NPASS Compound

Natural Product: NPC174342

Natural Product ID	NPC174342
Common Name ? The InCHIKey will be temporarily assigned as the "Common Name" if no IUPAC name or alternative short name is available.	Wightionolide
IUPAC Name	4-[2-[(1R,2S,4aS,8aS)-2,5,5-tris(hydroxymethyl)-8a-methyl-1,2,3,4,4a,6,7,8-octahydronaphthalen-1-yl]ethyl]-2H-furan-5-one
Synonyms
Synthetic Gene Cluster	n.a.
ChEMBL Identifier	CHEMBL2269920
PubChem CID	76326826
Chemical Classification	CHEMONTID:0000000 [Organic compounds] [CHEMONTID:0000012] Lipids and lipid-like molecules [CHEMONTID:0000259] Prenol lipids [CHEMONTID:0001283] Terpene lactones [CHEMONTID:0001538] Diterpene lactones

The Chemical Classification was calculated by Classyfire, a software for chemical taxonomy calculation. Reference: DOI:10.1186/s13321-016-0174-y.

Chemical Representations

RDKit 3D 57 59 0 0 0 0 0 0 0 0999 V2000 0.9985 -3.4356 -2.4946 O 0 0 0 0 0 0 0 0 0 0 0 0 0.6117 -2.9868 -1.2206 C 0 0 0 0 0 0 0 0 0 0 0 0 0.9215 -1.5108 -1.1437 C 0 0 1 0 0 0 0 0 0 0 0 0 0.1645 -0.7926 -2.1954 C 0 0 0 0 0 0 0 0 0 0 0 0 -1.2607 -0.6441 -1.8224 C 0 0 0 0 0 0 0 0 0 0 0 0 -1.5547 -0.5115 -0.3580 C 0 0 1 0 0 0 0 0 0 0 0 0 -0.4125 -0.1113 0.5165 C 0 0 1 0 0 0 0 0 0 0 0 0 0.7958 -0.9142 0.2274 C 0 0 2 0 0 0 0 0 0 0 0 0 2.1123 -0.3841 0.6780 C 0 0 0 0 0 0 0 0 0 0 0 0 2.7626 0.6537 -0.1689 C 0 0 0 0 0 0 0 0 0 0 0 0 4.0753 1.1068 0.4102 C 0 0 0 0 0 0 0 0 0 0 0 0 4.3295 2.3528 0.7601 C 0 0 0 0 0 0 0 0 0 0 0 0 5.7071 2.4968 1.2997 C 0 0 0 0 0 0 0 0 0 0 0 0 6.2050 1.1960 1.2171 O 0 0 0 0 0 0 0 0 0 0 0 0 5.2593 0.3265 0.6884 C 0 0 0 0 0 0 0 0 0 0 0 0 5.3745 -0.8952 0.4804 O 0 0 0 0 0 0 0 0 0 0 0 0 -0.2250 1.3713 0.6516 C 0 0 0 0 0 0 0 0 0 0 0 0 -0.8823 -0.5266 1.9364 C 0 0 0 0 0 0 0 0 0 0 0 0 -2.1645 0.0815 2.3406 C 0 0 0 0 0 0 0 0 0 0 0 0 -3.2360 0.1851 1.3301 C 0 0 0 0 0 0 0 0 0 0 0 0 -2.8578 0.1570 -0.1005 C 0 0 0 0 0 0 0 0 0 0 0 0 -3.1007 1.4687 -0.7813 C 0 0 0 0 0 0 0 0 0 0 0 0 -4.3960 1.8751 -0.3628 O 0 0 0 0 0 0 0 0 0 0 0 0 -3.8840 -0.7810 -0.8033 C 0 0 0 0 0 0 0 0 0 0 0 0 -5.1460 -0.2333 -0.6155 O 0 0 0 0 0 0 0 0 0 0 0 0 1.9479 -3.1103 -2.6024 H 0 0 0 0 0 0 0 0 0 0 0 0 -0.3981 -3.2755 -0.9626 H 0 0 0 0 0 0 0 0 0 0 0 0 1.3266 -3.4917 -0.5116 H 0 0 0 0 0 0 0 0 0 0 0 0 2.0119 -1.4712 -1.4644 H 0 0 0 0 0 0 0 0 0 0 0 0 0.6123 0.1757 -2.5006 H 0 0 0 0 0 0 0 0 0 0 0 0 0.2300 -1.4222 -3.1317 H 0 0 0 0 0 0 0 0 0 0 0 0 -1.8301 -1.5145 -2.2696 H 0 0 0 0 0 0 0 0 0 0 0 0 -1.6482 0.2296 -2.4277 H 0 0 0 0 0 0 0 0 0 0 0 0 -1.7596 -1.5868 -0.0270 H 0 0 0 0 0 0 0 0 0 0 0 0 0.6618 -1.8673 0.8780 H 0 0 0 0 0 0 0 0 0 0 0 0 2.0997 -0.0904 1.7721 H 0 0 0 0 0 0 0 0 0 0 0 0 2.8459 -1.2524 0.6981 H 0 0 0 0 0 0 0 0 0 0 0 0 2.2007 1.5289 -0.4456 H 0 0 0 0 0 0 0 0 0 0 0 0 3.0934 0.2013 -1.1645 H 0 0 0 0 0 0 0 0 0 0 0 0 3.6526 3.2140 0.6862 H 0 0 0 0 0 0 0 0 0 0 0 0 5.6523 2.9077 2.3136 H 0 0 0 0 0 0 0 0 0 0 0 0 6.2456 3.2212 0.6554 H 0 0 0 0 0 0 0 0 0 0 0 0 -0.1009 1.9294 -0.2721 H 0 0 0 0 0 0 0 0 0 0 0 0 -1.0485 1.8158 1.2979 H 0 0 0 0 0 0 0 0 0 0 0 0 0.6579 1.5742 1.2900 H 0 0 0 0 0 0 0 0 0 0 0 0 -0.0934 -0.2601 2.6466 H 0 0 0 0 0 0 0 0 0 0 0 0 -1.0186 -1.6390 1.8852 H 0 0 0 0 0 0 0 0 0 0 0 0 -2.5502 -0.5762 3.1849 H 0 0 0 0 0 0 0 0 0 0 0 0 -2.0383 1.0685 2.8834 H 0 0 0 0 0 0 0 0 0 0 0 0 -4.0146 -0.6123 1.5398 H 0 0 0 0 0 0 0 0 0 0 0 0 -3.8213 1.1339 1.5549 H 0 0 0 0 0 0 0 0 0 0 0 0 -3.2074 1.3899 -1.8801 H 0 0 0 0 0 0 0 0 0 0 0 0 -2.4451 2.2899 -0.5411 H 0 0 0 0 0 0 0 0 0 0 0 0 -4.3592 2.6193 0.2641 H 0 0 0 0 0 0 0 0 0 0 0 0 -3.7776 -1.8056 -0.4507 H 0 0 0 0 0 0 0 0 0 0 0 0 -3.6910 -0.7681 -1.8960 H 0 0 0 0 0 0 0 0 0 0 0 0 -5.6339 -0.1003 -1.4722 H 0 0 0 0 0 0 0 0 0 0 0 0 1 2 1 0 2 3 1 0 3 4 1 0 4 5 1 0 5 6 1 0 6 7 1 0 7 8 1 0 8 9 1 0 9 10 1 0 10 11 1 0 11 12 2 0 12 13 1 0 13 14 1 0 14 15 1 0 15 16 2 0 7 17 1 1 7 18 1 0 18 19 1 0 19 20 1 0 20 21 1 0 21 22 1 0 22 23 1 0 21 24 1 0 24 25 1 0 8 3 1 0 15 11 1 0 21 6 1 0 1 26 1 0 2 27 1 0 2 28 1 0 3 29 1 6 4 30 1 0 4 31 1 0 5 32 1 0 5 33 1 0 6 34 1 1 8 35 1 1 9 36 1 0 9 37 1 0 10 38 1 0 10 39 1 0 12 40 1 0 13 41 1 0 13 42 1 0 17 43 1 0 17 44 1 0 17 45 1 0 18 46 1 0 18 47 1 0 19 48 1 0 19 49 1 0 20 50 1 0 20 51 1 0 22 52 1 0 22 53 1 0 23 54 1 0 24 55 1 0 24 56 1 0 25 57 1 0 M END

