2226 Federal Register / Vol. 89, No. 9 / Friday, January 12, 2024 / Notices 

1See 12 U.S.C. 1424(a), 1430(a). 

2See 12 U.S.C. 1422(10)(A); 12 CFR 1263.1. 

3See 12 U.S.C. 1422(10)(B); 12 CFR 1263.1 

(defining the term ‘‘CFI asset cap’’). 

4See 87 FR 80184 (Dec. 29, 2022). 

statutory definition of a CFI certain 

advantages over non-CFI insured 

depository institutions in qualifying for 

Bank membership, and in the purposes 

for which they may receive long-term 

advances and the collateral they may 

pledge to secure advances.1 Section 

2(10)(A) of the Bank Act and § 1263.1 of 

FHFA’s regulations define a CFI as any 

Bank member the deposits of which are 

insured by the Federal Deposit 

Insurance Corporation and that has 

average total assets below the statutory 

cap.2 The Bank Act was amended in 

2008 to set the statutory cap at $1 

billion and to require FHFA to adjust 

the cap annually to reflect the 

percentage increase in the CPI–U, as 

published by the DOL.3 For 2023, FHFA 

set the CFI asset cap at $1,417,000,000, 

which reflected a 7.1 percent increase 

over 2022, based upon the increase in 

the CPI–U between 2021 and 2022.4

II. The CFI Asset Cap for 2024 

As of January 1, 2024, FHFA will 

increase the CFI asset cap to 

$1,461,000,000, which reflects a 3.1 

percent increase in the unadjusted CPI– 

U from November 2022 to November 

2023. Consistent with the practice of 

other Federal agencies required to 

calculate and make annual adjustments 

based on CPI–U changes, FHFA bases 

the annual adjustment to the CFI asset 

cap on the percentage increase in the 

CPI–U from November of the year prior 

to the preceding calendar year to 

November of the preceding calendar 

year, because the November figures 

represent the most recent available data 

as of January 1st of the current calendar 

year. The new CFI asset cap was 

obtained by applying the percentage 

increase in the CPI–U to the unrounded 

amount for the preceding year and 

rounding to the nearest million, as has 

been FHFA’s practice for all previous 

adjustments. 

In calculating the CFI asset cap, FHFA 

uses CPI–U data that have not been 

seasonally adjusted (i.e., the data have 

not been adjusted to remove the 

estimated effect of price changes that 

normally occur at the same time and in 

about the same magnitude every year). 

The DOL encourages use of unadjusted 

CPI–U data in applying ‘‘escalation’’ 

provisions such as that governing the 

CFI asset cap, because the factors that 

are used to seasonally adjust the data 

are amended annually, and seasonally 

adjusted data that are published earlier 

are subject to revision for up to five 

years following their original release. 

Unadjusted data are not routinely 

subject to revision, and previously 

published unadjusted data are only 

corrected when significant calculation 

errors are discovered. 

Joshua R. Stallings, 

Deputy Director, Division of Federal Home 

Loan Bank Regulation, Federal Housing 

Finance Agency. 

[FR Doc. 2024–00491 Filed 1–11–24; 8:45 am] 

BILLING CODE 8070–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Supplemental Evidence and Data 

Request on The Effect of Dietary 

Digestible Carbohydrate Intake on Risk 

of Cardiovascular Disease 

AGENCY: Agency for Healthcare Research 

and Quality (AHRQ), HHS. 

ACTION: Request for supplemental 

evidence and data submission. 

SUMMARY: The Agency for Healthcare 

Research and Quality (AHRQ) is seeking 

scientific information submissions from 

the public. Scientific information is 

being solicited to inform our review on 

The Effect of Dietary Digestible 

Carbohydrate Intake on Risk of 

Cardiovascular Disease, which is 

currently being conducted by the 

AHRQ’s Evidence-based Practice 

Centers (EPC) Program. Access to 

published and unpublished pertinent 

scientific information will improve the 

quality of this review. 

DATES: Submission Deadline on or 

before February 12, 2024. 

ADDRESSES:

Email submissions: epc@

ahrq.hhs.gov. 

Print submissions: 

Mailing Address: Center for Evidence 

and Practice Improvement Agency for 

Healthcare Research and Quality, 

ATTN: EPC SEADs Coordinator, 5600 

Fishers Lane, Mail Stop 06E53A, 

Rockville, MD 20857 

Shipping Address (FedEx, UPS, etc.): 

Center for Evidence and Practice 

Improvement, Agency for Healthcare 

Research and Quality, ATTN: EPC 

SEADs Coordinator, 5600 Fishers 

Lane, Mail Stop 06E77D, Rockville, 

MD 20857 

FOR FURTHER INFORMATION CONTACT: 

Kelly Carper, Telephone: 301–427–1656 

or Email: epc@ahrq.hhs.gov. 

