600 patients67,035 observations120 daysLIVE

Patient P-01432

Synthetic patientNBL-101 · Day 103 · 75+ · F · baseline S14Steering view · 3DOpen companion preview
Is the drug working?

Therapy response 43 at the day-84 endpoint (observed).

Why responding?

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

Is a side effect starting?

Drift detected on day 47 (resting HR +5 bpm, gi toxicity +15, inflammatory load +5); the side effect would have been reported on day 55 — 8 days of warning.

Still taking it?

8 of 9 scheduled doses in the last 60 days are biologically confirmed (89%). Dose signature: resting HR +6 bpm, HRV −11 ms.

last 9 doses · green confirmed · amber logged only · red missed
Plan for this patient
not yet offeredrecommendowner · Companionreview day 108Human Model →
Next action
AD-05 Adherence Support
33% probability of improvement

Adherence is 56% and stable; nothing else works if the dose is missed → adherence support first.

Kept if

33% of 284 similar trajectories improved after AD-05; if this one does, discontinuation risk is expected to fall from 55% to ~38%. Keeping histamine low is worth 3.7 GI points a day on its own. Losing this patient costs €57k; the intervention costs €180.

Daily to-dos in the companion
  • 🍽Keep meals regular; three to four moderate portions spaced through the day
  • 🍽Include a cooked vegetable portion with each main meal
  • Log the daily check-in; one line is enough
  • A 15-minute walk after lunch
  • 💊Take the scheduled dose as agreed with your care team
  • 💊No additional supplements this week
Adherence
56% stable

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

Changes the plan if

adherence still under 65% after 7 days

LLIFE OS insight
grounded · add an LLM key for prose

P-01432 is on day 103 of NBL-101 (EC-03, baseline S14): response declining, tolerance favorable, GI improving. Over 14 days response moved -10 and GI -4; discontinuation risk is 55%. The state is between basins, heading towards failing, after diverging from the model on day 47.

Biology sets the gain: FUT2 non-secretor, Poor metabolizer, Low butyrate capacity, Low microbial diversity, Baseline state S14, Cluster EC-03 (high response / high intolerance), Adherence < 60%; butyrate capacity 34/100, diversity 2.7. Pushing it down: Escherichia coli 30.739% (LPS load) (-32.8), Low butyrate capacity (-25.8), 6 keystone species absent (-19.3). Pulling it up: GI Support Protocol GI-04 (+41.1), Supportive Compound SC-12 (+31). From the daily log: histamine +3.7 GI next day, fat +3.5 GI next day, simple carbs +3.3 GI next day.

Past actions: NP-02 on day 32 → no change (2%); SC-12 on day 48 → improved (19%); GI-04 on day 57 → improved (28%).

Next: AD-05 — 33% of 284 similar trajectories improved, 33% probability here. Adherence is 56% 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.

Therapy response
Declining
Tolerance
Favorable
GI state
Improving
Inflammatory state
Favorable
Nutritional resilience
Improving
Discontinuation risk
55%

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 31 NP-02 recommendedDietary Support Protocol NP-02
  3. Day 32 Patient acceptedStarted NP-02 in the companion
  4. Day 42 No meaningful changeDietary Support Protocol NP-02
  5. Day 47 Trajectory diverged from predictionObserved response fell below the model's expected path.
  6. Day 47 SC-12 recommendedSupportive Compound SC-12
  7. Day 48 Patient acceptedStarted SC-12 in the companion
  8. Day 54 GI symptom burden −19% vs expectedSupportive Compound SC-12
  9. Day 56 GI-04 recommendedGI Support Protocol GI-04
  10. Day 57 Patient acceptedStarted GI-04 in the companion
  11. Day 60 Tolerance state changedUnstable → Improving
  12. Day 65 GI symptom burden −28% vs expectedGI Support Protocol GI-04
  13. Day 71 Tolerance state changedUnstable → Improving

What changed?

Trajectory began diverging from predicted response on Day 47.

Primary contributors, last 14 days
  • Nutritional resilience+7
  • GI instability-4
  • Toxicity+3
  • Treatment adherence-2

What helped?

  • Dietary Support Protocol NP-02Day 31
    Result: no meaningful change
  • Supportive Compound SC-12Day 47
    Result: symptom burden −19%
  • GI Support Protocol GI-04Day 56
    Result: symptom burden −28%
LIFE OS recommendation
Adherence Support AD-05 what is this →
33%
probability of meaningful tolerance improvement
  • 284 similar trajectories
  • 33% showed improvement
  • median effect visible after 5 days
Why this and not the default

Adherence is 56% and stable; nothing else works if the dose is missed → adherence support first.

