60 Day FRN

Federal Register / Vol. 88, No. 107 / Monday, June 5, 2023 / Notices
7. May not use Federal funds from a
contract to develop Challenge
applications or to fund efforts in
support of a Challenge submission.
8. Shall not be deemed ineligible
because the individual or entity used
Federal facilities or consulted with
Federal employees during a competition
if the facilities and employees are made
equitably available to all individuals
and entities participating in the
competition.
9. Shall not be required to purchase
liability insurance as a condition of
participation in this competition.

ddrumheller on DSK120RN23PROD with NOTICES1

Additional Rules of Participation
By participating in this Challenge,
each individual (whether participating
singly or in a group) or entity:
1. Agrees to follow all applicable
federal, state, and local laws,
regulations, and policies.
2. Agrees to comply with all terms
and conditions of participation in this
Challenge.
3. Agrees that the submission will not
use HHS or AHRQ logos or official seals
and will not claim endorsement by HHS
or AHRQ.
4. Understands that all materials
submitted to AHRQ as part of a
submission become AHRQ records.
5. Agrees that the submission must
not infringe upon copyright or any other
rights of any third party.
6. Agrees to assume any and all risks
and waive claims against the Federal
Government and its related entities,
except in the case of willful misconduct,
for any injury, death, damage, or loss of
property, revenue, or profits, whether
direct, indirect, or consequential, arising
from participation in this prize contest,
whether the injury, death, damage, or
loss arises through negligence or
otherwise.
7. Agrees to indemnify the Federal
Government against third-party claims
for damages arising from or related to
Challenge activities.
8. Understands that AHRQ reserves
the right to cancel, suspend, and/or
modify this prize contest, or any part of
it, for any reason, at AHRQ’s sole
discretion. AHRQ also reserves the right
not to award any prizes if no entries are
deemed worthy.
9. Understands that AHRQ will not
select a winner that is named on the
Excluded Parties List System (EPLS).
Intellectual Property (IP) Rights
1. Each participant retains title and
full ownership in and to their
submission. Participants expressly
reserve all intellectual property rights
not expressly granted.
2. By participating in the Challenge,
each participant (whether participating

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singly or in a group) acknowledges that
he or she is the sole author or owner of,
or has a right to use, any copyrightable
works that the submission comprises,
that the works are wholly original with
the participant (or is an improved
version of an existing work that the
participant has sufficient rights to use
and improve), and that the submission
does not infringe any copyright or any
other rights of any third party of which
participant is aware. In addition, each
participant (whether participating singly
or in a group) grants to the U.S.
Government a paid-up, nonexclusive,
royalty-free, irrevocable worldwide
license and the right to reproduce,
publish, post, link to, share, display
publicly (on the web or elsewhere) and
prepare derivative works, including the
right to authorize others to do so on
behalf of the U.S. Government.
3. If the submission includes any
third party works (such as third party
content or open source code), the
participant must be able to provide,
upon request, documentation of all
appropriate licenses and releases for use
of such third-party works. If the
participant cannot provide
documentation of all required licenses
and releases, AHRQ reserves the right,
in its sole discretion, to disqualify the
submission.
Dated: May 31, 2023.
Marquita Cullom,
Associate Director.
[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:

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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

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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

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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

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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.

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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

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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

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