SUPPLEMENTARY INFORMATION: The 

Agency for Healthcare Research and 

Quality has commissioned the 

Evidence-based Practice Centers (EPC) 

Program to complete a review of the 

evidence for The Effect of Dietary 

Digestible Carbohydrate Intake on Risk 

of Cardiovascular Disease. AHRQ is 

conducting this review pursuant to 

Section 902 of the Public Health Service 

Act, 42 U.S.C. 299a. 

The EPC Program is dedicated to 

identifying as many studies as possible 

that are relevant to the questions for 

each of its reviews. In order to do so, we 

are supplementing the usual manual 

and electronic database searches of the 

literature by requesting information 

from the public (e.g., details of studies 

conducted). We are looking for studies 

that report on The Effect of Dietary 

Digestible Carbohydrate Intake on Risk 

of Cardiovascular Disease. 

The entire research protocol is 

available online at: https://effective

healthcare.ahrq.gov/products/riskcardiovascular-disease. 

This is to notify the public that the 

EPC Program would find the following 

information on The Effect of Dietary 

Digestible Carbohydrate Intake on Risk 

of Cardiovascular Disease helpful: 

D A list of completed studies that 

your organization has sponsored for this 

topic. In the list, please indicate 

whether results are available on 

ClinicalTrials.gov along with the 

ClinicalTrials.gov trial number. 

D For completed studies that do not 

have results on ClinicalTrials.gov, a 

summary, including the following 

elements, if relevant: study number, 

study period, design, methodology, 

indication and diagnosis, proper use 

instructions, inclusion and exclusion 

criteria, primary and secondary 

outcomes, baseline characteristics, 

number of patients screened/eligible/ 

enrolled/lost to follow-up/withdrawn/ 

analyzed, effectiveness/efficacy, and 

safety results. 

D A list of ongoing studies that your 

organization has sponsored for this 

topic. In the list, please provide the 

ClinicalTrials.gov trial number or, if the 

trial is not registered, the protocol for 

the study including, if relevant, a study 

number, the study period, design, 

methodology, indication and diagnosis, 

proper use instructions, inclusion and 

exclusion criteria, and primary and 

secondary outcomes. 

D Description of whether the above 

studies constitute ALL Phase II and 

above clinical trials sponsored by your 

organization for this topic and an index 

outlining the relevant information in 

each submitted file. 


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Federal Register / Vol. 89, No. 9 / Friday, January 12, 2024 / Notices 2227 

Your contribution is very beneficial to 

the Program. Materials submitted must 

be publicly available or able to be made 

public. Materials that are considered 

confidential; marketing materials; study 

types not included in the review; or 

information on topics not included in 

the review cannot be used by the EPC 

Program. This is a voluntary request for 

information, and all costs for complying 

with this request must be borne by the 

submitter. 

The draft of this review will be posted 

on AHRQ’s EPC Program website and 

available for public comment for a 

period of 4 weeks. If you would like to 

be notified when the draft is posted, 

please sign up for the email list at: 

https://www.effectivehealthcare.

ahrq.gov/email-updates. 

The review will answer the following 

questions. This information is provided 

as background. AHRQ is not requesting 

that the public provide answers to these 

questions. 

Key Questions (KQ) 

KQ 1: What is the association between 

dietary digestible carbohydrate intake 

and the incidence of cardiovascular 

disease? 

PICOTS (Populations, Interventions, 

Comparators, Outcomes, Timing, and 

Setting) 

INCLUSION AND EXCLUSION CRITERIA BY POPULATION, INTERVENTION, COMPARATOR, OUTCOME, TIMING, SETTING/STUDY

DESIGN (PICOTS) 

PICOTS elements Inclusion criteria Exclusion criteria 

Population ............................ • Participants who are generally healthy, including participants who are determined to be overweight/obese,

women who are pregnant or lactating.

• Age of participants:

Æ Between 2 years and 9 years (before puberty). 

Æ Between 9 and 17 years. 

Æ 18 years and older. 

• Participants with diseases/health-related conditions

that impact carbohydrate absorption or metabolism,

cancer, and malabsorption syndromes.

• Participants hospitalized with an illness or injury.

