600 patients67,035 observations120 daysLIVE

Human Model · HM(t) at day 114

State-timeSynthetic demo data⟨ I, St, H0:t, Et, Θt, T, Ut ⟩ — belief, not fact; uncertainty shown, not hiddenSteering view
1
Localization — where is this individual biologically now?
Belief state b_t per dimension: value ± sd from within-person noise plus the observation model's semantic distance. Trajectory features (velocity, autocorrelation, recovery time) are state variables.
Dimensionb_tdS/dtautocorrrecoveryobservation model
Therapy response80 ± 8.7+0.22/d0.591 dImaging + tumour markers, interpolated · proxy · last read ≤ 14 d
Gastrointestinal function33 ± 6.2+0.39/d0.4220 dDaily GI check-in · direct · today
Treatment toxicity20 ± 9-0.02/d0.691 dLabs, interpolated between draws · proxy · last draw ≤ 7 d
Inflammatory activity34 ± 12.2+0.27/d0.41 dCRP/ferritin + immune signature · inferred · weeks
Immune / metabolic67 ± 11.1+0.07/d0.263 dMetabolic panel + wearable · inferred · weeks
Nutritional sufficiency57 ± 8.8-0.07/d0.622 dWeight, albumin, food log · proxy · days
Adherence97 ± 4.6-0.13/d0.615 dDose + to-do completion · direct · today
Function / quality of life73 ± 5.8-0.12/d0.359 dPRO items · direct · today

High autocorrelation and slow recovery are early-warning signatures of a critical transition (Scheffer et al.), independent of the level.

2
Provenance — how did they arrive here?
The path H_0:t: baseline constraints, divergence, perturbations, actions and responses in order.
  1. day 0baselineBaseline S03: EC-02 phenotype; Rapid metabolizer; butyrate 60
  2. day 17divergenceTrajectory diverged from the population model
  3. day 17noteTrajectory diverged from prediction
  4. day 51perturbationAlcohol on dosing days (-1.8)
  5. day 82perturbationPoor-sleep week (-3)

Now: in the restoration basin, heading towards failing.

3
Mechanism — which theories best explain the trajectory?
Versioned competing theories with supporting (E+), contradicting (E−) and missing-but-discriminative (E?) evidence. The contradiction engine lists what should NOT happen under each theory and whether it did.
T3 v1leading
confidence 52%

Drug-exposure toxicity: pharmacokinetic over-exposure drives GI and systemic toxicity together; dietary and microbial factors are secondary.

E+
  • DPYD variant
  • GI autocorrelation 0.76 (slow recovery)
E−
  • Rapid metabolizer
  • Toxicity within range
E? · would discriminate
  • Trough drug level
  • Dose-timing rechallenge (evening vs morning)
Forbidden under this theory
✓ holdsGI should not move with diet if exposure is the driver (0 dietary detractors with ≥ 80% confidence)
v1 baseline: pharmacogenomics
T4 v1competing
confidence 28%

Behavioural spiral: symptomatic days cut adherence and sleep, which raise GI and stress, which cut adherence further; the biology is a follower, not the driver.

E+
  • Sleep quality worsening
E−
  • Adherence intact
E? · would discriminate
  • Dose-taking timestamps vs symptom timestamps
  • Sleep-window rechallenge
Forbidden under this theory
✓ holdsGI should not worsen on days with full adherence and good sleep (insufficient paired days)
v1 from tracker trends
T1 v2competing
confidence 15%

Mucosal barrier loss: drug-induced epithelial injury amplified by a FUT2-dependent glycan deficit; histamine and inflammatory load add on top.

E+
  • DeepGene: Escherichia coli above range (LPS / zonulin)
E−
  • No FUT2 variant
  • No histamine signal in the log
E? · would discriminate
  • Faecal calprotectin (would separate barrier from motility)
  • Serum DAO / histamine
  • Zonulin
Forbidden under this theory
✓ holdsGI should not improve while histamine intake stays high (GI velocity 0.77/day)
✓ holdsLow-residue meals should reduce GI within a week (not tested)
v1 baseline: genotype + phenotype → v3 dietary attribution from 60-day log
T2 v2falsified
confidence 6%

Bile-acid diarrhoea on a low-butyrate ecology: reduced SCFA production leaves bile acids unconjugated after fat-rich meals; GI burden tracks fat intake with a one-day lag.

