Proposed Data Collection Submitted for Public Comment and Recommendations, 36581-36583 [2023-11859]
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Federal Register / Vol. 88, No. 107 / Monday, June 5, 2023 / Notices
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ddrumheller on DSK120RN23PROD with NOTICES1
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17:59 Jun 02, 2023
Jkt 259001
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Marquita Cullom,
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[FR Doc. 2023–11869 Filed 6–2–23; 8:45 am]
BILLING CODE 4160–90–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[60Day–23–23FJ; Docket No. CDC–2023–
0042]
Proposed Data Collection Submitted
for Public Comment and
Recommendations
Centers for Disease Control and
Prevention (CDC), Department of Health
and Human Services (HHS).
ACTION: Notice with comment period.
AGENCY:
The Centers for Disease
Control and Prevention (CDC), as part of
its continuing effort to reduce public
burden and maximize the utility of
government information, invites the
general public and other federal
agencies the opportunity to comment on
a proposed information collection, as
required by the Paperwork Reduction
Act of 1995. This notice invites
comment on a proposed information
SUMMARY:
PO 00000
Frm 00056
Fmt 4703
Sfmt 4703
36581
collection project titled Evaluating Deep
Learning Algorithm Assessment of
Digital Photographs for Dental Public
Health Surveillance. This project entails
one-time data collection of oral health
data from 1,000 school students to
examine the feasibility and validity of
using digital photos taken by non-dental
professionals, which are analyzed by
deep learning algorithms to assess
youth’s oral health status.
DATES: CDC must receive written
comments on or before August 4, 2023.
ADDRESSES: You may submit comments,
identified by Docket No. CDC–2023–
0042 by any of the following methods:
• Federal eRulemaking Portal:
www.regulations.gov. Follow the
instructions for submitting comments.
• Mail: Jeffrey M. Zirger, Information
Collection Review Office, Centers for
Disease Control and Prevention, 1600
Clifton Road NE, MS H21–8, Atlanta,
Georgia 30329.
Instructions: All submissions received
must include the agency name and
Docket Number. CDC will post, without
change, all relevant comments to
www.regulations.gov.
Please note: Submit all comments
through the Federal eRulemaking portal
(www.regulations.gov) or by U.S. mail to
the address listed above.
FOR FURTHER INFORMATION CONTACT: To
request more information on the
proposed project or to obtain a copy of
the information collection plan and
instruments, contact Jeffrey M. Zirger,
Information Collection Review Office,
Centers for Disease Control and
Prevention, 1600 Clifton Road NE, MS
H21–8, Atlanta, Georgia 30329;
Telephone: 404–639–7118; Email: omb@
cdc.gov.
SUPPLEMENTARY INFORMATION: Under the
Paperwork Reduction Act of 1995 (PRA)
(44 U.S.C. 3501–3520), federal agencies
must obtain approval from the Office of
Management and Budget (OMB) for each
collection of information they conduct
or sponsor. In addition, the PRA also
requires federal agencies to provide a
60-day notice in the Federal Register
concerning each proposed collection of
information, including each new
proposed collection, each proposed
extension of existing collection of
information, and each reinstatement of
previously approved information
collection before submitting the
collection to the OMB for approval. To
comply with this requirement, we are
publishing this notice of a proposed
data collection as described below.
The OMB is particularly interested in
comments that will help:
1. Evaluate whether the proposed
collection of information is necessary
E:\FR\FM\05JNN1.SGM
05JNN1
36582
Federal Register / Vol. 88, No. 107 / Monday, June 5, 2023 / Notices
for the proper performance of the
functions of the agency, including
whether the information will have
practical utility;
2. Evaluate the accuracy of the
agency’s estimate of the burden of the
proposed collection of information,
including the validity of the
methodology and assumptions used;
3. Enhance the quality, utility, and
clarity of the information to be
collected;
4. Minimize the burden of the
collection of information on those who
are to respond, including through the
use of appropriate automated,
electronic, mechanical, or other
technological collection techniques or
other forms of information technology,
e.g., permitting electronic submissions
of responses; and
5. Assess information collection costs.
ddrumheller on DSK120RN23PROD with NOTICES1
Proposed Project
Evaluating Deep Learning Algorithm
Assessment of Digital Photographs for
Dental Public Health Surveillance—
New—National Center for Chronic
Disease Prevention and Health
Promotion (NCCDPHP), Centers for
Disease Control and Prevention (CDC).
