81_FR_45645 81 FR 45510 - Office of the National Coordinator for Health Information Technology; Announcement of Requirements and Registration for “Blockchain and its Emerging Role in Health IT and Health-related Research”; Amendment

81 FR 45510 - Office of the National Coordinator for Health Information Technology; Announcement of Requirements and Registration for “Blockchain and its Emerging Role in Health IT and Health-related Research”; Amendment

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Federal Register Volume 81, Issue 135 (July 14, 2016)

Page Range45510-45511
FR Document2016-16607

This document amends the notice published in Federal Register, Friday July 8, 2016, volume 81, pages 44639-44640. This notice updates and extends the submission period to August 8, 2016, limits an investigator or co-investigator to one submission and adds prize details. The ``Use of Blockchain in Health IT and Health-related Research'' Ideation Challenge solicits white papers on the topic of Blockchain Technology and the potential use in Health IT to address privacy, security and scalability challenges of managing electronic health record and resources. Up to 15 winners will be awarded a cash prize and up to 8 winners may be invited to present their papers at an upcoming industry-wide workshop co-hosted with the National Institute of Standards and Technology (NIST). The statutory authority for this Challenge is section 105 of the America COMPETES Reauthorization Act of 2010 (Pub. L. 111-358).

Federal Register, Volume 81 Issue 135 (Thursday, July 14, 2016)
[Federal Register Volume 81, Number 135 (Thursday, July 14, 2016)]
[Notices]
[Pages 45510-45511]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-16607]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES


Office of the National Coordinator for Health Information 
Technology; Announcement of Requirements and Registration for 
``Blockchain and its Emerging Role in Health IT and Health-related 
Research''; Amendment

AGENCY: Office of the National Coordinator for Health Information 
Technology, HHS. Award Approving Official: Karen DeSalvo, National 
Coordinator for Health Information Technology.

ACTION: Notice; Amendment.

-----------------------------------------------------------------------

SUMMARY: This document amends the notice published in Federal Register, 
Friday July 8, 2016, volume 81, pages 44639-44640. This notice updates 
and extends the submission period to August 8, 2016, limits an 
investigator or co-investigator to one submission and adds prize 
details. The ``Use of Blockchain in Health IT and Health-related 
Research'' Ideation Challenge solicits white papers on the topic of 
Blockchain Technology and the potential use in Health IT to address 
privacy, security and scalability challenges of managing electronic 
health record and resources. Up to 15 winners will be awarded a cash 
prize and up to 8 winners may be invited to present their papers at an 
upcoming industry-wide workshop co-hosted with the National Institute 
of Standards and Technology (NIST). The statutory authority for this 
Challenge is section 105 of the America COMPETES Reauthorization Act of 
2010 (Pub. L. 111-358).

DATES: 
     Submission period begins: July 7, 2016.
     Submission period ends: August 8, 2016.
     Evaluation begins: August 9, 2016.
     Evaluation ends: August 19, 2016.
     Winners notified: August 22, 2016.
     Winners Announced: August 29, 2016.
     Winner Presentation: September 26-27, 2016.

FOR FURTHER INFORMATION CONTACT: Debbie Bucci, [email protected] 
(preferred), (202) 690-0213.

SUPPLEMENTARY INFORMATION:

Subject of Challenge

    A Blockchain is a data structure that can be timed-stamped and 
signed using a private key to prevent tampering. There are generally 
three types of Blockchain: Public, private and consortium. Potential 
uses include:
     Digitally sign information,
     Computable enforcement of policies and contracts (smart 
contracts),
     Management of Internet of Things devices,
     Distributed encrypted storage, and
     Distributed trust.
    This Ideation Challenge solicits White Papers on the topic of 
Blockchain Technology and the Potential for Its Use in Health IT and/or 
Healthcare Related Research Data. This nationwide call may be addressed 
by an individual investigator or an investigator team. Interested 
parties should submit a White Paper no longer than 10 pages describing 
the proposed subject. Investigators or co-investigators may only 
participate in one submission. Up to 15 of these submissions will be 
selected as winners. The selection of a White Paper may also result in 
an invitation to present at an upcoming industry-wide workshop on 
September 26th-27th, 2016, at NIST Headquarters in Gaithersburg, MD.