• Participants with the endpoint outcomes of CVD (i.e.,

studies that aim to treat participants already been diagnosed with the endpoint outcomes of interest).

• Participants who intend to reduce weight or receive

treatments for being overweight and having obesity

through energy restriction or hypocaloric diets for the

purposes of treating additional or other medical conditions.

• Participants who are determined to be undernourished, underweight, stunted, or wasted.

• Participants who are pre-bariatric or post-bariatric

surgery.

• People younger than 2 years old.

Interventions ......................... • Total dietary digestible carbohydrate intake from

foods, beverages, and dietary supplements.

Æ Total dietary digestible carbohydrate intake defined as collective starch and sugar intake; carbohydrate intake not including dietary fiber. 

• A dietary pattern that quantifies the intake of total dietary digestible carbohydrates and allows the isolation of the effect of carbohydrate intake from the effect of the intake of other macronutrients.

• Studies that do not specify the amount of total digestible carbohydrate intake (e.g., studies that only

report type or source of digestible carbohydrate).

• Studies that do not describe the entire macronutrient

distribution of the diet (i.e., studies that do not report

total digestible carbohydrate, total fat, and total protein contents of experimental or baseline diets).

• Studies that only assess digestible carbohydrate intake via infusions (rather than the GI tract).

• Studies that primarily measure postprandial responses, as opposed to longer term studies.

• Studies that examine food products or dietary supplements not widely available to U.S. consumers.

• Multi-component interventions that do not isolate the

effect or association of digestible carbohydrate.

Comparators ........................ • Different total dietary digestible carbohydrate intake

level(s).

• Comparison of different sources of carbohydrate

without specifying amount of carbohydrate intake.

• Studies that do not attempt to control for energy intake of participants such that comparisons are made

on an isocaloric basis.

• Comparisons of available carbohydrate exposure

should not be confounded by differences in participants’ energy intake.

Outcomes ............................. • Intermediate outcomes:

Æ LDL cholesterol (LDL). 

Æ Total cholesterol (TC). 

Æ HDL cholesterol (HDL). 

Æ Non-HDL cholesterol. 

Æ TC:HDL ratio. 

Æ LDL:HDL ratio. 

Æ Triglycerides. 

Æ Blood pressure (systolic and/or diastolic) and hypertension. 

• Hypertensive disorders during pregnancy and/or lactation (e.g., chronic hypertension, gestational hypertension, preeclampsia-eclampsia, chronic hypertension with superimposed preeclampsia).

• Final outcomes:

Æ Cardiovascular disease (e.g., myocardial infarction, coronary heart disease, congestive heart 

failure, peripheral artery disease). 

Æ Stroke. 

Æ Cardiovascular disease-related mortality. 


khammond on DSKJM1Z7X2PROD with NOTICES
2228 Federal Register / Vol. 89, No. 9 / Friday, January 12, 2024 / Notices 

INCLUSION AND EXCLUSION CRITERIA BY POPULATION, INTERVENTION, COMPARATOR, OUTCOME, TIMING, SETTING/STUDY

DESIGN (PICOTS)—Continued 

PICOTS elements Inclusion criteria Exclusion criteria 

Timing .................................. • At least 4 weeks .......................................................... • Less than 4 weeks. 

Settings ................................ • All except hospital and acute care .............................. • Hospital and acute care. 

Study design ........................ • Randomized controlled trials .......................................

• Nonrandomized controlled trials, including quasi-experimental and controlled before-and-after studies. 

• Prospective cohort studies. 

• Nested case-control studies. 

• Relevant systematic reviews, or meta-analyses (used 

for identifying additional studies). 

• In vitro studies, nonoriginal data (e.g., narrative reviews, scoping reviews, editorials, letters, or erratum), retrospective cohort studies, case series, qualitative studies, cost-benefit analysis, cross-sectional 

(i.e., nonlongitudinal) studies, survey. 

Publications .......................... • Studies published in English only ...............................

• Studies published in peer-reviewed journals. 

• Studies published at and after the year 2000. 

• Non-English language studies. 

Abbreviations: CVD = cardiovascular disease; GI = gastrointestinal; HDL = high-density lipoprotein; KQ = Key Question; LDL = low-density 

lipoprotein PICOTS = populations, interventions, comparators, outcomes, timing, and settings; RCT = randomized controlled trial; TC = total cholesterol; U.S. = United States. 

Dated: January 8, 2024. 

Marquita Cullom, 

Associate Director. 