Background and Brief Description
By age 19, 57% of U.S. adolescents
have experienced tooth decay and 17%
have at least one decayed tooth needing
treatment. Prevalence of untreated tooth
decay among non-Hispanic Black and
Mexican American adolescents is about
30% higher than among non-Hispanic
White adolescents, and among lowincome, almost twice the prevalence of
higher-income adolescents. Untreated
tooth decay will not resolve and can
cause pain, infection, and difficulties in
learning. Poor oral health in youth is
associated with both lower school
attendance and grades. More than 34
million school hours are lost annually
due to unplanned dental visits for acute
care needs. Reducing the percentage of
youths who have experienced tooth
decay and the percentage with untreated
tooth decay are national health goals
(Healthy People 2030).
There are two highly effective
interventions to prevent tooth decay.
Dental sealants prevent about 80% of
cavities over two years in the permanent
molars where about 90% of tooth decay
occurs. Fluoride can prevent decay in
permanent teeth by 15% to 43% per
year depending on mode of delivery.
Although the American Dental
Association recommends dentists
provide topical fluoride and dental
sealants to youth at risk for caries,
uptake of these services is low with
about 20% of low-income youth
VerDate Sep<11>2014
17:59 Jun 02, 2023
Jkt 259001
receiving them during an annual dental
visit. Access to these preventive services
as measured by dental sealant
prevalence and receipt of preventive
dental services among low-income
children are national health goals.
The Centers for Disease Control and
Prevention (CDC) has collected national
data on caries, sealant, and fluorosis
prevalence in the National Health and
Nutrition Examination Survey
(NHANES) for over 30 years and has
supported state oral health programs to
collect data on caries and sealant
prevalence through cooperative
agreements since 2001. Twenty states
are currently funded from September
2018 to August 2023 by Actions to
Improve Oral Health Outcomes, CDC–
RFA–DP18–1810. Collecting these data
can be resource intensive as they are
obtained through visual/tactile
examinations conducted by dental
professionals. These data, however,
have enabled federal and state agencies
to: (1) prioritize groups at elevated risk
for enhanced prevention efforts; (2)
monitor trends in children’s oral health
status and disparities; (3) inform
planning, implementation and
evaluation of effective oral health
interventions, programs, and policies;
(4) measure progress toward Healthy
People objectives; and (5) educate the
public and policy makers regarding
cross-cutting public health programs.
Having local estimates of these
measures would enable decision-makers
to better prioritize communities for
programs that increase access to
preventive dental services.
CDC is examining the feasibility and
validity of using digital photos taken by
non-dental professionals, which in turn
would be analyzed by deep learning
algorithms to assess youth’s oral health
status in lieu of human examination.
This deep learning assessment tool
ultimately could be used by public
health officials for dental public health
surveillance at the local, state, and
national level. It is anticipated that
obtaining information on dental
conditions via deep learning assessment
of digital images as opposed to human
assessment will: (1) be more costeffective as it would not require dental
personnel; and (2) improve the accuracy
of assessment due to minimal bias and
less confounding factors associated with
the examiner (e.g., subjective index and
thresholding). This tool also would offer
mobility, simplicity, and affordability
for rapid and scalable adaptation in
community-based settings.
In order to train and test the deep
learning algorithms to identify caries,
sealants, and fluorosis, data on these
PO 00000
Frm 00057
Fmt 4703
Sfmt 4703
conditions as assessed by standardized
examiners and corresponding photos are
required. The CDC requests a one-year
OMB approval for the one-time
collection of oral health data from 1,000
middle- and high-school students in
Colorado communities with naturally
occurring fluoride in the tap water at or
exceeding one part per million. The
Colorado State Health Department will
implement the collection by recruiting
selected schools and dental examiners,
gaining consent, arranging logistics, and
collecting data from dental examination
and photos taken by the dental
examiners. CDC will provide dental
examination and photo taking protocols
and train the examiners. Data collected
for each student will include: (1) human
assessment of fluorosis severity in the
six upper anterior teeth, and caries/
sealant assessment of the occlusal
surfaces of the eight permanent molars;
and (2) nine smartphone digital photos
of the upper anterior teeth and 24
intraoral camera digital photos of the
occlusal surfaces of the eight permanent
molars. Only de-identified data will be
collected. All de-identified data—digital
photos of the teeth and the completed
paper screening form—will be uploaded
to a HIPAA compliant cloud storage box
that can only be accessed by examiners
and designated CDC researchers with
administrative rights. CDC is authorized
to collect this information under the
Public Health Service Act, title 42,
section 247b–14, Oral health promotion
and disease prevention; and the Public
Health Service Act, title 42, section 301.