Daily trackers

Asset settings

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

GI burden
Companion
39.9/100
worsening · +5.5 vs previous 14 d
Toxicity
Blood
38.5/100
improving · -8.4 vs previous 14 d
Sleep quality
Wearable
35.3/100
stable · -0.7 vs previous 14 d
Energy level
Daily log
3.5/10
improving · +0.2 vs previous 14 d
Stress level
Daily log
5.6/10
stable · +0.2 vs previous 14 d
Steps
Wearable
3,305
stable · +153 vs previous 14 d
Adherence
Companion
55.5 %
stable · -1.6 vs previous 14 d
This trajectory is decaying — what would help, what would not
Steering view →

Heading towards failing · 47 from the failing basin, 41 from restoration.

Would help
  • ME-01 Monitoring Escalation
    100% improved among 66 similar · onset 3 d · confidence 64%
  • CR-01 Clinician Review
    100% improved among 8 similar · onset 5 d · confidence 64%
Would not help
  • NP-02 Dietary Support Protocol
    already tried, no meaningful change
  • Keep histamine low
    GI +3.7 next day on high-intake days · n 20
  • Keep fat low
    GI +3.5 next day on high-intake days · n 19
  • Keep simple carbs low
    GI +3.3 next day on high-intake days · n 19
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
    +3.7detractor · 95%
  • Dietary fat load
    +3.5detractor · 95%
  • Simple carbohydrates
    +3.3detractor · 95%
  • Alcohol
    -0.7no signal · 16%
  • Insoluble fibre
    -0.6no signal · 16%
  • Spicy / capsaicin
    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)
0
2 improved · 7 worsened
synthetic signature · consistent with this patient's biology
  • 4 opportunists above range: Escherichia coli, Klebsiella pneumoniae, Enterococcus faecium
  • 6 keystone species absent
  • Shannon 1.89 (expected ≥ 3)
  • 10 resistance genes
  • Tissue recycling index 56
Pathogens / opportunists4/5
Keystone species6/8
from 4
Diversity2/2
Metabolic modules0/4
Vitamin synthesis5/7
from 4
Oral translocation1/1
Host DNA0/1
Tissue recycling1/1
Central mechanisms2/2
Virulence factors6/6
from 4
Antibiotic resistance genes10/10
from 9
Genetic predisposition2/2
Opportunists above range
Escherichia coli 30.739% AR
Enterococcus faecium 15.37% AR
Klebsiella pneumoniae 9.222% AR
Clostridioides difficile 3.074% AR
Keystone species absent
Akkermansia muciniphila, Bifidobacterium longum, Butyricicoccus pullicaecorum, Eubacterium rectale, Faecalibacterium prausnitzii
Capacity
Shannon 1.89 · butyrate 340 CPM · SCFA 635
5 vitamins below
Host & mechanisms
tissue recycling 56/100
oral translocation 6.97% AR
molecular_mimicry above
estrobolome above
10 resistance genes · 6 virulence factors

Biological layers

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

Pathways under pressure
  • Autonomic recovery 65
    • WearableResting HR 74 bpm
    • Wearable3,305 steps/day
    • WearableShort sleep window
  • Mucosal barrier integrity 40
    • DNAFUT2 non-secretor lowers mucosal fucosylation
    • WearableSleep 5.9 h, below personal baseline
  • Drug metabolism and exposure 40
    • DNACYP2D6 poor metabolizer → higher exposure
  • Butyrate / short-chain fatty acid production 35
    • MicrobiomeButyrate capacity 34/100
  • Inflammatory signalling 20
    • MicrobiomeBacteroides fragilis expansion
DNA
Fictional pharmacogenomic panel
  • FUT2 rs601338 AA (non-secretor)
    Reduced mucosal fucosylation
  • CYP2D6 Poor metabolizer
    Higher exposure at standard dose
Microbiome
Shannon diversity 2.7 · butyrate capacity 34/100
  • Akkermansia muciniphilaNormal
  • Faecalibacterium prausnitziiNormal
  • Bacteroides fragilisHigh
  • Bifidobacterium longumNormal
  • EnterobacteriaceaeHigh
Wearable, last 14 days
daily evolution fed into the runtime
HRV
53 ms
Sleep
6.2 h
Steps
4,294
Resting HR
75 bpm
Daily log: GI score 40, nutritional resilience 56, adherence 56.

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
  • Keep meals regular; three to four moderate portions spaced through the day
  • Include a cooked vegetable portion with each main meal
  • 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
  • Log the daily check-in; one line is enough
  • 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
  • No additional supplements this week
  • Fictional demo item: continue vitamin D as before

284 biologically similar trajectories

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

PatientSimilarityBaselineInterventionOutcomeResponse today
P-0189733%S01SC-12improved49
P-0170632%S01NP-02improved42
P-0174631%S01NP-02improved40
P-0187727%S01CR-01improved61
P-0172426%S01SC-12no change60
P-0172525%S01CR-01improved62
P-0174825%S0167
P-0185825%S01ME-01improved41
P-0168424%S0164
P-0180024%S0136
P-0171342%S02GI-04improved50
P-0140734%S02GI-04improved43