Objective

    The goal of this Ideation Challenge is to solicit White Papers that 
investigate the relationship between Blockchain technology and its use 
in Health IT and/or Health Related research. The paper should discuss 
the cryptography and underlying fundamentals of Blockchain technology, 
examine how the use of Blockchain can advance industry interoperability 
needs expressed in the ONC's Shared Nationwide Interoperability 
Roadmap, as well as for Patient Centered Outcomes Research (PCOR), the 
Precision Medicine

[[Page 45511]]

Initiative (PMI), delivery system reform, and other health care 
delivery needs, as well as provide recommendations for Blockchain's 
implementation. In addition to a monetary award, winners may also have 
the opportunity to present their White Papers at an industry-wide 
``Blockchain & Healthcare Workshop'' co-hosted by ONC and NIST.

Submission Requirements

    The white paper must:
     Be no longer than ten (10) pages;
     Address whether there is a place in health IT and/or 
healthcare related research for the technology;
     Describe the value of Blockchain to the health-care 
system;
     Identify potential gaps in standards created and/or 
resolved by the use of Blockchain;
     Discuss the effectiveness of Blockchain to function in the 
``real world.'' This discussion may include information regarding 
meeting privacy and security standards, implementation and potential 
performance issues, and cost implications. Risk analysis and mitigation 
would be appropriate to include here as well; and
     Discuss how Blockchain links to the stated objectives in 
the Nationwide Interoperability Roadmap, PCOR, PMI, delivery system 
reform, and other national health care delivery priorities.

How To Enter

    Challenge participants will submit their submission on the 
challenge Web site [http://www.cccinnovationcenter.com/challenges/block-chain-challenge].

Eligibility Rules for Participating in the Challenge

    To be eligible to win a prize under this Challenge, an individual 
or entity:
    1. Shall have registered to participate in the Challenge under the 
rules promulgated by the Office of the National Coordinator for Health 
Information Technology.
    2. Shall have complied with all the stated requirements of the 
Blockchain and Its Emerging Role in Healthcare and Health-related 
Research Challenge.
    3. In the case of a private entity, shall be incorporated in and 
maintain a primary place of business in the United States, and in the 
case of an individual, whether participating singly or in a group, 
shall be a citizen or permanent resident of the United States.
    4. May not be a Federal entity or Federal employee acting within 
the scope of their employment.
    5. Shall not be an HHS employee working on their applications or 
Submissions during assigned duty hours.
    6. Shall not be an employee of the Office of the National 
Coordinator for Health Information Technology.
    7. Federal grantees may not use Federal funds to develop COMPETES 
Act challenge applications unless consistent with the purpose of their 
grant award.
    8. Federal contractors may not use Federal funds from a contract to 
develop COMPETES Act challenge applications or to fund efforts in 
support of a COMPETES Act challenge Submission.
    9. An individual or entity shall not be deemed ineligible because 
the individual or entity used Federal facilities or consulted with 
Federal employees during a Challenge if the facilities and employees 
are made available to all individuals and entities participating in the 
Challenge on an equitable basis.
    10. Submissions must not display HHS' or ONC's logos or official 
seals and must not claim endorsement.
    11. Accuracy--A white paper submission may be disqualified if it 
provides inaccurate or incomplete information.

Registration Process for Participants

    To register for this Challenge, participants can access http://www.challenge.gov and search for ``Blockchain and Its Emerging Role in 
Healthcare and Health-related Research.''

Prize

     12-15 white papers will be awarded a cash prize in the 
range of $ 1,500-5,000,
     Up to 8 winners may be given the opportunity to present 
their paper at a Blockchain & Healthcare Workshop Hosted at NIST,
     Inclusion of the white papers in the Blockchain workshop 
proceedings.

Payment of the Prize

    Prize will be paid by contractor.

Basis Upon Which Winner Will Be Selected

    The judging panel will rate each submission based upon:
     Potential of the overall concept to help foster 
transformative change in the culture of health IT,
     Viability of the proposed recommendations,
     Innovativeness of the approach,
     Potential for achieving the objectives of ONC.

