Human Model · HM(t) at day 148

State-timeSynthetic demo data⟨ I, S_t, H_0:t, E_t, Θ_t, T, U_t ⟩ — belief, not fact; uncertainty shown, not hiddenSteering view

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.

Dimension	b_t	dS/dt	autocorr	recovery	observation model
Therapy response	62 ± 9	-0.63/d	0.79	16 d	Imaging + tumour markers, interpolated · proxy · last read ≤ 14 d
Gastrointestinal function	19 ± 6.3	-0.6/d	0.86	—	Daily GI check-in · direct · today
Treatment toxicity	19 ± 7.3	+0.14/d	0.44	5 d	Labs, interpolated between draws · proxy · last draw ≤ 7 d
Inflammatory activity	29 ± 10.9	-0.18/d	0.54	1 d	CRP/ferritin + immune signature · inferred · weeks
Immune / metabolic	59 ± 11.3	-0.2/d	0.03	7 d	Metabolic panel + wearable · inferred · weeks
Nutritional sufficiency	66 ± 7.9	+0.35/d	0.46	1 d	Weight, albumin, food log · proxy · days
Adherence	91 ± 4.8	-0.12/d	0.73	7 d	Dose + to-do completion · direct · today
Function / quality of life	66 ± 5.7	-0.1/d	0.39	1 d	PRO items · direct · today

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

Provenance — how did they arrive here?

The path H_0:t: baseline constraints, divergence, perturbations, actions and responses in order.

day 0baselineBaseline S15: MR phenotype; Normal metabolizer; butyrate 75
day 87perturbationDaily walks resumed (3.3)
day 122perturbationDietary drift (-2.6)

Now: in the restoration basin, heading towards failing.

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.

T1 v2leading

confidence 86%

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

E+

FUT2 non-secretor genotype (barrier glycan deficit)
Histamine load → GI +3.6 next day

E−

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 -0.31/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 5%

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 -1.2 over 44 low-fat days)

v1 baseline: microbiome → v2 dietary attribution

T3 v1falsified

confidence 5%

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

E+

GI autocorrelation 0.83 (slow recovery)

E−

Normal metabolizer
Toxicity within range

E? · would discriminate

Trough drug level
Dose-timing rechallenge (evening vs morning)

Forbidden under this theory

✗ violatedGI should not move with diet if exposure is the driver (2 dietary detractors with ≥ 80% confidence)

v1 baseline: pharmacogenomics

T4 v1competing

confidence 5%

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+

E−

Adherence intact
Sleep and stress stable

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

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 19 → 24

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.

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).

Class	Action	Health	Info	Conf.	Risk	Burden	Cost	Utility
Observe	Continue passive collection, no perturbation A clean transition can be observed only without a new perturbation.	0	0.15	0.05	0	0.05	0	0.03
Measure	Faecal calprotectin (would separate barrier from motility) Discriminates T1 from its competitors (E?).	0	0.45	0.2	0.02	0.25	0.2	0.01
Maintain	Hold current regimen and content Protects nothing while the state deteriorates.	0.05	0.05	0.05	0.05	0.05	0	0
Test	Serum DAO / histamine Discriminates T1 from its competitors (E?).	0	0.45	0.2	0.02	0.25	0.5	-0.05

Excluded from the safe set

DT-01 Not indicated for the current state.
GI-04 Not indicated for the current state.
HY-01 Not indicated for the current state.
ME-01 Not indicated for the current state.
AD-05 Not indicated for the current state.
CR-01 Not indicated for the current state.
BR-03 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 Normal metabolizer; FUT2, IL6, CYP2D6
Germline panel, baseline
0.86 (0.95·0.9·1)
High-authority clinical Toxicity 19, response 62
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 13/100, Shannon 3.42, butyrate 776 CPM, 1 opportunists above, 1 keystone absent
Synthetic DeepGene metagenomics + host DNA, sample 966746-R (compositional proxy)
0.43 (0.7·1·0.6100000000000001)
Dynamic state GI 19, sleep 8.3 h, HRV 38
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 91%
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-03091 is on day 148 of ONX-7 (MR, baseline S15): response favorable, tolerance favorable, GI favorable. Over 14 days response moved 0 and GI 0; discontinuation risk is 15%. The state is in the restoration basin, heading towards failing.

Biology sets the gain: FUT2 non-secretor, IL6 high-expression variant; butyrate capacity 75/100, diversity 3.4. Pushing it down: FUT2 non-secretor (-20.9), Clostridioides difficile 0.809% (LPS load) (-18.7), Histamine load (-15.2). Pulling it up: Protein (supports) (+14.8), Butyrate producers intact (+14.7). From the daily log: histamine +3.6 GI next day, protein -3.2 GI next day, lactose +2.4 GI next day.

No action has been tried yet.

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