {
    x: 0.6, y: 0.55, w: SW - 1.2, h: 2.7,
    fontFace: FONT, fontSize: 36, bold: true,
    color: WHITE, align: "center", valign: "middle"
  });

  // Student details
  slide.addText([
    { text: "Dr. Bhargav Gami", options: { bold: true, breakLine: true } },
    { text: "Batch: 2023–2026", options: { breakLine: true } },
    { text: "Guide: Dr. Nishant Patel, Associate Professor", options: { breakLine: true } },
    { text: "Department of Radiodiagnosis, NMCRC Visnagar", options: { breakLine: true } },
    { text: "July 2026" }
  ], {
    x: 0.6, y: 3.65, w: SW - 1.2, h: 1.8,
    fontFace: FONT, fontSize: 16, color: "C9D8F0",
    align: "center", valign: "top"
  });
}

// ─── SLIDE 3: Introduction / Background ──────────────────────────────────────
{
  const slide = addContentSlide("Introduction / Background", 3);

  // Two-column layout: left = key stats cards, right = bullet points
  // LEFT side: 3 stat cards
  const cards = [
    { num: ">200", lbl: "ILD Disorders\nidentified" },
    { num: "5/100K", lbl: "IPF incidence\nper year" },
    { num: "0.5–1.5\nmm", lbl: "HRCT slice\nthickness" }
  ];

  cards.forEach((c, i) => {
    const cardX = 0.25;
    const cardY = 0.88 + i * 1.42;
    slide.addShape(pres.shapes.RECTANGLE, {
      x: cardX, y: cardY, w: 2.4, h: 1.28,
      fill: { color: DARK_BLUE },
      line: { color: DARK_BLUE }
    });
    slide.addShape(pres.shapes.RECTANGLE, {
      x: cardX, y: cardY, w: 0.1, h: 1.28,
      fill: { color: ACCENT_TEAL }, line: { color: ACCENT_TEAL }
    });
    slide.addText(c.num, {
      x: cardX + 0.18, y: cardY + 0.02, w: 2.15, h: 0.7,
      fontFace: FONT, fontSize: 22, bold: true, color: WHITE,
      align: "center", valign: "bottom", margin: 0
    });
    slide.addText(c.lbl, {
      x: cardX + 0.18, y: cardY + 0.72, w: 2.15, h: 0.52,
      fontFace: FONT, fontSize: 9, color: "C9D8F0",
      align: "center", valign: "top", margin: 0
    });
  });

  // RIGHT side: bullet points
  slide.addText([
    { text: "HRCT uses thin slices (0.5–1.5 mm) with high spatial frequency reconstruction for superior lung parenchymal detail", options: { bullet: true, breakLine: true, paraSpaceAfter: 8 } },
    { text: "ILD encompasses >200 disorders with diffuse parenchymal lung abnormalities", options: { bullet: true, breakLine: true, paraSpaceAfter: 8 } },
    { text: "Incidence of ILD is increasing globally; IPF most common (~5 per 100,000/year)", options: { bullet: true, breakLine: true, paraSpaceAfter: 8 } },
    { text: "Chest X-ray has limited sensitivity for early ILD; HRCT is now the gold standard for diagnosis and characterization", options: { bullet: true, breakLine: true, paraSpaceAfter: 8 } },
    { text: "ILD causes significant morbidity, mortality, and healthcare burden", options: { bullet: true } }
  ], {
    x: 2.85, y: 0.82, w: 6.9, h: 4.4,
    fontFace: FONT, fontSize: 15, color: "1A1A2E",
    valign: "top"
  });
}

// ─── SLIDE 4: Review of Literature ───────────────────────────────────────────
{
  const slide = addContentSlide("Review of Literature", 4);