E+
E−
  • Butyrate producers intact
  • No fat-load signal in the log
E? · would discriminate
  • Faecal bile acids
  • 7α-hydroxy-4-cholesten-3-one (C4)
  • Rechallenge: 3 high-fat days under observation
Forbidden under this theory
✗ violatedGI should not rise on low-fat days (fat effect -1 over 41 low-fat days)
v1 baseline: microbiome → v2 dietary attribution
4
Forecast — which futures are likely under alternative actions?
30-day rollout of GI burden under the baseline model T and under each safe candidate action (effect ramps over onset). Dashed = prediction, never fact.
No action
GI 3320
8
Intervention as measurement
Each past action as a measurement of this patient's transition dynamics: predicted ΔGI vs observed, prediction error ε_t, and the within-patient evidence patterns → individualized response confidence (observational, kept separate from randomized evidence).

No action started yet.

5
Decision — the Restore controller
Safe set computed first, then A* = argmax E[HealthGain + λ₁·InformationGain + λ₂·ConfidenceGain − λ₃·Risk − λ₄·Burden − λ₅·Cost]. λ₁ = 0.3 (a theory leads), λ₃ = 1 (stable enough). Execution stays with the clinician or the informed patient (EU MDR Class I).
ClassActionHealthInfoConf.RiskBurdenCostUtility
ObserveContinue passive collection, no perturbation
A clean transition can be observed only without a new perturbation.
00.150.0500.0500.03
MeasureTrough drug level
Discriminates T3 from its competitors (E?).
00.450.20.020.250.20.01
MaintainHold current regimen and content
Protects nothing while the state deteriorates.
0.050.050.050.050.0500
TestDose-timing rechallenge (evening vs morning)
Discriminates T3 from its competitors (E?).
00.450.20.020.250.5-0.05
Excluded from the safe set
  • GI-04 Not indicated for the current state.
  • DT-01 Not indicated for the current state.
  • CR-01 Not indicated for the current state.
  • HY-01 Not indicated for the current state.
  • BR-03 Not indicated for the current state.
  • ME-01 Not indicated for the current state.
  • AD-05 Not indicated for the current state.
  • NP-02 Not indicated for the current state.
  • SC-12 Not indicated for the current state.
Evidence weights · w = Authority × Relevance × Persistence
  • Biological identity Rapid metabolizer; DPYD, CYP2D6, MTHFR
    Germline panel, baseline
    0.86 (0.95·0.9·1)
  • High-authority clinical Toxicity 20, response 80
    Labs / imaging, ≤ 14 d
    0.77 (0.9·1·0.85)
  • Intervention response 0 within-patient responses recorded
    ΔS after each action, accumulating
    0.68 (0.75·1·0.9)
  • Deep biological state DeepGene retest day 90: damage 32/100, Shannon 3.1, butyrate 789 CPM, 3 opportunists above, 2 keystone absent
    Synthetic DeepGene metagenomics + host DNA, sample 910954-R (compositional proxy)
    0.55 (0.7·1·0.78)
  • Dynamic state GI 33, sleep 6.5 h, HRV 56
    Companion + wearable, today
    0.18 (0.6·1·0.3)
  • Exposure context Keep meals regular; three to four moderate portions spaced through the day; dosing per protocol; adherence 97%
    Food log + dose log, event-level
    0.1 (0.55·0.9·0.2)
LLIFE OS insight · the five questions, in prose
grounded · add an LLM key for prose

P-01479 is on day 114 of NBL-101 (EC-02, baseline S03): response favorable, tolerance favorable, GI deteriorating. Over 14 days response moved +1 and GI +5; discontinuation risk is 27%. The state is in the restoration basin, heading towards failing, after diverging from the model on day 17.

Butyrate capacity 60/100, diversity 3.5, rapid metabolizer. Pushing it down: Escherichia coli 9.78% (LPS load) (-25.8), Rapid metabolizer (-12.7), Poor-sleep week (-3). Pulling it up: Butyrate producers intact (+11.9).

No action has been tried yet.

No action is indicated now; the trajectory is stable relative to similar patients.