600 patients67,035 observations120 daysLIVE

Patient P-01778

Synthetic patientNBL-101 · Day 116 · 35–44 · M · baseline S17Steering view · 3DOpen companion preview
Is the drug working?

Therapy response 51 at the day-84 endpoint (observed).

Why responding?

Responding: response probability 58%, therapy response 58 today; biology is not blocking the drug.

Is a side effect starting?

Drift detected on day 83 (HRV −9 ms, resting HR +9 bpm, sleep −0.8 h, gi toxicity +35, inflammatory load +27); the side effect would have been reported on day 91 — 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 +4 bpm, HRV −8 ms.

last 9 doses · green confirmed · amber logged only · red missed
Plan for this patient
not yet offeredrecommendowner · Companionreview day 124Human Model →
Next action
GI-04 GI Support Protocol
56% probability of improvement
Kept if

81% of 284 similar trajectories improved after GI-04; if this one does, discontinuation risk is expected to fall from 55% to ~34%. Keeping fat low is worth 4.8 GI points a day on its own. Losing this patient costs €57k; the intervention costs €180.

Daily to-dos in the companion
  • 🍽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
  • Keep the current walking rhythm
  • 💊Take the scheduled dose as agreed with your care team
  • 💊Electrolyte solution, one sachet after any loose stool
Adherence
72% worsening

Partial adherence; to-dos are being skipped on symptomatic days.

Changes the plan if

GI burden above 62 for 3 days within the onset window

LLIFE OS insight
grounded · add an LLM key for prose

P-01778 is on day 116 of NBL-101 (LT, baseline S17): response improving, tolerance unstable, GI improving. Over 14 days response moved +6 and GI -10; discontinuation risk is 55%. The state is between basins, heading towards restoration, after diverging from the model on day 83.

Biology sets the gain: FUT2 non-secretor, Low butyrate capacity, Low microbial diversity; butyrate capacity 28/100, diversity 1.8. Pushing it down: Escherichia coli 32.033% (LPS load) (-36), Low butyrate capacity (-28.3), 6 keystone species absent (-21.2). From the daily log: fat +4.8 GI next day, alcohol +4.8 GI next day, histamine +4.7 GI next day, spicy +3.7 GI next day.

Past actions: CR-01 on day 82 → declined.

Next: GI-04 — 81% of 284 similar trajectories improved, 56% probability here. This would be contradicted by a further GI rise within the onset window or falling adherence.

Therapy response
Improving
Tolerance
Unstable
GI state
Improving
Inflammatory state
Unstable
Nutritional resilience
Unstable
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 S17
  2. Day 82 CR-01 recommendedClinician Review CR-01
  3. Day 83 Trajectory diverged from predictionObserved response fell below the model's expected path.
  4. Day 83 Patient declinedNot now

What changed?

Trajectory began diverging from predicted response on Day 83.

Primary contributors, last 14 days
  • Toxicity+27
  • GI instability-10
  • Inflammatory activity+9
  • Treatment adherence+7

What helped?

  • Clinician Review CR-01Day 82
    Declined by patient
LIFE OS recommendation
GI Support Protocol GI-04 what is this →
56%
probability of meaningful tolerance improvement
  • 284 similar trajectories
  • 81% showed improvement
  • median effect visible after 8 days

Daily trackers

Asset settings

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

GI burden
Companion
53.5/100
improving · -13.6 vs previous 14 d
Toxicity
Blood
62.7/100
worsening · +11.7 vs previous 14 d
Sleep quality
Wearable
38.5/100
improving · +5.2 vs previous 14 d
Energy level
Daily log
2.9/10
improving · +0.6 vs previous 14 d
Stress level
Daily log
6.3/10
improving · -0.4 vs previous 14 d
Steps
Wearable
6,268
improving · +627 vs previous 14 d
Adherence
Companion
71.5 %
worsening · -11.7 vs previous 14 d
This trajectory is doing well — what to keep, what to watch
Steering view →

Heading towards restoration · 37 from the failing basin, 57 from restoration.

