Patient P-01438
Therapy response 46 at the day-84 endpoint (observed).
Responding: response probability 45%, therapy response 44 today; biology is not blocking the drug.
Drift detected on day 53 (HRV −10 ms, resting HR +5 bpm, sleep −0.6 h, gi toxicity +29, inflammatory load +16); the side effect would have been reported on day 60 — 7 days of warning.
5 of 8 scheduled doses in the last 60 days are biologically confirmed (63%). Dose signature: resting HR +7 bpm, HRV −9 ms.
100% of 284 similar trajectories improved after ME-01; if this one does, discontinuation risk is expected to fall from 60% to ~44%. Keeping fat low is worth 4.4 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.
GI burden above 62 for 3 days within the onset window
P-01438 is on day 112 of NBL-101 (EC-03, baseline S06): response declining, tolerance deteriorating, GI stable. Over 14 days response moved -8 and GI -2; discontinuation risk is 60%. The state is between basins, heading towards failing, after diverging from the model on day 53.
Biology sets the gain: IL6 high-expression variant, Low butyrate capacity, Low microbial diversity, Cluster EC-03 (high response / high intolerance), Adherence < 60%; butyrate capacity 28/100, diversity 2.1. Pushing it down: Enterococcus faecium 15.941% (LPS load) (-32.6), Low butyrate capacity (-27.5), 6 keystone species absent (-20.6). Pulling it up: Dietary Support Protocol NP-02 (+32.1), GI Support Protocol GI-04 (+30.5). From the daily log: fat +4.4 GI next day, simple carbs +3.4 GI next day, spicy +3.4 GI next day.
Past actions: NP-02 on day 32 → improved (17%); GI-04 on day 51 → improved (18%).
Next: ME-01 — 100% of 284 similar trajectories improved, 71% probability here. 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 S06
- Day 31 NP-02 recommended — Dietary Support Protocol NP-02
- Day 32 Patient accepted — Started NP-02 in the companion
- Day 42 GI symptom burden −17% vs expected — Dietary Support Protocol NP-02
- Day 48 Tolerance state changed — Unstable → Improving
- Day 50 GI-04 recommended — GI Support Protocol GI-04
- Day 51 Patient accepted — Started GI-04 in the companion
- Day 53 Trajectory diverged from prediction — Observed response fell below the model's expected path.
- Day 59 GI symptom burden −18% vs expected — GI Support Protocol GI-04
- Day 65 Tolerance state changed — Unstable → Improving
What changed?
Trajectory began diverging from predicted response on Day 53.
- Toxicity+9
- Treatment adherence-8
- Inflammatory activity-3
- GI instability-2
What helped?
- Dietary Support Protocol NP-02Day 31Result: symptom burden −17%
- GI Support Protocol GI-04Day 50Result: symptom burden −18%
- 284 similar trajectories
- 100% showed improvement
- median effect visible after 3 days
Daily trackers
Asset settingsThe trackers this program marks as important, last 14 days vs the 14 before.
Heading towards failing · 30 from the failing basin, 57 from restoration.
- Keep fat lowGI +4.4 next day on high-intake days · n 21
- Keep simple carbs lowGI +3.4 next day on high-intake days · n 19
- Keep spicy lowGI +3.4 next day on high-intake days · n 19
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.
- Dietary fat load+4.4detractor · 95%
- Simple carbohydrates+3.4detractor · 78%
- Spicy / capsaicin+3.4detractor · 68%
- Insoluble fibre+2.3no signal · 46%
- Histamine load+0.9no signal · 15%
- Alcohol-0.3no 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.
- 4 opportunists above range: Klebsiella pneumoniae, Enterococcus faecium, Streptococcus gallolyticus
- 6 keystone species absent
- Shannon 1.63 (expected ≥ 3)
- 10 resistance genes
- Host DNA fragmentation atypical
- Tissue recycling index 64
Biological layers
Which pathways look influenced, and by which layer of this person's biology.
- Butyrate / short-chain fatty acid production ↓80
- MicrobiomeButyrate capacity 28/100
- MicrobiomeF. prausnitzii depleted
- Daily logFibre intake low in recent food logs
- Inflammatory signalling ↓65
- DNAIL6 -174 variant raises baseline inflammatory tone
- BloodInflammatory load index 51
- WearableHRV 30 ms, trending down
- Mucosal barrier integrity ↓60
- MicrobiomeAkkermansia low → thinner mucus layer
- Daily logGI symptom score 54 and rising
- WearableSleep 5.6 h, below personal baseline
- Drug metabolism and exposure ↑20
- BloodToxicity index 46
- Autonomic recovery ↓20
- WearableShort sleep window
- IL6 -174 G/CHigher inflammatory tone
- CYP2D6 Normal metabolizerExpected exposure
- Akkermansia muciniphilaLow
- Faecalibacterium prausnitziiLow
- Bacteroides fragilisNormal
- Bifidobacterium longumNormal
- EnterobacteriaceaeHigh
- HRV
- 27 ms
- Sleep
- 5.6 h
- Steps
- 6,705
- Resting HR
- 70 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
- 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
- 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.
| Patient | Similarity | Baseline | Intervention | Outcome | Response today |
|---|---|---|---|---|---|
| P-01582 | 58% | S07 | GI-04 | improved | 43 |
| P-01465 | 54% | S14 | NP-02 | improved | 47 |
| P-01772 | 53% | S14 | SC-12 | improved | 46 |
| P-01709 | 52% | S14 | NP-02 | improved | 42 |
| P-01647 | 51% | S14 | GI-04 | improved | 42 |
| P-01797 | 51% | S14 | NP-02 | improved | 45 |
| P-01842 | 51% | S14 | NP-02 | improved | 44 |
| P-01368 | 50% | S15 | GI-04 | improved | 49 |
| P-01393 | 50% | S10 | GI-04 | improved | 50 |
| P-01400 | 50% | S14 | GI-04 | improved | 49 |
| P-01413 | 50% | S14 | GI-04 | improved | 47 |
| P-01544 | 50% | S14 | SC-12 | improved | 46 |