Standard InCHIKey	ISJXTDPNEXILTC-VXNCWWDNSA-N
Standard InCHI	InChI=1S/C20H32O5/c1-19-8-2-9-20(12-22,13-23)17(19)6-4-15(11-21)16(19)5-3-14-7-10-25-18(14)24/h7,15-17,21-23H,2-6,8-13H2,1H3/t15-,16-,17+,19+/m1/s1
SMILES	OC[C@H]1CC[C@H]2[C@@]([C@@H]1CCC1=CCOC1=O)(C)CCCC2(CO)CO

Calculated Properties

Physi-Chem Properties

Molecular Weight:	352.22	Volume:	367.485 ? Van der Waals volume.
Dense:	0.958	LogP:	0.784 ? The logarithm of the n-octanol/water distribution coefficients.
logD7.4:	1.131 ? The logarithm of the n-octanol/water distribution coefficient at pH=7.4.	LogS:	-2.328 ? The logarithm of aqueous solubility value.
Rotatable Bonds:	6.0	Rigid Bonds:	17.0
TPSA:	86.99 ? Topological Polar Surface Area.	H-Bond Acceptor:	5.0
H-Bond Donor:	3.0	Rings:	3.0
Heavy Atoms:	5.0

MedChem Properties

QED Drug-Likeness Score:	0.637	GASA:	1.0 ? GASA represents the probability of being difficult to synthesize, ranging from 0 to 1.
Synthetic Accessibility Score:	4.616	Fsp³:	0.85
MCE-18:	51.892 ? MCE-18 stands for medicinal chemistry evolution.MCE-18≥45 is considered a suitable value.	Lipinski Rule-of-5:	Rejected
Pfizer Rule:	Rejected	GSK Rule:	Rejected
Golden Triangle Rule:	Rejected	BMS Rule:	0
Chelating Alert:	0	PAINS Alert:	0
Colloidal aggregators:	0.115	Fluc inhibitor:	0.043 ? The fluc inhibitor value is the probability of being fLuc inhibitors, within the range of 0 to 1.
Blue fluorescence:	0.005 ? The blue fluorescence value is the probability of being blue fluorescence, within the range of 0 to 1	Green fluorescence:	0.0 ? The green fluorescence value is the probability of being green fluorescence, within the range of 0 to 1
Reactive compounds:	0.505	Promiscuous compounds:	0.318

ADMET Properties (ADMETlab3.0)

ADMET: Absorption

Caco-2 Permeability:	-5.325	MDCK Permeability:	-4.796
Pgp-inhibitor:	0.021	Pgp-substrate:	0.051
PAMPA:	0.559 ? The experimental data for Peff was logarithmically transformed (logPeff). Molecules with log Peff values below 2.0 were classified as low-permeability (Category 0), while those with log Peff values exceeding 2.5 were classified as high-permeability (Category 1).	Human Intestinal Absorption (HIA):	0.073
20% Bioavailability (F20%):	0.263	30% Bioavailability (F30%):	0.408
50% Bioavailability (F50%):	0.866

ADMET: Distribution

Blood-Brain-Barrier Penetration (BBB):	0.434	MRP1:	0.312
Plasma Protein Binding (PPB):	32.605%	Volume Distribution (VD):	-0.238
Fu:	73.525% ? The fraction unbound in plasms.	OATP1B1 inhibitor:	0.386
OATP1B3 inhibitor:	0.575	BCRP inhibitor:	0.009
BSEP inhibitor:	0.347

ADMET: Metabolism

CYP1A2-inhibitor:	0.0	CYP1A2-substrate:	0.0
CYP2C19-inhibitor:	0.0	CYP2C19-substrate:	0.0
CYP2C9-inhibitor:	0.968	CYP2C9-substrate:	0.0
CYP2D6-inhibitor:	0.081	CYP2D6-substrate:	0.006
CYP3A4-inhibitor:	0.267	CYP3A4-substrate:	0.169
CYP2B6-substrate:	0.0	CYP2C8-inhibitor:	0.413
HLM stability:	0.0 ? Human liver microsomal (HLM) stability. Category 0: stable+ (HLM > 30 min); Category 1: unstable- (HLM ≤ 30 min). The output value is the probability of human liver microsomal instability, where a value closer to 1 indicates a higher likelihood of instability.