[FR Doc. 2024–00505 Filed 1–11–24; 8:45 am] 

BILLING CODE 4160–90–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Health Resources and Services 

Administration 

Agency Information Collection 

Activities: Submission to OMB for 

Review and Approval; Public Comment 

Request; CAREWare Customer 

Satisfaction and Usage Survey, OMB 

No. 0906–xxxx–New 

AGENCY: Health Resources and Services 

Administration (HRSA), Department of 

Health and Human Services. 

ACTION: Notice. 

SUMMARY: In compliance with of the 

Paperwork Reduction Act of 1995, 

HRSA has submitted an Information 

Collection Request (ICR) to the Office of 

Management and Budget (OMB) for 

review and approval. Comments 

submitted during the first public review 

of this ICR will be provided to OMB. 

OMB will accept further comments from 

the public during the review and 

approval period. OMB may act on 

HRSA’s ICR only after the 30-day 

comment period for this notice has 

closed. 

DATES: Comments on this ICR should be 

received no later than February 12, 

2024. 

ADDRESSES: Written comments and 

recommendations for the proposed 

information collection should be sent 

within 30 days of publication of this 

notice to www.reginfo.gov/public/do/ 

PRAMain. Find this particular 

information collection by selecting 

‘‘Currently under Review—Open for 

Public Comments’’ or by using the 

search function. 

FOR FURTHER INFORMATION CONTACT: To 

request a copy of the clearance requests 

submitted to OMB for review, email 

Joella Roland, the HRSA Information 

Collection Clearance Officer at 

paperwork@hrsa.gov or call (301) 443– 

3983. 

SUPPLEMENTARY INFORMATION: 

Information Collection Request Title: 

CAREWare Customer Satisfaction and 

Usage Survey, OMB No. 0906–xxxx– 

New. 

Abstract: HRSA developed 

CAREWare, a software application first 

released in 2000, to help meet the data 

collection and reporting needs of Ryan 

White HIV/AIDS Program (RWHAP) 

grant recipients. The secure software is 

a free, electronic health and social 

support services information system for 

RWHAP grant recipients and their 

subrecipients to assist in the data 

requirement submissions that inform 

the development of the Ryan White 

HIV/AIDS Program Service Report, the 

AIDS Drug Assistance Program Data 

Report, the Ending the HIV Epidemic 

Initiative Triannual Report, and the 

voluntary Clinical Quality Measures 

Performance Measures module. Over 

time, the software has evolved into a 

comprehensive health information 

system and is now the source of more 

than half of all the RWHAP client-level 

data received from recipients and 

subrecipients of RWHAP grant funding. 

CAREWare software manages HIV 

clinical and support service data from 

more than 360,000 client records in 48 

states; Washington, DC; Puerto Rico; 

and the U.S. Virgin Islands. 

The CAREWare software application 

contains customizable modules for 

tracking demographic information, 

services, medications, laboratory test 

results, immunization history, diagnoses 

(updated with International 

Classification of Diseases, Tenth 

Revision codes), referrals to outside 

agencies, and an appointment 

scheduler. There is a custom report 

generator and a performance measures 

module that supports quality of care 

initiatives at the provider level. The 

software also has several ways to import 

data from third-party sources, including 

commercial labs and other electronic 

health records (using both Health Level 

Seven and simple Comma Separated 

Value-formatted files), HIV surveillance 

systems, and for RWHAP Part B AIDS 

Drug Assistance Programs, pharmacy 

benefit programs. The software and user 

support materials can be accessed here: 

https://hab.hrsa.gov/program-grantsmanagement/careware. Finally, 

CAREWare supports users through an 

experienced helpdesk with ongoing 

software maintenance issues and 

enhancements to the user interface. 

HRSA is proposing a customer 

satisfaction survey to gather feedback 

from CAREWare users regarding their 

experiences and satisfaction with the 

software platform and to obtain 

suggestions for improvement. 

A 60-day Federal Register Notice 

(FRN) was published in the Federal 

Register on October 20, 2023 (Volume 

88, No. 202, pages 72493–94). There was 

one out-of-scope public comment 

received in response to the FRN. 

Need and Proposed Use of the 

Information: HRSA aims to understand 

CAREWare users’ needs and concerns 

by collecting information on current 

software features and inquiring about 

opportunities to improve the user 

experience and product features. The 

survey will address the software’s 

functionality and how well it meets the 

data collection, reporting, and quality 


khammond on DSKJM1Z7X2PROD with NOTICES