600 patients67,035 observations120 daysLIVE

Patient P-01339

Synthetic patientNBL-101 · Day 117 · 75+ · F · baseline S14Steering view · 3DOpen companion preview
Is the drug working?

Therapy response 44 at the day-84 endpoint (observed).

Why responding?

Responding: response probability 47%, therapy response 48 today; biology is not blocking the drug.

Is a side effect starting?

Drift detected on day 46 (HRV −7 ms, resting HR +4 bpm, gi toxicity +16, inflammatory load +14); the side effect would have been reported on day 50 — 4 days of warning.

Still taking it?

6 of 9 scheduled doses in the last 60 days are biologically confirmed (67%); 1 were logged but show no dose signature. Dose signature: resting HR +7 bpm, HRV −9 ms.

last 9 doses · green confirmed · amber logged only · red missed
Plan for this patient
not yet offeredrequiredowner · Study nursereview day 127Human Model →
Next action
NP-02 Dietary Support Protocol
67% probability of improvement
Kept if

77% of 284 similar trajectories improved after NP-02; if this one does, discontinuation risk is expected to fall from 96% to ~77%. Keeping histamine low is worth 6.2 GI points a day on its own. Losing this patient costs €57k; the intervention costs €180.

Daily to-dos in the companion
  • 🍽Prepare a plain, low-fat pasta or rice meal and note how it feels afterwards
  • 🍽Choose a freshly cooked, lean protein; avoid frying, rich sauces and leftovers for now
  • Track each bowel movement today: time, stool form, urgency, overnight waking
  • A 15-minute walk after lunch
  • 💊Take the scheduled dose as agreed with your care team
  • 💊Electrolyte solution, one sachet after any loose stool
Adherence
51% improving

Dose is being missed; nothing else works until this is fixed.

Changes the plan if

GI burden above 80 for 3 days within the onset window

LLIFE OS insight
grounded · add an LLM key for prose

P-01339 is on day 117 of NBL-101 (EC-03, baseline S14): response improving, tolerance improving, GI unstable. Over 14 days response moved +11 and GI +20; discontinuation risk is 96%. The state is between basins, heading towards failing, after diverging from the model on day 46.

Biology sets the gain: FUT2 non-secretor, IL6 high-expression variant, Low butyrate capacity, Low microbial diversity, Baseline state S14, Cluster EC-03 (high response / high intolerance), Adherence < 60%; butyrate capacity 27/100, diversity 2.0. Pushing it down: Escherichia coli 31.089% (LPS load) (-36.3), Low butyrate capacity (-28.5), Histamine load (-22.5). Pulling it up: GI Support Protocol GI-04 (+31.2). From the daily log: histamine +6.2 GI next day, fat +6 GI next day, simple carbs +5.8 GI next day, spicy +5.6 GI next day.

Past actions: GI-04 on day 60 → improved (19%).

Next: NP-02 — 77% of 284 similar trajectories improved, 67% probability here. This would be contradicted by a further GI rise within the onset window or falling adherence.

Therapy response
Improving
Tolerance
Improving
GI state
Unstable
Inflammatory state
Stable
Nutritional resilience
Unstable
Discontinuation risk
96%

Trajectory

Baseline → today → 30-day prediction · hover a day for signals and events
solid = observed · dashed = predicted · dose (weekly infusion, day 1 of each 7-day cycle)
  1. Day 0 NBL-101 startedBaseline state S14
  2. Day 46 Trajectory diverged from predictionObserved response fell below the model's expected path.
  3. Day 59 GI-04 recommendedGI Support Protocol GI-04
  4. Day 60 Patient acceptedStarted GI-04 in the companion
  5. Day 68 GI symptom burden −19% vs expectedGI Support Protocol GI-04
  6. Day 74 Tolerance state changedUnstable → Improving

What changed?

Trajectory began diverging from predicted response on Day 46.

Primary contributors, last 14 days
  • GI instability+20
  • Nutritional resilience-10
  • Toxicity-7
  • Inflammatory activity+2

What helped?

  • GI Support Protocol GI-04Day 59
    Result: symptom burden −19%
LIFE OS recommendation
67%
probability of meaningful tolerance improvement
  • 284 similar trajectories
  • 77% showed improvement
  • median effect visible after 10 days

Daily trackers

Asset settings

The trackers this program marks as important, last 14 days vs the 14 before.

GI burden
Companion
72/100
worsening · +16.5 vs previous 14 d
Toxicity
Blood
44.6/100
improving · -5.2 vs previous 14 d
Sleep quality
Wearable
22/100
worsening · -6.0 vs previous 14 d
Energy level
Daily log
2.6/10
worsening · -1.0 vs previous 14 d
Stress level
Daily log
7.9/10
worsening · +0.6 vs previous 14 d
Steps
Wearable
511
worsening · -837 vs previous 14 d
Adherence
Companion
50.7 %
improving · +4.2 vs previous 14 d
This trajectory is decaying — what would help, what would not
Steering view →

Heading towards failing · 28 from the failing basin, 71 from restoration.

Would help
  • ME-01 Monitoring Escalation
    100% improved among 67 similar · onset 3 d · confidence 71%
  • NP-02 Dietary Support Protocol
    63% improved among 63 similar · onset 10 d · confidence 71%
  • SC-12 Supportive Compound
    65% improved among 46 similar · onset 6 d · confidence 71%
Would not help
  • Keep histamine low
    GI +6.2 next day on high-intake days · n 20
  • Keep fat low
    GI +6 next day on high-intake days · n 22
  • Keep simple carbs low
    GI +5.8 next day on high-intake days · n 17
State influencers · digestive

Next-day GI change on high-intake vs low-intake days, last 60 days. Attribution from this patient's own log; sensitivity set by their biology.