ADMET: Excretion

Clearance (CL):

6.04

Half-life (T1/2):

1.607

ADMET: Toxicity

hERG Blockers:	0.036	hERG Blockers (10um):	0.182
Human Hepatotoxicity (H-HT):	0.527	Drug-induced Liver Injury (DILI):	0.045
AMES Toxicity:	0.533	Rat Oral Acute Toxicity:	0.102
Maximum Recommended Daily Dose:	0.408	Skin Sensitization:	0.996
Carcinogencity:	0.924	Eye Corrosion:	0.005
Eye Irritation:	0.482	Respiratory Toxicity:	0.261
Drug-induced Neurotoxicity:	0.064	Ototoxicity:	0.632
Hematotoxicity:	0.575	Drug-induced Nephrotoxicity:	0.742
Genotoxicity:	0.059	RPMI-8226 Immunitoxicity:	0.057
A549 Cytotoxicity:	0.071	Hek293 Cytotoxicity:	0.188
BCF:	0.888 ? Bioconcentration factors are used for considering secondary poisoning potential and assessing risks to human health via the food chain. The unit is -log10[(mg/L)/(1000*MW)].	IGC50:	3.622 ? 48 hour Tetrahymena pyriformis IGC50. The unit of IGC50 is -log10[(mg/L)/(1000*MW)].
LC50DM:	5.321 ? 48 hour Daphnia magna LC50. The unit of LC50DM is -log10[(mg/L)/(1000*MW)].	LC50FM:	4.325 ? 96 hour fathead minnow LC50. The unit of LC50FM is -log10[(mg/L)/(1000*MW)].

Species Source

Organism ID	Organism Name	Taxonomy Level	Family	SuperKingdom	Isolation Part	Collection Location	Collection Time	Reference
NPO17551	Phytolacca americana	Species	Phytolaccaceae	Eukaryota	roots	n.a.	n.a.	PMID[18177012]
NPO17551	Phytolacca americana	Species	Phytolaccaceae	Eukaryota	Seeds	n.a.	n.a.	PMID[26595875]
NPO17278	Mitragyna parvifolia	Species	Rubiaceae	Eukaryota	n.a.	n.a.	n.a.	Database[COCONUT]
NPO18552	Cucumaria conicospermium	Species	Cucumariidae	Eukaryota	n.a.	n.a.	n.a.	Database[COCONUT]
NPO19471	Ascobulla ulla	Species	n.a.	Eukaryota	n.a.	n.a.	n.a.	Database[COCONUT]
NPO19661	Nectria cinnabarina	Species	Nectriaceae	Eukaryota	n.a.	n.a.	n.a.	Database[COCONUT]
NPO17551	Phytolacca americana	Species	Phytolaccaceae	Eukaryota	n.a.	n.a.	n.a.	Database[COCONUT]
NPO17551	Phytolacca americana	Species	Phytolaccaceae	Eukaryota		n.a.	n.a.	Database[FooDB]
NPO17551	Phytolacca americana	Species	Phytolaccaceae	Eukaryota	Shoot	n.a.	n.a.	Database[FooDB]
NPO17551	Phytolacca americana	Species	Phytolaccaceae	Eukaryota	Fruit	n.a.	n.a.	Database[FooDB]
NPO17551	Phytolacca americana	Species	Phytolaccaceae	Eukaryota	n.a.	n.a.	n.a.	Database[HerDing]
NPO17551	Phytolacca americana	Species	Phytolaccaceae	Eukaryota	n.a.	n.a.	n.a.	Database[TCMID]
NPO17551	Phytolacca americana	Species	Phytolaccaceae	Eukaryota	n.a.	n.a.	n.a.	Database[TCM_Taiwan]
NPO17551	Phytolacca americana	Species	Phytolaccaceae	Eukaryota	n.a.	n.a.	n.a.	Database[TM-MC]
NPO17278	Mitragyna parvifolia	Species	Rubiaceae	Eukaryota	n.a.	n.a.	n.a.	Database[UNPD]
NPO20300	Trapa maeotica	Species	Lythraceae	Eukaryota	n.a.	n.a.	n.a.	Database[UNPD]
NPO4008	Blaps lethifera	Species	Tenebrionidae	Eukaryota	n.a.	n.a.	n.a.	Database[UNPD]
NPO17665	Aria tomentosa	Species	Rosaceae	Eukaryota	n.a.	n.a.	n.a.	Database[UNPD]
NPO18552	Cucumaria conicospermium	Species	Cucumariidae	Eukaryota	n.a.	n.a.	n.a.	Database[UNPD]
NPO19661	Nectria cinnabarina	Species	Nectriaceae	Eukaryota	n.a.	n.a.	n.a.	Database[UNPD]
NPO18879	Drosera auriculata	Species	Droseraceae	Eukaryota	n.a.	n.a.	n.a.	Database[UNPD]
NPO19471	Ascobulla ulla	Species	n.a.	Eukaryota	n.a.	n.a.	n.a.	Database[UNPD]
NPO17551	Phytolacca americana	Species	Phytolaccaceae	Eukaryota	n.a.	n.a.	n.a.	Database[UNPD]