CDC proposes using data collected
from 750 students to train the deep
learning algorithms to assess caries,
sealants, and fluorosis and data from
250 students to evaluate the accuracy of
the algorithms in terms of agreement
with standardized examiner assessment.
Manuscripts on: (1) the methodologies
used to ensure sufficient photo quality
when taken under field conditions; and
(2) the performance of the deep learning
algorithms will be submitted to peerreviewed journals. The deep learning
tool if sufficiently accurate will be
piloted in one data collection cycle of
NHANES that is administered by the
National Centers for Health Statistics
(NCHS). Ultimately, the tool would be
shared with the state and local oral
health programs, the Association of
State and Territorial Dental Directors,
and other pertinent partners.
The CDC requests OMB clearance for
data collection for one year. The total
estimated annualized burden hours are
827. There are no costs to student
respondents other than their time.
E:\FR\FM\05JNN1.SGM
05JNN1
36583
Federal Register / Vol. 88, No. 107 / Monday, June 5, 2023 / Notices
ESTIMATED ANNUALIZED BURDEN HOURS
Average
burden per
response
(in hr)
Total burden
(in hr)
Form name
Child ...............................
Parent or caretaker ........
Screener ........................
Screening/photo/form ..........................................
Consent ...............................................................
Screening/photo form includes training, travel,
screening and photos, and ongoing technical
assistance.
1,000
1,000
6
1
1
1
16/60
1/60
90
270
17
540
Total ........................
..............................................................................
........................
........................
........................
827
Jeffrey M. Zirger,
Lead, Information Collection Review Office,
Office of Public Health Ethics and
Regulations, Office of Science, Centers for
Disease Control and Prevention.
[FR Doc. 2023–11859 Filed 6–2–23; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[60Day–23–1289; Docket No. CDC–2023–
0041]
Proposed Data Collection Submitted
for Public Comment and
Recommendations
Centers for Disease Control and
Prevention (CDC), Department of Health
and Human Services (HHS).
AGENCY:
ACTION:
Notice with comment period.
The Centers for Disease
Control and Prevention (CDC), as part of
its continuing effort to reduce public
burden and maximize the utility of
government information, invites the
general public and other federal
agencies the opportunity to comment on
a continuing information collection, as
required by the Paperwork Reduction
Act of 1995. This notice invites
comment on a proposed information
collection project titled Sealant
Efficiency Assessment for Locals and
States (SEALS). This data will be
collected from local school sealant
programs to generate efficiency
performance measures, which will
allow CDC to identify feasible
benchmarks and best practices
contributing to school sealant program
efficiency.
SUMMARY:
ddrumheller on DSK120RN23PROD with NOTICES1
Number of
responses per
respondent
Number of
respondents
Type of respondent
CDC must receive written
comments on or before August 4, 2023.
DATES:
You may submit comments,
identified by Docket No. CDC–2023–
0041 by any of the following methods:
ADDRESSES:
VerDate Sep<11>2014
17:59 Jun 02, 2023
Jkt 259001
• Federal eRulemaking Portal:
www.regulations.gov. Follow the
instructions for submitting comments.
• Mail: Jeffrey M. Zirger, Information
Collection Review Office, Centers for
Disease Control and Prevention, 1600
Clifton Road NE, MS H21–8, Atlanta,
Georgia 30329.
Instructions: All submissions received
must include the agency name and
Docket Number. CDC will post, without
change, all relevant comments to
www.regulations.gov.