  • Histamine load
    +6.2detractor · 95%
  • Dietary fat load
    +6detractor · 95%
  • Simple carbohydrates
    +5.8detractor · 95%
  • Spicy / capsaicin
    +5.6detractor · 95%
  • Alcohol
    -2.5no signal · 41%
  • Insoluble fibre
    0no signal · 15%

DeepGene damage signature

The metagenomic + host-DNA read-out that initializes this patient's biology and, on retest, measures whether the steering worked.

Damage score · retest day 90
78/100
vs baseline (day 0)
-3
2 improved · 8 worsened
synthetic signature · consistent with this patient's biology
  • 5 opportunists above range: Escherichia coli, Klebsiella pneumoniae, Enterococcus faecium
  • 6 keystone species absent
  • Shannon 2.05 (expected ≥ 3)
  • 11 resistance genes
  • Tissue recycling index 55
Pathogens / opportunists5/5
from 3
Keystone species6/8
from 5
Diversity2/2
Metabolic modules0/4
Vitamin synthesis5/7
from 4
Oral translocation1/1
Host DNA0/1
from 1
Tissue recycling1/1
Central mechanisms2/2
Virulence factors6/6
from 5
Antibiotic resistance genes11/11
from 8
Genetic predisposition2/2
Opportunists above range
Escherichia coli 31.089% AR
Enterococcus faecium 15.544% AR
Klebsiella pneumoniae 9.327% AR
Streptococcus gallolyticus 3.109% AR
Keystone species absent
Akkermansia muciniphila, Bifidobacterium longum, Butyricicoccus pullicaecorum, Eubacterium rectale, Faecalibacterium prausnitzii
Capacity
Shannon 2.05 · butyrate 312 CPM · SCFA 615
5 vitamins below
Host & mechanisms
tissue recycling 55/100
oral translocation 7.05% AR
molecular_mimicry above
estrobolome above
11 resistance genes · 6 virulence factors

Biological layers

Which pathways look influenced, and by which layer of this person's biology.

Pathways under pressure
  • Mucosal barrier integrity 90
    • DNAFUT2 non-secretor lowers mucosal fucosylation
    • MicrobiomeAkkermansia low → thinner mucus layer
    • Daily logGI symptom score 72 and rising
    • WearableSleep 5.8 h, below personal baseline
  • Inflammatory signalling 85
    • DNAIL6 -174 variant raises baseline inflammatory tone
    • MicrobiomeBacteroides fragilis expansion
    • BloodInflammatory load index 57
    • WearableHRV 31 ms, trending down
  • Butyrate / short-chain fatty acid production 80
    • MicrobiomeButyrate capacity 27/100
    • MicrobiomeF. prausnitzii depleted
    • Daily logFibre intake low in recent food logs
  • Autonomic recovery 65
    • WearableResting HR 89 bpm
    • Wearable511 steps/day
    • WearableShort sleep window
  • Drug metabolism and exposure 20
    • BloodToxicity index 45
DNA
Fictional pharmacogenomic panel
  • FUT2 rs601338 AA (non-secretor)
    Reduced mucosal fucosylation
  • IL6 -174 G/C
    Higher inflammatory tone
  • CYP2D6 Normal metabolizer
    Expected exposure
Microbiome
Shannon diversity 2 · butyrate capacity 27/100
  • Akkermansia muciniphilaLow
  • Faecalibacterium prausnitziiLow
  • Bacteroides fragilisHigh
  • Bifidobacterium longumLow
  • EnterobacteriaceaeNormal
Wearable, last 14 days
daily evolution fed into the runtime
HRV
35 ms
Sleep
5.5 h
Steps
526
Resting HR
86 bpm
Daily log: GI score 72, nutritional resilience 34, adherence 51.

What this patient sees in NostraAI

The content that steers the trajectory: what to eat, what to do, what to take.

Open companion preview
What to eat
  • Prepare a plain, low-fat pasta or rice meal and note how it feels afterwards
  • Choose a freshly cooked, lean protein; avoid frying, rich sauces and leftovers for now
  • Add one soluble-fibre source (oats, cooked carrots, banana) to breakfast
  • Avoid known triggers for now: fried or oily food, dairy, alcohol
What to do
  • Track each bowel movement today: time, stool form, urgency, overnight waking
  • A 15-minute walk after lunch
  • Protect a 7.5-hour sleep window; screens off 30 minutes before
  • Keep hydration steady: small amounts through the day rather than large volumes at once
What to take
  • Take the scheduled dose as agreed with your care team
  • Electrolyte solution, one sachet after any loose stool
  • Fictional demo item: oral nutrition supplement with lunch

284 biologically similar trajectories

Black: this patient. Green: similar patients whose intervention worked. Orange: similar patients where it did not.

PatientSimilarityBaselineInterventionOutcomeResponse today
P-0134520%S02AD-05improved36
P-0165021%S14BR-03improved38
P-0154020%S14BR-03improved32
P-0160035%S09CR-01improved58
P-0176835%S17CR-01improved58
P-0187730%S01CR-01improved61
P-0151429%S13CR-01improved46
P-0170829%S14CR-01improved63
P-0169928%S19CR-01improved55
P-0169724%S13CR-01improved56
P-0172523%S01CR-01improved62
P-0179422%S13CR-01improved51