Note for Reference:
In addition to directly collecting NP source organism data from primary literature (where reference will provided as NCBI PMID or DOI links), NPASS also integrated them from below databases:
☉ UNPD: Universal Natural Products Database [PMID: 23638153].
☉ StreptomeDB: a database of streptomycetes natural products [PMID: 33051671].
☉ TM-MC: a database of medicinal materials and chemical compounds in Northeast Asian traditional medicine [PMID: 26156871].
☉ TCM@Taiwan: a Traditional Chinese Medicine database [PMID: 21253603].
☉ TCMID: a Traditional Chinese Medicine database [PMID: 29106634].
☉ TCMSP: The traditional Chinese medicine systems pharmacology database and analysis platform [PMID: 24735618].
☉ HerDing: a herb recommendation system to treat diseases using genes and chemicals [PMID: 26980517].
☉ MetaboLights: a metabolomics database [PMID: 27010336].
☉ FooDB: a database of constituents, chemistry and biology of food species [www.foodb.ca].

NP Quantity Composition/Concentration

Organism ID	Organism Name	Organism Material Preparation	Organism Part	NP Quantity (Standard)	NP Quantity (Minimum)	NP Quantity (Maximum)	Quantity Unit	Reference

Note for Reference:
In addition to directly collecting NP quantitative data from primary literature (where reference will provided as NCBI PMID or DOI links), NPASS also integrated NP quantitative records for specific NP domains (e.g., NPS from foods or herbs) from domain-specific databases. These databases include:
☉ DUKE: Dr. Duke's Phytochemical and Ethnobotanical Databases.
☉ PHENOL EXPLORER: is the first comprehensive database on polyphenol content in foods [PMID: 24103452], its homepage can be accessed at here.
☉ FooDB: a database of constituents, chemistry and biology of food species [www.foodb.ca].

Biological Activity

Activity Type	# Activity
Activity	6

Activity Type	# Activity
Organism	6

Molecular-level activity

Target ID	Target Type	Target Name	Target Organism	Activity Type	Activity Relation	Value	Unit	Reference

In vitro activity

Target ID	Target Type	Target Name	Target Organism	Activity Type	Activity Relation	Value	Unit	Reference
NPT1369	Organism	Henosepilachna vigintioctopunctata	Henosepilachna vigintioctopunctata	Activity	=	-14.03	%	DOI[10.1016/S0367-326X(99)00033-7]
NPT1369	Organism	Henosepilachna vigintioctopunctata	Henosepilachna vigintioctopunctata	Activity	=	-4.1	%	DOI[10.1016/S0367-326X(99)00033-7]
NPT1369	Organism	Henosepilachna vigintioctopunctata	Henosepilachna vigintioctopunctata	Activity	=	18.42	%	DOI[10.1016/S0367-326X(99)00033-7]
NPT1369	Organism	Henosepilachna vigintioctopunctata	Henosepilachna vigintioctopunctata	Activity	=	-11.72	%	DOI[10.1016/S0367-326X(99)00033-7]
NPT1369	Organism	Henosepilachna vigintioctopunctata	Henosepilachna vigintioctopunctata	Activity	=	-52.79	%	DOI[10.1016/S0367-326X(99)00033-7]
NPT1369	Organism	Henosepilachna vigintioctopunctata	Henosepilachna vigintioctopunctata	Activity	=	7.15	%	DOI[10.1016/S0367-326X(99)00033-7]

In vivo activity

Target ID	Target Type	Target Name	Target Organism	Activity Type	Activity Relation	Value	Unit	Reference