Please note: Submit all comments
through the Federal eRulemaking portal
(www.regulations.gov) or by U.S. mail to
the address listed above.
FOR FURTHER INFORMATION CONTACT: To
request more information on the
proposed project or to obtain a copy of
the information collection plan and
instruments, contact Jeffrey M. Zirger,
Information Collection Review Office,
Centers for Disease Control and
Prevention, 1600 Clifton Road NE, MS
H21–8, Atlanta, Georgia 30329;
Telephone: 404–639–7570; Email: omb@
cdc.gov.
SUPPLEMENTARY INFORMATION: Under the
Paperwork Reduction Act of 1995 (PRA)
(44 U.S.C. 3501–3520), federal agencies
must obtain approval from the Office of
Management and Budget (OMB) for each
collection of information they conduct
or sponsor. In addition, the PRA also
requires federal agencies to provide a
60-day notice in the Federal Register
concerning each proposed collection of
information, including each new
proposed collection, each proposed
extension of existing collection of
information, and each reinstatement of
previously approved information
collection before submitting the
collection to the OMB for approval. To
comply with this requirement, we are
publishing this notice of a proposed
data collection as described below.
The OMB is particularly interested in
comments that will help:
1. Evaluate whether the proposed
collection of information is necessary
for the proper performance of the
functions of the agency, including
PO 00000
Frm 00058
Fmt 4703
Sfmt 4703
whether the information will have
practical utility;
2. Evaluate the accuracy of the
agency’s estimate of the burden of the
proposed collection of information,
including the validity of the
methodology and assumptions used;
3. Enhance the quality, utility, and
clarity of the information to be
collected;
4. Minimize the burden of the
collection of information on those who
are to respond, including through the
use of appropriate automated,
electronic, mechanical, or other
technological collection techniques or
other forms of information technology,
e.g., permitting electronic submissions
of responses; and
5. Assess information collection costs.
Proposed Project
Sealant Efficiency Assessment for
Locals and States (SEALS) (OMB
Control No. 0920–1289)—Reinstatement
with change—National Center for
Chronic Disease Prevention and Health
Promotion (NCCDPHP), Centers for
Disease Control and Prevention (CDC).
Background and Brief Description
By age 19, 67% of U.S. adolescents
living in poverty have experienced tooth
decay and 27% have at least one
decayed tooth needing treatment.
School sealant programs provide dental
sealants, which protect against 80% of
cavities for two years, and continue to
protect against 50% of cavities for up to
four years. CDC requests information
from states regarding children’s cavity
risk, one-year sealant retention rate,
sealant program services delivered, and
school sealant program cost and
quantity of resources used at each
school event. This data will allow CDC
and states to monitor the performance
and efficiency of their school sealant
programs, which will improve and
extend program delivery to more
children.
CDC requests OMB approval for a
Reinstatement of a previously approved
data collection. The total estimated
E:\FR\FM\05JNN1.SGM
05JNN1
]]>Agencies
[Federal Register Volume 88, Number 107 (Monday, June 5, 2023)]
[Notices]
[Pages 36581-36583]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-11859]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[60Day-23-23FJ; Docket No. CDC-2023-0042]
Proposed Data Collection Submitted for Public Comment and
Recommendations
AGENCY: Centers for Disease Control and Prevention (CDC), Department of
Health and Human Services (HHS).
ACTION: Notice with comment period.
-----------------------------------------------------------------------
SUMMARY: The Centers for Disease Control and Prevention (CDC), as part
of its continuing effort to reduce public burden and maximize the
utility of government information, invites the general public and other
federal agencies the opportunity to comment on a proposed information
collection, as required by the Paperwork Reduction Act of 1995. This
notice invites comment on a proposed information collection project
titled Evaluating Deep Learning Algorithm Assessment of Digital
Photographs for Dental Public Health Surveillance. This project entails
one-time data collection of oral health data from 1,000 school students
to examine the feasibility and validity of using digital photos taken
by non-dental professionals, which are analyzed by deep learning
algorithms to assess youth's oral health status.
DATES: CDC must receive written comments on or before August 4, 2023.
ADDRESSES: You may submit comments, identified by Docket No. CDC-2023-
0042 by any of the following methods:
Federal eRulemaking Portal: www.regulations.gov. Follow
the instructions for submitting comments.
