Project Summary and Abstract This supplement requests support of effort for key individuals that will allow the University of Pittsburgh site for the Strategies to Innovate Emergency Care Clinical Trials Network (SIREN) to continue operations as a Hub for recruiting participants into emergency care research. Uninterrupted support of the Hub will ensure successful enrollment of participants into the following SIREN trials; ICECAP, BOOST-3, and Peds-ICECAP. We will continue to support the ancillary studies for these trials: PRECICECAP, Bio-BOOST and electro- BOOST. Our specific Aims remain: 1. Provide administrative structure to rapidly implement and enroll in clinical trials of emergency treatments. 2. Minimize time, cost and regulatory barriers to multicenter clinical trials in emergency settings. 3. Explore innovative strategies to increase identification, recruitment, and consent in emergency treatment trials. 4. Explore innovative strategies to increase quality of emergency care data and to ensure retention of subjects enrolled in emergency settings.