Experimental ADME

Experiment Model	Experiment Tissue	ADME Type	ADME Relation	ADME Value	ADME Unit	Reference

Experimental Toxicity

Quantitative toxicity

Experiment Model	Experiment Organism	Toxicity Type	Toxicity Relation	Toxicity Value	Toxicity Unit	Reference

Common Abbreviations:
LC: Lethal Concentration; LD: Lethal Dose; LT:Lethal Time; NOAEL: No-observed-adverse-effect Level; BMDL: Benchmark Dose Lower Confidence Limit; BMD: Benchmark Dose; BMC:Benchmark Concentration; LOAEL: Lowest Observed Adverse Effect Level; RfD:Reference Dose; RfC:Reference Concentration; MRL: Minimal Risk Level; MEG: Maximum Exposure Guideline; PAC: Protective Action Criteria

Categorical toxicity labels

Hepatotoxicity	Carcinogenicity	Mutagenicity	Cardiotoxicity	Respiratory Toxicity	Eye Irritation	Endocrine Disruption

Note for Reference:
In addition to directly collecting NP quantitative data from primary literature (where reference will provided as NCBI PMID or DOI links), NPASS also integrated NP toxicity records from domain-specific databases. These databases include:
☉ ToxValDB: a curated database that compiles quantitative toxicity values for chemicals from diverse public sources to support toxicological research and risk assessment.
☉ TOXRIC: a comprehensive, free-to-access, online database providing toxicological/feature data. The toxicity labels are retrieved from this database. [PMID: 36400569]

Chemically structural similarity

Similar Active Natural Products in NPASS

Top-200 similar NPs were calculated against the active-NP-set (includes approximately 50,000 NPs with experimentally-derived bioactivity available in NPASS)

Similarity is measured using the Tanimoto coefficient (Tc) , which compares the binary fingerprints of two molecules. Tc is calculated as the intersection divided by the union of '1' bits in the fingerprints, ranging from 0 to 1, with 1 indicating highest similarity.

● The left chart: Distribution of similarity level between NPC174342 and all remaining natural products in the NPASS database.
● The right table: Most similar natural products (Tc>=0.5 or Top200).

range	Tanimoto Coefficient
0-0.1	17483
0.1-0.2	27414
0.2-0.3	4748
0.3-0.4	178
0.4-0.5	32
0.5-0.6	3
0.6-0.7	0
0.7-0.8	0
0.8-0.85	0
0.85-0.9	0
0.9-0.95	0
0.95-1	0

Similarity Score	Similarity Level	Natural Product ID
0.5789	Remote Similarity	NPC106416
0.5789	Remote Similarity	NPC86316
0.5789	Remote Similarity	NPC609165

Similar Clinical/Approved Drugs

Similarity level is defined by Tanimoto coefficient (Tc) between two molecules.

● The left chart: Distribution of similarity level between NPC174342 and all drugs/candidates.
● The right table: Most similar clinical/approved drugs (Tc>=0.5 or Top200).

range	Tanimoto Coefficient
0-0.1	6031
0.1-0.2	2936
0.2-0.3	180
0.3-0.4	1
0.4-0.5	2
0.5-0.6	0
0.6-0.7	0
0.7-0.8	0
0.8-0.85	0
0.85-0.9	0
0.9-0.95	0
0.95-1	0

Similarity Score	Similarity Level	Drug ID	Developmental Stage
		NPD

Bioactivity similarity

Similar Natural Products in NPASS

Similarity level is defined by Bioactivity similarity was calculated based on bioactivity descriptors of compounds. The bioactivity descriptors were calculated by a recently developed AI algorithm Chemical Checker (CC) [Nature Biotechnology, 38:1087–1096, 2020; Nature Communications, 12:3932, 2021], which evaluated bioactivity similarities at five levels:
☉ A: chemistry similarity;
☉ B: biological targets similarity;
☉ C: networks similarity;
☉ D: cell-based bioactivity similarity;
☉ E: similarity based on clinical data.
Those 5 categories of CC bioactivity descriptors were calculated and then subjected to manifold projection using UMAP algorithm, to project all NPs on a 2-Dimensional space. The current NP was highlighted with a small circle in the 2-D map. Below figures: left-to-right, A-to-E.

A: chemistry similarity

B: biological targets similarity

C: networks similarity

D: cell-based bioactivity similarity

E: similarity based on clinical data