Mail: Jeffrey M. Zirger, Information Collection Review
Office, Centers for Disease Control and Prevention, 1600 Clifton Road
NE, MS H21-8, Atlanta, Georgia 30329.
Instructions: All submissions received must include the agency name
and Docket Number. CDC will post, without change, all relevant comments
to www.regulations.gov.
Please note: Submit all comments through the Federal eRulemaking
portal (www.regulations.gov) or by U.S. mail to the address listed
above.
FOR FURTHER INFORMATION CONTACT: To request more information on the
proposed project or to obtain a copy of the information collection plan
and instruments, contact Jeffrey M. Zirger, Information Collection
Review Office, Centers for Disease Control and Prevention, 1600 Clifton
Road NE, MS H21-8, Atlanta, Georgia 30329; Telephone: 404-639-7118;
Email: [email protected].
SUPPLEMENTARY INFORMATION: Under the Paperwork Reduction Act of 1995
(PRA) (44 U.S.C. 3501-3520), federal agencies must obtain approval from
the Office of Management and Budget (OMB) for each collection of
information they conduct or sponsor. In addition, the PRA also requires
federal agencies to provide a 60-day notice in the Federal Register
concerning each proposed collection of information, including each new
proposed collection, each proposed extension of existing collection of
information, and each reinstatement of previously approved information
collection before submitting the collection to the OMB for approval. To
comply with this requirement, we are publishing this notice of a
proposed data collection as described below.
The OMB is particularly interested in comments that will help:
1. Evaluate whether the proposed collection of information is
necessary
[[Page 36582]]
for the proper performance of the functions of the agency, including
whether the information will have practical utility;
2. Evaluate the accuracy of the agency's estimate of the burden of
the proposed collection of information, including the validity of the
methodology and assumptions used;
3. Enhance the quality, utility, and clarity of the information to
be collected;
4. Minimize the burden of the collection of information on those
who are to respond, including through the use of appropriate automated,
electronic, mechanical, or other technological collection techniques or
other forms of information technology, e.g., permitting electronic
submissions of responses; and
5. Assess information collection costs.
Proposed Project
Evaluating Deep Learning Algorithm Assessment of Digital
Photographs for Dental Public Health Surveillance--New--National Center
for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers
for Disease Control and Prevention (CDC).
Background and Brief Description
By age 19, 57% of U.S. adolescents have experienced tooth decay and
17% have at least one decayed tooth needing treatment. Prevalence of
untreated tooth decay among non-Hispanic Black and Mexican American
adolescents is about 30% higher than among non-Hispanic White
adolescents, and among low-income, almost twice the prevalence of
higher-income adolescents. Untreated tooth decay will not resolve and
can cause pain, infection, and difficulties in learning. Poor oral
health in youth is associated with both lower school attendance and
grades. More than 34 million school hours are lost annually due to
unplanned dental visits for acute care needs. Reducing the percentage
of youths who have experienced tooth decay and the percentage with
untreated tooth decay are national health goals (Healthy People 2030).
There are two highly effective interventions to prevent tooth
decay. Dental sealants prevent about 80% of cavities over two years in
the permanent molars where about 90% of tooth decay occurs. Fluoride
can prevent decay in permanent teeth by 15% to 43% per year depending
on mode of delivery. Although the American Dental Association
recommends dentists provide topical fluoride and dental sealants to
youth at risk for caries, uptake of these services is low with about
20% of low-income youth receiving them during an annual dental visit.
Access to these preventive services as measured by dental sealant
prevalence and receipt of preventive dental services among low-income
children are national health goals.
The Centers for Disease Control and Prevention (CDC) has collected
national data on caries, sealant, and fluorosis prevalence in the
National Health and Nutrition Examination Survey (NHANES) for over 30
years and has supported state oral health programs to collect data on
caries and sealant prevalence through cooperative agreements since
2001. Twenty states are currently funded from September 2018 to August
2023 by Actions to Improve Oral Health Outcomes, CDC-RFA-DP18-1810.
Collecting these data can be resource intensive as they are obtained
through visual/tactile examinations conducted by dental professionals.