Good elements to keep
  • Daily walks resumed
    perturbation · steering +3.3
Main detractors to watch
  • Escherichia coli 32.033% (LPS load)
    hidden · steering -36
  • Low butyrate capacity
    hidden · steering -28.3
  • 6 keystone species absent
    hidden · steering -21.2
  • Dietary fat load
    perturbation · steering -18.3
  • Dietary fat load
    detractor · GI +4.8 next day
  • Alcohol
    detractor · GI +4.8 next day
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.

  • Dietary fat load
    +4.8detractor · 95%
  • Alcohol
    +4.8detractor · 95%
  • Histamine load
    +4.7detractor · 95%
  • Spicy / capsaicin
    +3.7detractor · 90%
  • Simple carbohydrates
    +2.5detractor · 58%
  • Insoluble fibre
    -0.8no signal · 18%

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
89/100
vs baseline (day 0)
+39
0 improved · 21 worsened
synthetic signature · consistent with this patient's biology
  • 5 opportunists above range: Escherichia coli, Klebsiella pneumoniae, Enterococcus faecium
  • 6 keystone species absent
  • Shannon 1.92 (expected ≥ 3)
  • 11 resistance genes
  • Host DNA fragmentation atypical
  • Tissue recycling index 64
Pathogens / opportunists5/5
from 0
Keystone species6/8
from 3
Diversity2/2
from 1
Metabolic modules1/4
from 0
Vitamin synthesis5/7
from 3
Oral translocation1/1
Host DNA1/1
Tissue recycling1/1
Central mechanisms2/2
from 0
Species dominance1/1
from 0
Virulence factors6/6
from 3
Antibiotic resistance genes11/11
from 8
Genetic predisposition2/2
Opportunists above range
Escherichia coli 32.033% AR
Enterococcus faecium 16.017% AR
Klebsiella pneumoniae 9.61% AR
Streptococcus gallolyticus 3.203% AR
Keystone species absent
Akkermansia muciniphila, Bifidobacterium longum, Butyricicoccus pullicaecorum, Eubacterium rectale, Faecalibacterium prausnitzii
Capacity
Shannon 1.92 · butyrate 288 CPM · SCFA 641
H2S above band
5 vitamins below
Host & mechanisms
host DNA fragmentation atypical
tissue recycling 64/100
oral translocation 7.26% AR
molecular_mimicry above
estrobolome above
11 resistance genes · 6 virulence factors

Biological layers

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

Pathways under pressure
  • Butyrate / short-chain fatty acid production 55
    • MicrobiomeButyrate capacity 28/100
    • Daily logFibre intake low in recent food logs
  • Mucosal barrier integrity 50
    • DNAFUT2 non-secretor lowers mucosal fucosylation
    • Daily logGI symptom score 54 and rising
  • Inflammatory signalling 40
    • BloodInflammatory load index 62
    • WearableHRV 37 ms, trending down
  • Autonomic recovery 25
    • WearableResting HR 73 bpm
  • Drug metabolism and exposure 20
    • BloodToxicity index 63
DNA
Fictional pharmacogenomic panel
  • FUT2 rs601338 AA (non-secretor)
    Reduced mucosal fucosylation
  • CYP2D6 Normal metabolizer
    Expected exposure
Microbiome
Shannon diversity 1.8 · butyrate capacity 28/100
  • Akkermansia muciniphilaNormal
  • Faecalibacterium prausnitziiNormal
  • Bacteroides fragilisNormal
  • Bifidobacterium longumLow
  • EnterobacteriaceaeNormal
Wearable, last 14 days
daily evolution fed into the runtime
HRV
41 ms
Sleep
5.8 h
Steps
7,551
Resting HR
71 bpm
Daily log: GI score 54, nutritional resilience 39, adherence 72.

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
  • 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
What to do
  • Track each bowel movement today: time, stool form, urgency, overnight waking
  • Keep the current walking rhythm
  • Keep the sleep window steady
  • 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
  • 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.

PatientSimilarityBaselineInterventionOutcomeResponse today
P-0187742%S01CR-01improved61
P-0189729%S01SC-12improved49
P-0174627%S01NP-02improved40
P-0170625%S01NP-02improved42
P-0185825%S01ME-01improved41
P-0172524%S01CR-01improved62
P-0168422%S0164
P-0180022%S0136
P-0152621%S0165
P-0172421%S01SC-12no change60
P-0174821%S0167
P-0140728%S02GI-04improved43