Patient P-01400
Therapy response 50 at the day-84 endpoint (observed).
Responding: response probability 48%, therapy response 49 today; biology is not blocking the drug.
Drift detected on day 46 (HRV −11 ms, resting HR +7 bpm, sleep −2.0 h, gi toxicity +25, inflammatory load +23); the side effect would have been reported on day 56 — 10 days of warning.
6 of 9 scheduled doses in the last 60 days are biologically confirmed (67%). Dose signature: resting HR +6 bpm, HRV −12 ms.
Adherence is 49% and stable; nothing else works if the dose is missed → adherence support first.
50% of 284 similar trajectories improved after AD-05; if this one does, discontinuation risk is expected to fall from 66% to ~46%. Keeping alcohol low is worth 7 GI points a day on its own. Losing this patient costs €57k; the intervention costs €180.
- 🍽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
Dose is being missed; nothing else works until this is fixed.
adherence still under 65% after 7 days
P-01400 is on day 109 of NBL-101 (EC-03, baseline S14): response stable, tolerance deteriorating, GI stable. Over 14 days response moved -2 and GI +4; discontinuation risk is 66%. The state is between basins, heading towards failing, after diverging from the model on day 46.
Biology sets the gain: FUT2 non-secretor, Low butyrate capacity, Low microbial diversity, Baseline state S14, Cluster EC-03 (high response / high intolerance), Adherence < 60%; butyrate capacity 23/100, diversity 1.9. Pushing it down: Low butyrate capacity (-27), Klebsiella pneumoniae 10.192% (LPS load) (-25.4), Alcohol (-22.2). Pulling it up: GI Support Protocol GI-04 (+46.6). From the daily log: alcohol +7 GI next day, fat +6 GI next day, histamine +5.1 GI next day, fibre +3.4 GI next day.
Past actions: GI-04 on day 61 → improved (31%).
Next: AD-05 — 50% of 284 similar trajectories improved, 45% probability here. Adherence is 49% and stable; nothing else works if the dose is missed → adherence support first. This would be contradicted by a further GI rise within the onset window or falling adherence.
Trajectory
Baseline → today → 30-day prediction · hover a day for signals and events- Day 0 NBL-101 started — Baseline state S14
- Day 46 Trajectory diverged from prediction — Observed response fell below the model's expected path.
- Day 60 GI-04 recommended — GI Support Protocol GI-04
- Day 61 Patient accepted — Started GI-04 in the companion
- Day 69 GI symptom burden −31% vs expected — GI Support Protocol GI-04
- Day 75 Tolerance state changed — Unstable → Improving
What changed?
Trajectory began diverging from predicted response on Day 46.
- Inflammatory activity+10
- Toxicity+6
- GI instability+4
- Treatment adherence-4
- Nutritional resilience+3
What helped?
- GI Support Protocol GI-04Day 60Result: symptom burden −31%
- 284 similar trajectories
- 50% showed improvement
- median effect visible after 5 days
Adherence is 49% and stable; nothing else works if the dose is missed → adherence support first.
Daily trackers
Asset settingsThe trackers this program marks as important, last 14 days vs the 14 before.
Heading towards failing · 39 from the failing basin, 48 from restoration.
- Keep alcohol lowGI +7 next day on high-intake days · n 15
- Keep fat lowGI +6 next day on high-intake days · n 20
- Keep histamine lowGI +5.1 next day on high-intake days · n 13
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.
- Alcohol+7detractor · 95%
- Dietary fat load+6detractor · 95%
- Histamine load+5.1detractor · 95%
- Insoluble fibre+3.4detractor · 92%
- Simple carbohydrates+2.3no signal · 49%
- Spicy / capsaicin+0.4no 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.
- 1 opportunist above range: Klebsiella pneumoniae
- 6 keystone species absent
- Shannon 1.84 (expected ≥ 3)
- 12 resistance genes
- Host DNA fragmentation atypical
- Tissue recycling index 65
Biological layers
Which pathways look influenced, and by which layer of this person's biology.
- Inflammatory signalling ↑60
- MicrobiomeBacteroides fragilis expansion
- BloodInflammatory load index 52
- WearableHRV 37 ms, trending down
- Butyrate / short-chain fatty acid production ↓55
- MicrobiomeButyrate capacity 23/100
- Daily logFibre intake low in recent food logs
- Mucosal barrier integrity ↓30
- DNAFUT2 non-secretor lowers mucosal fucosylation
- Drug metabolism and exposure ↑20
- BloodToxicity index 48
- Autonomic recovery ↑20
- Wearable2,075 steps/day
- FUT2 rs601338 AA (non-secretor)Reduced mucosal fucosylation
- CYP2D6 Normal metabolizerExpected exposure
- Akkermansia muciniphilaNormal
- Faecalibacterium prausnitziiNormal
- Bacteroides fragilisHigh
- Bifidobacterium longumNormal
- EnterobacteriaceaeNormal
- HRV
- 31 ms
- Sleep
- 7.4 h
- Steps
- 1,606
- Resting HR
- 68 bpm
What this patient sees in NostraAI
The content that steers the trajectory: what to eat, what to do, what to take.
- 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
- Track each bowel movement today: time, stool form, urgency, overnight waking
- A 15-minute walk after lunch
- Keep the sleep window steady
- Keep hydration steady: small amounts through the day rather than large volumes at once
- 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.