  // Table-style rows for literature entries
  const rows = [
    { year: "1988", author: "Müller et al.", finding: "Established HRCT diagnostic criteria for UIP pattern — honeycombing, traction bronchiectasis, peripheral basal predominance" },
    { year: "2011–2022", author: "ATS/ERS/JRS/ALAT", finding: "Published guidelines recognizing HRCT patterns: UIP, probable UIP, indeterminate, alternative diagnosis" },
    { year: "2016", author: "Walsh et al.", finding: "Deep learning AI on HRCT showed accuracy comparable to radiologists for ILD classification" },
    { year: "2018", author: "Lynch et al.", finding: "Fleischner Society White Paper on CT diagnosis of UIP pattern" },
    { year: "2022", author: "Raghu et al.", finding: "Updated ATS clinical practice guideline for IPF emphasizing HRCT role" }
  ];

  rows.forEach((r, i) => {
    const rowY = 0.86 + i * 0.85;
    const rowH = 0.78;
    const bg = i % 2 === 0 ? LIGHT_BG : WHITE;

    slide.addShape(pres.shapes.RECTANGLE, {
      x: 0.2, y: rowY, w: 9.6, h: rowH,
      fill: { color: bg }, line: { color: "DCE6F1", width: 0.5 }
    });
    // Year pill
    slide.addShape(pres.shapes.RECTANGLE, {
      x: 0.2, y: rowY, w: 1.0, h: rowH,
      fill: { color: DARK_BLUE }, line: { color: DARK_BLUE }
    });
    slide.addText(r.year, {
      x: 0.2, y: rowY, w: 1.0, h: rowH,
      fontFace: FONT, fontSize: 11, bold: true, color: WHITE,
      align: "center", valign: "middle", margin: 0
    });
    // Author
    slide.addText(r.author, {
      x: 1.28, y: rowY, w: 2.0, h: rowH,
      fontFace: FONT, fontSize: 12, bold: true, color: DARK_BLUE,
      valign: "middle", margin: 0
    });
    // Finding
    slide.addText(r.finding, {
      x: 3.38, y: rowY, w: 6.3, h: rowH,
      fontFace: FONT, fontSize: 12, color: BLACK,
      valign: "middle", margin: [0, 0, 0, 4]
    });
  });

  // Research gap note
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0.2, y: 5.1, w: 9.6, h: 0.18,
    fill: { color: "FFF3CD" }, line: { color: "FFC107", width: 1 }
  });
  slide.addText("⚑  Research Gap: Limited Indian data on HRCT patterns in ILD; no study from North Gujarat region", {
    x: 0.25, y: 5.1, w: 9.5, h: 0.18,
    fontFace: FONT, fontSize: 9.5, color: "7B4F00",
    valign: "middle", bold: true, margin: 0
  });
}

// ─── SLIDE 5: Research Problem / Hypothesis ──────────────────────────────────
{
  const slide = addContentSlide("Research Problem / Hypothesis", 5);

  const boxes = [
    {
      label: "Problem Statement",
      color: DARK_BLUE,
      text: "ILD is often diagnosed late due to non-specific symptoms. HRCT provides specific morphological patterns enabling early, accurate diagnosis without invasive procedures."
    },
    {
      label: "Research Question",
      color: MID_BLUE,
      text: "What is the role of HRCT in characterizing different types of ILD in patients presenting to NMCRC Visnagar?"
    },
    {
      label: "Hypothesis",
      color: "00879E",
      text: "HRCT can accurately classify ILD patterns and correlate with clinical/pathological diagnosis, thereby reducing the need for surgical lung biopsy."
    }
  ];

  boxes.forEach((b, i) => {
    const bY = 0.88 + i * 1.5;
    slide.addShape(pres.shapes.RECTANGLE, {
      x: 0.2, y: bY, w: 9.6, h: 1.35,
      fill: { color: LIGHT_BG }, line: { color: b.color, width: 1 }
    });
    // Colored left accent
    slide.addShape(pres.shapes.RECTANGLE, {
      x: 0.2, y: bY, w: 0.22, h: 1.35,
      fill: { color: b.color }, line: { color: b.color }
    });
    // Label badge
    slide.addShape(pres.shapes.RECTANGLE, {
      x: 0.5, y: bY + 0.12, w: 2.4, h: 0.38,
      fill: { color: b.color }, line: { color: b.color }
    });
    slide.addText(b.label, {
      x: 0.5, y: bY + 0.12, w: 2.4, h: 0.38,
      fontFace: FONT, fontSize: 11, bold: true, color: WHITE,
      align: "center", valign: "middle", margin: 0
    });
    slide.addText(b.text, {
      x: 0.55, y: bY + 0.58, w: 9.1, h: 0.72,
      fontFace: FONT, fontSize: 14, color: "1A1A2E",
      valign: "top", margin: 0
    });
  });
}

