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Define rule DDF99975: An Activity should refer to at least 1 Procedure, BiomedicalConceptSurrogate, BiomedicalConcept or BiomedicalConceptCategory #153
CHK0057: An activity should refer to at least 1 procedure, BC surrogate, BC or BC category An activity can be of one of these types
This means that an activity must reference at least one of these classes. I'm not sure whether an activity can reference a mixture of different types.