These data, however, have enabled federal and state agencies to: (1)
prioritize groups at elevated risk for enhanced prevention efforts; (2)
monitor trends in children's oral health status and disparities; (3)
inform planning, implementation and evaluation of effective oral health
interventions, programs, and policies; (4) measure progress toward
Healthy People objectives; and (5) educate the public and policy makers
regarding cross-cutting public health programs. Having local estimates
of these measures would enable decision-makers to better prioritize
communities for programs that increase access to preventive dental
services.
CDC is examining the feasibility and validity of using digital
photos taken by non-dental professionals, which in turn would be
analyzed by deep learning algorithms to assess youth's oral health
status in lieu of human examination. This deep learning assessment tool
ultimately could be used by public health officials for dental public
health surveillance at the local, state, and national level. It is
anticipated that obtaining information on dental conditions via deep
learning assessment of digital images as opposed to human assessment
will: (1) be more cost-effective as it would not require dental
personnel; and (2) improve the accuracy of assessment due to minimal
bias and less confounding factors associated with the examiner (e.g.,
subjective index and thresholding). This tool also would offer
mobility, simplicity, and affordability for rapid and scalable
adaptation in community-based settings.
In order to train and test the deep learning algorithms to identify
caries, sealants, and fluorosis, data on these conditions as assessed
by standardized examiners and corresponding photos are required. The
CDC requests a one-year OMB approval for the one-time collection of
oral health data from 1,000 middle- and high-school students in
Colorado communities with naturally occurring fluoride in the tap water
at or exceeding one part per million. The Colorado State Health
Department will implement the collection by recruiting selected schools
and dental examiners, gaining consent, arranging logistics, and
collecting data from dental examination and photos taken by the dental
examiners. CDC will provide dental examination and photo taking
protocols and train the examiners. Data collected for each student will
include: (1) human assessment of fluorosis severity in the six upper
anterior teeth, and caries/sealant assessment of the occlusal surfaces
of the eight permanent molars; and (2) nine smartphone digital photos
of the upper anterior teeth and 24 intraoral camera digital photos of
the occlusal surfaces of the eight permanent molars. Only de-identified
data will be collected. All de-identified data--digital photos of the
teeth and the completed paper screening form--will be uploaded to a
HIPAA compliant cloud storage box that can only be accessed by
examiners and designated CDC researchers with administrative rights.
CDC is authorized to collect this information under the Public Health
Service Act, title 42, section 247b-14, Oral health promotion and
disease prevention; and the Public Health Service Act, title 42,
section 301.
CDC proposes using data collected from 750 students to train the
deep learning algorithms to assess caries, sealants, and fluorosis and
data from 250 students to evaluate the accuracy of the algorithms in
terms of agreement with standardized examiner assessment. Manuscripts
on: (1) the methodologies used to ensure sufficient photo quality when
taken under field conditions; and (2) the performance of the deep
learning algorithms will be submitted to peer-reviewed journals. The
deep learning tool if sufficiently accurate will be piloted in one data
collection cycle of NHANES that is administered by the National Centers
for Health Statistics (NCHS). Ultimately, the tool would be shared with
the state and local oral health programs, the Association of State and
Territorial Dental Directors, and other pertinent partners.
The CDC requests OMB clearance for data collection for one year.
The total estimated annualized burden hours are 827. There are no costs
to student respondents other than their time.
[[Page 36583]]
Estimated Annualized Burden Hours
--------------------------------------------------------------------------------------------------------------------------------------------------------
Number of Average burden
Type of respondent Form name Number of responses per per response Total burden
respondents respondent (in hr) (in hr)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Child.......................................... Screening/photo/form................... 1,000 1 16/60 270
Parent or caretaker............................ Consent................................ 1,000 1 1/60 17
Screener....................................... Screening/photo form includes training, 6 1 90 540
travel, screening and photos, and
ongoing technical assistance.
---------------------------------------------------------------
Total...................................... ....................................... .............. .............. .............. 827
--------------------------------------------------------------------------------------------------------------------------------------------------------
Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Public Health
Ethics and Regulations, Office of Science, Centers for Disease Control
and Prevention.
[FR Doc. 2023-11859 Filed 6-2-23; 8:45 am]
BILLING CODE 4163-18-P