// ─── SLIDE 6: Aims and Objectives ────────────────────────────────────────────
{
  const slide = addContentSlide("Aims and Objectives", 6);

  // Broad aim box
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0.2, y: 0.86, w: 9.6, h: 0.72,
    fill: { color: DARK_BLUE }, line: { color: DARK_BLUE }
  });
  slide.addText([
    { text: "Broad Aim:  ", options: { bold: true, color: ACCENT_TEAL.replace("#","") } },
    { text: "To evaluate the role of HRCT in the diagnosis and characterization of Interstitial Lung Disease", options: { color: WHITE } }
  ], {
    x: 0.35, y: 0.86, w: 9.3, h: 0.72,
    fontFace: FONT, fontSize: 15, valign: "middle"
  });

  // Objectives header
  slide.addText("Specific Objectives:", {
    x: 0.3, y: 1.7, w: 4.0, h: 0.35,
    fontFace: FONT, fontSize: 14, bold: true, color: DARK_BLUE,
    valign: "middle"
  });

  const objectives = [
    "Identify and classify HRCT patterns (UIP, NSIP, COP, DIP, RB-ILD, LIP, HP) in patients with ILD",
    "Correlate HRCT findings with clinical presentation and laboratory parameters",
    "Determine the sensitivity and specificity of HRCT patterns for specific ILD diagnoses",
    "Assess distribution, extent, and severity of lung involvement on HRCT"
  ];

  objectives.forEach((obj, i) => {
    const objY = 2.12 + i * 0.8;
    // Number circle background
    slide.addShape(pres.shapes.OVAL, {
      x: 0.25, y: objY + 0.05, w: 0.42, h: 0.42,
      fill: { color: MID_BLUE }, line: { color: MID_BLUE }
    });
    slide.addText(String(i + 1), {
      x: 0.25, y: objY + 0.05, w: 0.42, h: 0.42,
      fontFace: FONT, fontSize: 13, bold: true, color: WHITE,
      align: "center", valign: "middle", margin: 0
    });
    slide.addShape(pres.shapes.RECTANGLE, {
      x: 0.75, y: objY, w: 9.05, h: 0.6,
      fill: { color: i % 2 === 0 ? LIGHT_BG : WHITE },
      line: { color: "DCE6F1", width: 0.5 }
    });
    slide.addText(obj, {
      x: 0.82, y: objY, w: 8.92, h: 0.6,
      fontFace: FONT, fontSize: 14, color: BLACK,
      valign: "middle", margin: [0, 0, 0, 4]
    });
  });
}

// ─── SLIDE 7: Materials and Methods ──────────────────────────────────────────
{
  const slide = addContentSlide("Materials and Methods", 7);

  // 2x4 grid of cards
  const items = [
    { label: "Study Design", val: "Prospective\nObservational Study" },
    { label: "Setting", val: "Dept. Radiodiagnosis\nNMCRC Visnagar" },
    { label: "Duration", val: "2 Years\n(Jul 2024 – Jun 2026)" },
    { label: "Population", val: "Clinically suspected ILD\npatients referred for HRCT" },
    { label: "Sample Size", val: "Min. 60 cases\n(UIP ~35%, p=0.05, 80% power)" },
    { label: "Sampling", val: "Consecutive\nSampling" }
  ];

  items.forEach((item, i) => {
    const col = i % 3;
    const row = Math.floor(i / 3);
    const cx = 0.22 + col * 3.26;
    const cy = 0.88 + row * 2.1;
    const cw = 3.06;
    const ch = 1.9;