Additional Information

    General Conditions: ONC reserves the right to cancel, suspend, and/
or modify the Challenge, or any part of it, for any reason, at ONC's 
sole discretion.
    Intellectual Property: Each participant retains title and full 
ownership in and to their Submission. Participants expressly reserve 
all intellectual property rights not expressly granted under the 
challenge agreement. By participating in the Challenge, each entrant 
hereby irrevocably grants to the Government a limited, non-exclusive, 
royalty-free, perpetual, worldwide license and right to reproduce, 
publically perform, publically display, and use the Submission to the 
extent necessary to administer the challenge, and to publically perform 
and publically display the Submission, including, without limitation, 
for advertising and promotional purposes relating to the Challenge. 
This may also include displaying the results of the Challenge on a 
public Web site or during a public presentation.

Representation, Warranties and Indemnification

    By entering the Challenge, each applicant represents, warrants and 
covenants as follows:
    (a) Participant is the sole author, creator, and owner of the 
Submission;
    (b) The Submission is not the subject of any actual or threatened 
litigation or claim;
    (c) The Submission does not and will not violate or infringe upon 
the intellectual property rights, privacy rights, publicity rights, or 
other legal rights of any third party.
    Participants must indemnify, defend, and hold harmless the Federal 
Government from and against all third party claims, actions, or 
proceedings of any kind and from any and all damages, liabilities, 
costs, and expenses relating to or arising from participant's 
Submission or any breach or alleged breach of any of the 
representations, warranties, and covenants of participant hereunder. 
The Federal sponsors reserve the right to disqualify any Submission 
that, in their discretion, deems to violate these Official Rules, Terms 
& Conditions.

    Authority: 15 U.S.C. 3719.

Karen DeSalvo, MD., M.P.H., M.Sc.
National Coordinator for Health Information Technology.
[FR Doc. 2016-16607 Filed 7-13-16; 8:45 am]
BILLING CODE 4150-45-P



