Patient P-01454
Therapy response 45 at the day-84 endpoint (observed).
Responding: response probability 43%, therapy response 41 today; biology is not blocking the drug.
Drift detected on day 48 (HRV −10 ms, resting HR +8 bpm, sleep −0.8 h, gi toxicity +26, inflammatory load +26); the side effect would have been reported on day 59 — 11 days of warning.
5 of 9 scheduled doses in the last 60 days are biologically confirmed (56%). Dose signature: resting HR +5 bpm, HRV −11 ms.
77% of 284 similar trajectories improved after NP-02; if this one does, discontinuation risk is expected to fall from 92% to ~74%. Keeping fat low is worth 5.4 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 92 for 3 days within the onset window
P-01454 is on day 115 of NBL-101 (EC-03, baseline S06): response unstable, tolerance unstable, GI unstable. Over 14 days response moved -8 and GI +9; discontinuation risk is 92%. The state is between basins, heading towards failing, after diverging from the model on day 48.
Biology sets the gain: Poor metabolizer, Low microbial diversity, Cluster EC-03 (high response / high intolerance), Adherence < 60%; butyrate capacity 44/100, diversity 2.9. Pushing it down: Enterococcus faecium 16.476% (LPS load) (-34), Low butyrate capacity (-28.1), 6 keystone species absent (-21). From the daily log: fat +5.4 GI next day, alcohol +3.9 GI next day, simple carbs +3.8 GI next day.
Past actions: GI-04 on day 51 → worsened (-4%); ME-01 on day 60 → improved (3%).
Next: NP-02 — 77% of 284 similar trajectories improved, 70% 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 48 Trajectory diverged from prediction — Observed response fell below the model's expected path.
- Day 50 GI-04 recommended — GI Support Protocol GI-04
- Day 51 Patient accepted — Started GI-04 in the companion
- Day 59 No meaningful change — GI Support Protocol GI-04
- Day 59 ME-01 recommended — Monitoring Escalation ME-01
- Day 60 Patient accepted — Started ME-01 in the companion
- Day 63 Deterioration detected before clinical escalation — Monitoring Escalation ME-01
What changed?
Trajectory began diverging from predicted response on Day 48.
- GI instability+9
- Toxicity+9
- Nutritional resilience-5
- Inflammatory activity+3
- Treatment adherence+2
What helped?
- GI Support Protocol GI-04Day 50Result: no meaningful change
- Monitoring Escalation ME-01Day 59Result: deterioration detected before clinical escalation
- 284 similar trajectories
- 77% showed improvement
- median effect visible after 10 days
Daily trackers
Asset settingsThe trackers this program marks as important, last 14 days vs the 14 before.
Heading towards failing · 25 from the failing basin, 90 from restoration.
- GI-04 GI Support Protocolalready tried, no meaningful change
- Keep fat lowGI +5.4 next day on high-intake days · n 21
- Keep alcohol lowGI +3.9 next day on high-intake days · n 22
- Keep simple carbs lowGI +3.8 next day on high-intake days · n 16
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+5.4detractor · 95%
- Alcohol+3.9detractor · 93%
- Simple carbohydrates+3.8detractor · 86%
- Histamine load-1.9no signal · 29%
- Insoluble fibre+1.7no signal · 34%
- Spicy / capsaicin-0.9no 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.
- 3 opportunists above range: Klebsiella pneumoniae, Enterococcus faecium, Streptococcus gallolyticus
- 6 keystone species absent
- Shannon 1.67 (expected ≥ 3)
- 12 resistance genes
- Host DNA fragmentation atypical
- Tissue recycling index 62
Biological layers
Which pathways look influenced, and by which layer of this person's biology.
- Butyrate / short-chain fatty acid production ↓80
- MicrobiomeButyrate capacity 44/100
- MicrobiomeF. prausnitzii depleted
- Daily logFibre intake low in recent food logs
- Drug metabolism and exposure ↑60
- DNACYP2D6 poor metabolizer → higher exposure
- BloodToxicity index 60
- Mucosal barrier integrity ↓50
- MicrobiomeAkkermansia low → thinner mucus layer
- Daily logGI symptom score 84 and rising
- Autonomic recovery ↓45
- WearableResting HR 89 bpm
- Wearable300 steps/day
- Inflammatory signalling ↑40
- BloodInflammatory load index 70
- WearableHRV 34 ms, trending down
- CYP2D6 Poor metabolizerHigher exposure at standard dose
- Akkermansia muciniphilaLow
- Faecalibacterium prausnitziiLow
- Bacteroides fragilisNormal
- Bifidobacterium longumLow
- EnterobacteriaceaeHigh
- HRV
- 32 ms
- Sleep
- 6.5 h
- Steps
- 418
- Resting HR
- 86 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.
| Patient | Similarity | Baseline | Intervention | Outcome | Response today |
|---|---|---|---|---|---|
| P-01462 | 49% | S14 | ME-01 | improved | 41 |
| P-01813 | 47% | S02 | ME-01 | improved | 44 |
| P-01762 | 46% | S15 | ME-01 | improved | 42 |
| P-01888 | 46% | S12 | ME-01 | improved | 46 |
| P-01865 | 45% | S14 | ME-01 | improved | 46 |
| P-01556 | 44% | S14 | ME-01 | improved | 44 |
| P-01887 | 44% | S14 | ME-01 | improved | 48 |
| P-01492 | 43% | S14 | ME-01 | improved | 43 |
| P-01826 | 43% | S05 | ME-01 | improved | 51 |
| P-01858 | 43% | S01 | ME-01 | improved | 41 |
| P-01473 | 42% | S16 | NP-02 | improved | 46 |
| P-01612 | 42% | S04 | ME-01 | improved | 45 |