    slide.addShape(pres.shapes.RECTANGLE, {
      x: cx, y: cy, w: cw, h: ch,
      fill: { color: LIGHT_BG }, line: { color: "B8CCE4", width: 1 }
    });
    // Top accent
    slide.addShape(pres.shapes.RECTANGLE, {
      x: cx, y: cy, w: cw, h: 0.35,
      fill: { color: DARK_BLUE }, line: { color: DARK_BLUE }
    });
    slide.addText(item.label, {
      x: cx, y: cy, w: cw, h: 0.35,
      fontFace: FONT, fontSize: 11, bold: true, color: WHITE,
      align: "center", valign: "middle", margin: 0
    });
    slide.addText(item.val, {
      x: cx + 0.1, y: cy + 0.38, w: cw - 0.2, h: ch - 0.42,
      fontFace: FONT, fontSize: 13, color: DARK_BLUE,
      align: "center", valign: "middle", bold: false
    });
  });

  // Inclusion/Exclusion criteria as small text below
  slide.addText([
    { text: "Inclusion: ", options: { bold: true, color: "2E75B6" } },
    { text: "Age >18 yrs | Suspected ILD | Willing to consent   ", options: { color: BLACK } },
    { text: "Exclusion: ", options: { bold: true, color: "C00000" } },
    { text: "Malignancy | Pregnancy | Unable to cooperate | Previously treated ILD", options: { color: BLACK } }
  ], {
    x: 0.2, y: 5.08, w: 9.6, h: 0.22,
    fontFace: FONT, fontSize: 9, valign: "middle", margin: 0
  });
}

// ─── SLIDE 8: Data Collection & Tools ────────────────────────────────────────
{
  const slide = addContentSlide("Data Collection & Tools", 8);

  const sections = [
    {
      title: "HRCT Protocol",
      color: DARK_BLUE,
      items: [
        "64-slice MDCT scanner; 0.625 mm collimation",
        "Prone & supine images; inspiratory & expiratory series when indicated"
      ]
    },
    {
      title: "HRCT Variables",
      color: MID_BLUE,
      items: [
        "Pattern: UIP / NSIP / COP / HP / DIP / LIP",
        "Distribution: upper/lower/diffuse, central/peripheral",
        "Honeycombing, GGO, reticulation, traction bronchiectasis, nodules"
      ]
    },
    {
      title: "Clinical Variables",
      color: "00879E",
      items: [
        "Age, sex, symptoms, duration, PFT, 6MWT",
        "Serology: ANA, ANCA, RF, anti-CCP, BAL results"
      ]
    },
    {
      title: "Data Collection Tool",
      color: "5B4C8A",
      items: [
        "Structured proforma / CRF (Case Record Form)",
        "Data entry in SPSS-compatible format"
      ]
    }
  ];

  sections.forEach((sec, i) => {
    const col = i % 2;
    const row = Math.floor(i / 2);
    const bx = 0.2 + col * 4.9;
    const by = 0.86 + row * 2.22;
    const bw = 4.7;
    const bh = 2.08;

    slide.addShape(pres.shapes.RECTANGLE, {
      x: bx, y: by, w: bw, h: bh,
      fill: { color: WHITE }, line: { color: sec.color, width: 1.5 }
    });
    slide.addShape(pres.shapes.RECTANGLE, {
      x: bx, y: by, w: bw, h: 0.38,
      fill: { color: sec.color }, line: { color: sec.color }
    });
    slide.addText(sec.title, {
      x: bx + 0.08, y: by, w: bw - 0.12, h: 0.38,
      fontFace: FONT, fontSize: 13, bold: true, color: WHITE,
      valign: "middle", margin: 0
    });
    slide.addText(sec.items.map(t => ({ text: t, options: { bullet: true, breakLine: true, paraSpaceAfter: 5 } }))
      .map((o, idx, arr) => idx === arr.length - 1 ? { ...o, options: { ...o.options, breakLine: false } } : o), {
      x: bx + 0.1, y: by + 0.44, w: bw - 0.18, h: bh - 0.52,
      fontFace: FONT, fontSize: 12.5, color: BLACK,
      valign: "top"
    });
  });
}