                                                    45510                          Federal Register / Vol. 81, No. 135 / Thursday, July 14, 2016 / Notices

                                                    FOR FURTHER INFORMATION CONTACT:                         II. The Paperwork Reduction Act of                    Reauthorization Act of 2010 (Pub. L.
                                                    Edward Weinstein, Center for Drug                        1995                                                  111–358).
                                                    Evaluation and Research, Food and                           This guidance refers to previously                 DATES:
                                                    Drug Administration, 10903 New                           approved collections of information that                • Submission period begins: July 7,
                                                    Hampshire Ave., Bldg. 22, Rm. 6382,                      are subject to review by the Office of                2016.
                                                    Silver Spring, MD 20993–0002, 301–                       Management and Budget (OMB) under                       • Submission period ends: August 8,
                                                    796–1400.                                                the Paperwork Reduction Act of 1995                   2016.
                                                    SUPPLEMENTARY INFORMATION:                               (44 U.S.C. 3501–3520). The collections                  • Evaluation begins: August 9, 2016.
                                                                                                             of information in 21 CFR parts 312 and                  • Evaluation ends: August 19, 2016.
                                                    I. Background                                            314 have been approved under OMB                        • Winners notified: August 22, 2016.
                                                                                                             control numbers 0910–0014 and 0910–                     • Winners Announced: August 29,
                                                       FDA is announcing the availability of                                                                       2016.
                                                    a draft guidance for industry entitled                   0001, respectively.
                                                                                                                                                                     • Winner Presentation: September
                                                    ‘‘Bacterial Vaginosis: Developing Drugs                  III. Electronic Access                                26–27, 2016.
                                                    for Treatment.’’ The purpose of this                        Persons with access to the Internet
                                                    guidance is to assist sponsors in the                                                                          FOR FURTHER INFORMATION CONTACT:
                                                                                                             may obtain the draft guidance at either               Debbie Bucci, debbie.bucci@hhs.gov
                                                    development of drugs for the treatment                   http://www.fda.gov/Drugs/Guidance
                                                    of BV. This draft guidance helps define                                                                        (preferred), (202) 690–0213.
                                                                                                             ComplianceRegulatoryInformation/
                                                    enrollment criteria for BV trials and                                                                          SUPPLEMENTARY INFORMATION:
                                                                                                             Guidances/default.htm or http://
                                                    recommends that such trials be                           www.regulations.gov.                                  Subject of Challenge
                                                    superiority trials. The draft guidance
                                                                                                               Dated: July 8, 2016.                                  A Blockchain is a data structure that
                                                    reflects recent developments in
                                                    scientific information that pertain to                   Leslie Kux,                                           can be timed-stamped and signed using
                                                    drugs being developed for the treatment                  Associate Commissioner for Policy.                    a private key to prevent tampering.
                                                    of BV, including the characterization of                 [FR Doc. 2016–16636 Filed 7–13–16; 8:45 am]           There are generally three types of
                                                    the primary efficacy endpoint.                           BILLING CODE 4164–01–P                                Blockchain: Public, private and
                                                                                                                                                                   consortium. Potential uses include:
                                                       Issuance of this guidance fulfills a                                                                          • Digitally sign information,
                                                    portion of the requirements of Title VIII,                                                                       • Computable enforcement of policies
                                                                                                             DEPARTMENT OF HEALTH AND
                                                    section 804, of the Food and Drug                                                                              and contracts (smart contracts),
                                                                                                             HUMAN SERVICES
                                                    Administration Safety and Innovation                                                                             • Management of Internet of Things
                                                    Act (Pub. L. 112–144), which requires                    Office of the National Coordinator for                devices,
                                                    FDA to review and, as appropriate,                       Health Information Technology;                          • Distributed encrypted storage, and
                                                    revise not fewer than three guidance                     Announcement of Requirements and                        • Distributed trust.
                                                    documents per year for the conduct of                    Registration for ‘‘Blockchain and its                   This Ideation Challenge solicits White
                                                    clinical trials with respect to                          Emerging Role in Health IT and Health-                Papers on the topic of Blockchain
                                                    antibacterial and antifungal drugs. In                   related Research’’; Amendment                         Technology and the Potential for Its Use
                                                    1998, FDA published a draft guidance                                                                           in Health IT and/or Healthcare Related
                                                    entitled ‘‘Bacterial Vaginosis—                          AGENCY:   Office of the National
                                                                                                             Coordinator for Health Information                    Research Data. This nationwide call
                                                    Developing Antimicrobial Drugs for                                                                             may be addressed by an individual
                                                    Treatment’’ (the 1998 draft guidance). In                Technology, HHS. Award Approving
                                                                                                             Official: Karen DeSalvo, National                     investigator or an investigator team.
                                                    a Federal Register notice dated August                                                                         Interested parties should submit a White
                                                    7, 2013 (78 FR 48175), FDA announced                     Coordinator for Health Information
                                                                                                             Technology.                                           Paper no longer than 10 pages
                                                    an initiative in the Center for Drug                                                                           describing the proposed subject.
                                                    Evaluation and Research involving the                    ACTION: Notice; Amendment.
                                                                                                                                                                   Investigators or co-investigators may
                                                    review of draft guidance documents                       SUMMARY:   This document amends the                   only participate in one submission. Up
                                                    issued before 2010 to determine their                    notice published in Federal Register,                 to 15 of these submissions will be
                                                    status and to decide whether those                       Friday July 8, 2016, volume 81, pages                 selected as winners. The selection of a
                                                    guidances should be withdrawn,                           44639–44640. This notice updates and                  White Paper may also result in an
                                                    revised, or finalized with only minor                    extends the submission period to                      invitation to present at an upcoming
                                                    changes. In the August 7, 2013, Federal                  August 8, 2016, limits an investigator or             industry-wide workshop on September
                                                    Register notice, FDA announced that                      co-investigator to one submission and                 26th–27th, 2016, at NIST Headquarters
                                                    the 1998 draft guidance, as well as other                adds prize details. The ‘‘Use of                      in Gaithersburg, MD.
                                                    draft guidances, was being withdrawn                     Blockchain in Health IT and Health-
                                                    (78 FR 48175). FDA is now issuing a                      related Research’’ Ideation Challenge                 Objective
                                                    new draft guidance that revises the                      solicits white papers on the topic of                   The goal of this Ideation Challenge is
                                                    recommendations in the 1998 draft                        Blockchain Technology and the                         to solicit White Papers that investigate
                                                    guidance.                                                potential use in Health IT to address                 the relationship between Blockchain
                                                       This draft guidance is being issued                   privacy, security and scalability                     technology and its use in Health IT and/
                                                    consistent with FDA’s good guidance                      challenges of managing electronic                     or Health Related research. The paper
                                                    practices regulation (21 CFR 10.115).                    health record and resources. Up to 15                 should discuss the cryptography and
asabaliauskas on DSK3SPTVN1PROD with NOTICES