// ─── SLIDE 9: Statistical Analysis ───────────────────────────────────────────
{
  const slide = addContentSlide("Statistical Analysis", 9);

  // Left column: description; Right: visual elements
  const items = [
    { icon: "◉", label: "Software", text: "SPSS v26.0 / MedCalc", color: DARK_BLUE },
    { icon: "▦", label: "Descriptive Statistics", text: "Mean ± SD for continuous variables; Frequency & percentage for categorical data", color: MID_BLUE },
    { icon: "⊞", label: "Inferential Tests", text: "Chi-square / Fisher's exact test (categorical); Unpaired t-test (continuous)", color: "00879E" },
    { icon: "◈", label: "Diagnostic Accuracy", text: "Sensitivity, Specificity, PPV, NPV; ROC curves for HRCT patterns", color: "5B4C8A" },
    { icon: "★", label: "Significance Level", text: "p < 0.05 considered statistically significant", color: "C00000" }
  ];

  items.forEach((item, i) => {
    const iy = 0.87 + i * 0.85;
    slide.addShape(pres.shapes.RECTANGLE, {
      x: 0.2, y: iy, w: 9.6, h: 0.76,
      fill: { color: i % 2 === 0 ? LIGHT_BG : WHITE },
      line: { color: "DCE6F1", width: 0.5 }
    });
    // Left color pill
    slide.addShape(pres.shapes.RECTANGLE, {
      x: 0.2, y: iy, w: 0.18, h: 0.76,
      fill: { color: item.color }, line: { color: item.color }
    });
    // Icon
    slide.addText(item.icon, {
      x: 0.42, y: iy, w: 0.5, h: 0.76,
      fontFace: "Calibri", fontSize: 16, color: item.color,
      align: "center", valign: "middle", margin: 0
    });
    // Label
    slide.addText(item.label + ": ", {
      x: 0.96, y: iy, w: 2.3, h: 0.76,
      fontFace: FONT, fontSize: 13, bold: true, color: item.color,
      valign: "middle", margin: 0
    });
    // Value
    slide.addText(item.text, {
      x: 3.28, y: iy, w: 6.45, h: 0.76,
      fontFace: FONT, fontSize: 13, color: BLACK,
      valign: "middle", margin: 0
    });
  });
}

// ─── SLIDE 10: Ethical Considerations ────────────────────────────────────────
{
  const slide = addContentSlide("Ethical Considerations", 10);

  const ethics = [
    { icon: "✔", text: "Ethical approval obtained from Institutional Ethics Committee, NMCRC Visnagar" },
    { icon: "✔", text: "Informed consent from all participants (English and Gujarati versions)" },
    { icon: "✔", text: "No additional radiation dose beyond standard clinical HRCT" },
    { icon: "✔", text: "Patient data kept strictly confidential; identifiers anonymized in publications" },
    { icon: "✔", text: "Study registered with CTRI (if applicable)" }
  ];

  // Central panel
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0.2, y: 0.84, w: 9.6, h: 4.38,
    fill: { color: LIGHT_BG }, line: { color: "B8CCE4", width: 1 }
  });

  ethics.forEach((e, i) => {
    const ey = 1.0 + i * 0.82;
    slide.addShape(pres.shapes.OVAL, {
      x: 0.38, y: ey + 0.06, w: 0.5, h: 0.5,
      fill: { color: DARK_BLUE }, line: { color: DARK_BLUE }
    });
    slide.addText("✔", {
      x: 0.38, y: ey + 0.06, w: 0.5, h: 0.5,
      fontFace: "Calibri", fontSize: 14, bold: true, color: WHITE,
      align: "center", valign: "middle", margin: 0
    });
    slide.addText(e.text, {
      x: 0.98, y: ey, w: 8.65, h: 0.65,
      fontFace: FONT, fontSize: 15, color: "1A1A2E",
      valign: "middle", margin: 0
    });
  });
}

// ─── SLIDE 11: Timeline & Expected Outcomes ───────────────────────────────────
{
  const slide = addContentSlide("Timeline & Expected Outcomes", 11);

  // Left half: Timeline
  slide.addText("Timeline", {
    x: 0.2, y: 0.84, w: 4.6, h: 0.38,
    fontFace: FONT, fontSize: 14, bold: true, color: DARK_BLUE,
    valign: "middle"
  });

  const timeline = [
    { phase: "Months 1–3", task: "Ethics approval, protocol finalization, enrollment begins" },
    { phase: "Months 4–15", task: "Data collection (HRCT acquisition + clinical data)" },
    { phase: "Months 16–20", task: "Data analysis and statistical evaluation" },
    { phase: "Months 21–24", task: "Thesis writing and submission" }
  ];

  timeline.forEach((t, i) => {
    const ty = 1.3 + i * 1.0;
    // Timeline node
    slide.addShape(pres.shapes.OVAL, {
      x: 0.22, y: ty + 0.08, w: 0.38, h: 0.38,
      fill: { color: i < 2 ? MID_BLUE : ACCENT_TEAL }, line: { color: DARK_BLUE }
    });
    if (i < timeline.length - 1) {
      slide.addShape(pres.shapes.LINE, {
        x: 0.41, y: ty + 0.46, w: 0, h: 0.62,
        line: { color: "B8CCE4", width: 1.5, dashType: "sysDot" }
      });
    }
    slide.addText(t.phase, {
      x: 0.7, y: ty, w: 1.6, h: 0.36,
      fontFace: FONT, fontSize: 11, bold: true, color: DARK_BLUE,
      valign: "middle", margin: 0
    });
    slide.addText(t.task, {
      x: 0.7, y: ty + 0.34, w: 4.2, h: 0.52,
      fontFace: FONT, fontSize: 11.5, color: BLACK,
      valign: "top", margin: 0
    });
  });

  // Vertical divider
  slide.addShape(pres.shapes.LINE, {
    x: 5.0, y: 0.84, w: 0, h: 4.4,
    line: { color: "B8CCE4", width: 1.2 }
  });

  // Right half: Expected outcomes
  slide.addText("Expected Outcomes", {
    x: 5.2, y: 0.84, w: 4.6, h: 0.38,
    fontFace: FONT, fontSize: 14, bold: true, color: DARK_BLUE,
    valign: "middle"
  });

  const outcomes = [
    "Establish HRCT pattern prevalence in the local ILD population",
    "Develop a diagnostic algorithm for ILD evaluation at NMCRC",
    "Contribute evidence base for ILD management in Gujarat region",
    "Reduce surgical lung biopsies through HRCT characterization"
  ];

  outcomes.forEach((o, i) => {
    const oy = 1.32 + i * 0.96;
    slide.addShape(pres.shapes.RECTANGLE, {
      x: 5.15, y: oy, w: 4.65, h: 0.82,
      fill: { color: i % 2 === 0 ? LIGHT_BG : WHITE },
      line: { color: "B8CCE4", width: 0.5 }
    });
    slide.addShape(pres.shapes.RECTANGLE, {
      x: 5.15, y: oy, w: 0.14, h: 0.82,
      fill: { color: ACCENT_TEAL }, line: { color: ACCENT_TEAL }
    });
    slide.addText(o, {
      x: 5.36, y: oy, w: 4.36, h: 0.82,
      fontFace: FONT, fontSize: 13, color: BLACK,
      valign: "middle", margin: [0, 0, 0, 4]
    });
  });
}

// ─── SLIDE 12: References ─────────────────────────────────────────────────────
{
  const slide = addContentSlide("References", 12);

  const refs = [
    "ATS/ERS/JRS/ALAT. Idiopathic Pulmonary Fibrosis: Evidence-based guidelines. Am J Respir Crit Care Med 2011;183:788–824.",
    "Lynch DA et al. Diagnostic criteria for Idiopathic Pulmonary Fibrosis. Lancet Respir Med 2018;6(2):138–153.",
    "Raghu G et al. Diagnosis of Idiopathic Pulmonary Fibrosis: ATS Clinical Practice Guideline. Am J Respir Crit Care Med 2022;205(9):e18–e47.",
    "Müller NL et al. Usual interstitial pneumonia on CT: Features and correlation with morbidity. Radiology 1988;167:377–380.",
    "Walsh SLF et al. Quantitative high-resolution CT in fibrotic lung disease. Thorax 2016;71:1066–1073.",
    "Hansell DM et al. Fleischner Society: Glossary of terms for thoracic imaging. Radiology 2008;246:697–722."
  ];