                                                    The draft guidance, when finalized, will                 winners will be awarded a cash prize                  underlying fundamentals of Blockchain
                                                    represent the current thinking of FDA                    and up to 8 winners may be invited to                 technology, examine how the use of
                                                    on this topic. It does not establish any                 present their papers at an upcoming                   Blockchain can advance industry
                                                    rights for any person and is not binding                 industry-wide workshop co-hosted with                 interoperability needs expressed in the
                                                    on FDA or the public. You can use an                     the National Institute of Standards and               ONC’s Shared Nationwide
                                                    alternative approach if it satisfies the                 Technology (NIST). The statutory                      Interoperability Roadmap, as well as for
                                                    requirements of the applicable statutes                  authority for this Challenge is section               Patient Centered Outcomes Research
                                                    and regulations.                                         105 of the America COMPETES                           (PCOR), the Precision Medicine


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                                                                                   Federal Register / Vol. 81, No. 135 / Thursday, July 14, 2016 / Notices                                                 45511

                                                    Initiative (PMI), delivery system reform,                Submissions during assigned duty                      the Challenge, or any part of it, for any
                                                    and other health care delivery needs, as                 hours.                                                reason, at ONC’s sole discretion.
                                                    well as provide recommendations for                        6. Shall not be an employee of the                     Intellectual Property: Each participant
                                                    Blockchain’s implementation. In                          Office of the National Coordinator for
                                                                                                                                                                   retains title and full ownership in and
                                                    addition to a monetary award, winners                    Health Information Technology.
                                                                                                               7. Federal grantees may not use                     to their Submission. Participants
                                                    may also have the opportunity to
                                                                                                             Federal funds to develop COMPETES                     expressly reserve all intellectual
                                                    present their White Papers at an
                                                                                                             Act challenge applications unless                     property rights not expressly granted
                                                    industry-wide ‘‘Blockchain & Healthcare
                                                    Workshop’’ co-hosted by ONC and                          consistent with the purpose of their                  under the challenge agreement. By
                                                    NIST.                                                    grant award.                                          participating in the Challenge, each
                                                                                                               8. Federal contractors may not use                  entrant hereby irrevocably grants to the
                                                    Submission Requirements                                  Federal funds from a contract to develop              Government a limited, non-exclusive,
                                                      The white paper must:                                  COMPETES Act challenge applications                   royalty-free, perpetual, worldwide
                                                      • Be no longer than ten (10) pages;                    or to fund efforts in support of a                    license and right to reproduce,
                                                      • Address whether there is a place in                  COMPETES Act challenge Submission.                    publically perform, publically display,
                                                    health IT and/or healthcare related                        9. An individual or entity shall not be             and use the Submission to the extent
                                                    research for the technology;                             deemed ineligible because the                         necessary to administer the challenge,
                                                      • Describe the value of Blockchain to                  individual or entity used Federal                     and to publically perform and
                                                    the health-care system;                                  facilities or consulted with Federal                  publically display the Submission,
                                                      • Identify potential gaps in standards                 employees during a Challenge if the                   including, without limitation, for
                                                    created and/or resolved by the use of                    facilities and employees are made                     advertising and promotional purposes
                                                    Blockchain;                                              available to all individuals and entities             relating to the Challenge. This may also
                                                      • Discuss the effectiveness of                         participating in the Challenge on an                  include displaying the results of the
                                                    Blockchain to function in the ‘‘real                     equitable basis.
                                                                                                                                                                   Challenge on a public Web site or
                                                    world.’’ This discussion may include                       10. Submissions must not display
                                                                                                             HHS’ or ONC’s logos or official seals                 during a public presentation.
                                                    information regarding meeting privacy
                                                    and security standards, implementation                   and must not claim endorsement.                       Representation, Warranties and
                                                    and potential performance issues, and                      11. Accuracy—A white paper                          Indemnification
                                                    cost implications. Risk analysis and                     submission may be disqualified if it
                                                    mitigation would be appropriate to                       provides inaccurate or incomplete                        By entering the Challenge, each