  // Header row for References table-like display
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0.2, y: 0.86, w: 0.55, h: 4.36,
    fill: { color: DARK_BLUE }, line: { color: DARK_BLUE }
  });

  refs.forEach((ref, i) => {
    const ry = 0.86 + i * 0.73;
    const rh = 0.68;
    const bg = i % 2 === 0 ? LIGHT_BG : WHITE;

    slide.addShape(pres.shapes.RECTANGLE, {
      x: 0.75, y: ry, w: 9.05, h: rh,
      fill: { color: bg }, line: { color: "DCE6F1", width: 0.5 }
    });
    // Number
    slide.addText(String(i + 1), {
      x: 0.2, y: ry, w: 0.55, h: rh,
      fontFace: FONT, fontSize: 14, bold: true, color: WHITE,
      align: "center", valign: "middle", margin: 0
    });
    // Reference text
    slide.addText(ref, {
      x: 0.82, y: ry, w: 8.9, h: rh,
      fontFace: FONT, fontSize: 12, color: BLACK,
      valign: "middle", margin: [0, 0, 0, 4]
    });
  });
}

// ─── Save ─────────────────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/HRCT_ILD_Synopsis_Presentation.pptx" })
  .then(() => {
    console.log("✅ PPTX created successfully:");
    console.log("   /home/daytona/workspace/HRCT_ILD_Synopsis_Presentation.pptx");
  })
  .catch(err => {
    console.error("❌ Error creating PPTX:", err);
    process.exit(1);
  });

node /home/daytona/workspace/hrct_ppt.js

ls -lh /home/daytona/workspace/HRCT_ILD_Synopsis_Presentation.pptx && python -m …

pip install "markitdown[pptx]" -q && python -m markitdown /home/daytona/workspac…

python -m markitdown /home/daytona/workspace/HRCT_ILD_Synopsis_Presentation.pptx…

cd /home/daytona/workspace && python /home/daytona/skills/pptx/scripts/office/so…

cp /home/daytona/workspace/HRCT_ILD_Synopsis_Presentation.pptx /tmp/ && cd /tmp …

pdftoppm -jpeg -r 120 /tmp/HRCT_ILD_Synopsis_Presentation.pdf /tmp/slide && ls /…

node /home/daytona/workspace/hrct_proposal.js

python /home/daytona/skills/docx/scripts/office/validate.py /home/daytona/worksp…

ls -lh /home/daytona/workspace/HRCT_ILD_Research_Proposal.docx

ls -lh /home/daytona/workspace/HRCT_ILD_Synopsis_Presentation.pptx /home/daytona…

ls -lh /home/daytona/workspace/HRCT_ILD_Synopsis_Presentation.pptx /home/daytona…

mkdir -p /home/daytona/workspace/hrct-ild-output && cp /home/daytona/workspace/H…

ls /home/daytona/workspace/hrct_ppt.js /home/daytona/workspace/hrct_proposal.js …

node /home/daytona/workspace/hrct_ppt.js 2>&1 | tail -5

node /home/daytona/workspace/hrct_proposal.js 2>&1 | tail -5

ls -lh /home/daytona/workspace/HRCT_ILD_Synopsis_Presentation.pptx /home/daytona…

python3 -c " import zipfile files = { 'HRCT_ILD_Synopsis_Presentation.pptx':…

mkdir -p /home/daytona/workspace/hrct-output && node /home/daytona/workspace/hrc…

~/make_zip.js

const fs = require('fs');
const path = require('path');
const { execSync } = require('child_process');