                                                    include here as well; and                                information.                                          applicant represents, warrants and
                                                      • Discuss how Blockchain links to the                  Registration Process for Participants                 covenants as follows:
                                                    stated objectives in the Nationwide                                                                               (a) Participant is the sole author,
                                                    Interoperability Roadmap, PCOR, PMI,                        To register for this Challenge,
                                                                                                             participants can access http://                       creator, and owner of the Submission;
                                                    delivery system reform, and other
                                                    national health care delivery priorities.                www.challenge.gov and search for                         (b) The Submission is not the subject
                                                                                                             ‘‘Blockchain and Its Emerging Role in                 of any actual or threatened litigation or
                                                    How To Enter                                             Healthcare and Health-related                         claim;
                                                       Challenge participants will submit                    Research.’’                                              (c) The Submission does not and will
                                                    their submission on the challenge Web                    Prize                                                 not violate or infringe upon the
                                                    site [http://                                                                                                  intellectual property rights, privacy
                                                    www.cccinnovationcenter.com/                               • 12–15 white papers will be awarded
                                                                                                             a cash prize in the range of $ 1,500–                 rights, publicity rights, or other legal
                                                    challenges/block-chain-challenge].                                                                             rights of any third party.
                                                                                                             5,000,
                                                    Eligibility Rules for Participating in the                 • Up to 8 winners may be given the                     Participants must indemnify, defend,
                                                    Challenge                                                opportunity to present their paper at a               and hold harmless the Federal
                                                      To be eligible to win a prize under                    Blockchain & Healthcare Workshop                      Government from and against all third
                                                    this Challenge, an individual or entity:                 Hosted at NIST,                                       party claims, actions, or proceedings of
                                                      1. Shall have registered to participate                  • Inclusion of the white papers in the              any kind and from any and all damages,
                                                    in the Challenge under the rules                         Blockchain workshop proceedings.                      liabilities, costs, and expenses relating
                                                    promulgated by the Office of the                         Payment of the Prize                                  to or arising from participant’s
                                                    National Coordinator for Health                                                                                Submission or any breach or alleged
                                                                                                               Prize will be paid by contractor.
                                                    Information Technology.                                                                                        breach of any of the representations,
                                                      2. Shall have complied with all the                    Basis Upon Which Winner Will Be                       warranties, and covenants of participant
                                                    stated requirements of the Blockchain                    Selected                                              hereunder. The Federal sponsors reserve
                                                    and Its Emerging Role in Healthcare and                    The judging panel will rate each                    the right to disqualify any Submission
                                                    Health-related Research Challenge.                       submission based upon:                                that, in their discretion, deems to violate
                                                      3. In the case of a private entity, shall                • Potential of the overall concept to               these Official Rules, Terms &
                                                    be incorporated in and maintain a                        help foster transformative change in the              Conditions.
                                                    primary place of business in the United                  culture of health IT,
                                                    States, and in the case of an individual,                  • Viability of the proposed                           Authority: 15 U.S.C. 3719.
asabaliauskas on DSK3SPTVN1PROD with NOTICES




                                                    whether participating singly or in a                     recommendations,                                      Karen DeSalvo, MD., M.P.H., M.Sc.
                                                    group, shall be a citizen or permanent                     • Innovativeness of the approach,                   National Coordinator for Health Information
                                                    resident of the United States.                             • Potential for achieving the
                                                                                                                                                                   Technology.
                                                      4. May not be a Federal entity or                      objectives of ONC.
                                                    Federal employee acting within the                                                                             [FR Doc. 2016–16607 Filed 7–13–16; 8:45 am]
                                                    scope of their employment.                               Additional Information                                BILLING CODE 4150–45–P
                                                      5. Shall not be an HHS employee                           General Conditions: ONC reserves the
                                                    working on their applications or                         right to cancel, suspend, and/or modify


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Document Created: 2016-07-14 01:55:23
Document Modified: 2016-07-14 01:55:23
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionNotices
ActionNotice; Amendment.
Dates<bullet> Submission period begins: July 7, 2016.
ContactDebbie Bucci, [email protected] (preferred), (202) 690-0213.
FR Citation81 FR 45510 

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