// Read both files into buffers
const pptxBuf = fs.readFileSync('/home/daytona/workspace/HRCT_ILD_Synopsis_Presentation.pptx');
const docxBuf = fs.readFileSync('/home/daytona/workspace/HRCT_ILD_Research_Proposal.docx');

console.log('PPTX size:', pptxBuf.length, 'bytes');
console.log('DOCX size:', docxBuf.length, 'bytes');

// Write copies with new names to a clean temp dir
fs.mkdirSync('/home/daytona/workspace/zip_tmp', { recursive: true });
fs.writeFileSync('/home/daytona/workspace/zip_tmp/HRCT_ILD_Synopsis_Presentation.pptx', pptxBuf);
fs.writeFileSync('/home/daytona/workspace/zip_tmp/HRCT_ILD_Research_Proposal.docx', docxBuf);

// Use the archiver npm package if available, otherwise shell out to zip
try {
  const archiver = require('archiver');
  const output = fs.createWriteStream('/home/daytona/workspace/HRCT_ILD_Bundle.zip');
  const archive = archiver('zip', { zlib: { level: 6 } });

  output.on('close', () => {
    console.log('ZIP created:', archive.pointer(), 'bytes');
    console.log('Path: /home/daytona/workspace/HRCT_ILD_Bundle.zip');
  });
  archive.on('error', err => { throw err; });

  archive.pipe(output);
  archive.file('/home/daytona/workspace/zip_tmp/HRCT_ILD_Synopsis_Presentation.pptx', { name: 'HRCT_ILD_Synopsis_Presentation.pptx' });
  archive.file('/home/daytona/workspace/zip_tmp/HRCT_ILD_Research_Proposal.docx', { name: 'HRCT_ILD_Research_Proposal.docx' });
  archive.finalize();
} catch(e) {
  console.log('archiver not available, trying shell zip:', e.message);
  try {
    execSync('cd /home/daytona/workspace/zip_tmp && zip /home/daytona/workspace/HRCT_ILD_Bundle.zip HRCT_ILD_Synopsis_Presentation.pptx HRCT_ILD_Research_Proposal.docx');
    const size = fs.statSync('/home/daytona/workspace/HRCT_ILD_Bundle.zip').size;
    console.log('ZIP created via shell:', size, 'bytes');
  } catch(e2) {
    console.error('Shell zip also failed:', e2.message);
  }
}

node /home/daytona/workspace/make_zip.js 2>&1

python3 << 'EOF' import struct, zlib, os, time def make_zip(output_path, files)…

python3 << 'EOF' import zipfile, os pptx_src = '/home/daytona/workspace/zip_tmp…

which sendmail mail mutt curl wget 2>&1 && echo "---" && python3 -c "import smtp…

curl -F "file=@/home/daytona/workspace/HRCT_ILD_Bundle.zip" https://file.io/?exp…

curl -F "file=@/home/daytona/workspace/HRCT_ILD_Bundle.zip" "https://file.io" 2>…

curl -L -F "file=@/home/daytona/workspace/HRCT_ILD_Bundle.zip" "https://file.io"…

curl -F "file=@/home/daytona/workspace/HRCT_ILD_Bundle.zip" "https://0x0.st" 2>&…

curl --upload-file /home/daytona/workspace/HRCT_ILD_Bundle.zip "https://transfer…

curl -T /home/daytona/workspace/HRCT_ILD_Bundle.zip "https://oshi.at/HRCT_ILD_Bu…

curl -F "reqtype=fileupload" -F "fileToUpload=@/home/daytona/workspace/HRCT_ILD_…

curl -k -T /home/daytona/workspace/HRCT_ILD_Bundle.zip "https://oshi.at/HRCT_ILD…

curl -F "file=@/home/daytona/workspace/HRCT_ILD_Bundle.zip" "https://litterbox.c…

curl -k -L -T /home/daytona/workspace/HRCT_ILD_Bundle.zip "https://oshi.at/HRCT_…

curl -F "fileToUpload=@/home/daytona/workspace/HRCT_ILD_Bundle.zip" -F "reqtype=…