Project Summary and Abstract This supplement requests support of key activities and effort for key individuals that will allow the University of Minnesota SIREN Hub to continue operations for recruiting participants into emergency care research. Supplemental support is requested to maintain operations between the end of regular funding for the first 5 years of SIREN and start of the second 5 years of SIREN. Uninterrupted support of the Minnesota Hub will ensure successful enrollment of participants into the ongoing SIREN trials (ICECAP, BOOST-3, and HOBIT), and the continued support for the ancillary studies for these trials (Bio-BOOST to start soon, and Bio- HOBIT). During the height of the COVID pandemic, SIREN research activities were paused or severely limited at our Hub institutions and Spokes, and enrollment options (and accompanying funds to support research teams) were often unavailable, despite continued Hub financial needs. We therefore anticipate ending the current SIREN funding cycle with a deficit, which we will cover with funding from the Dean’s office and some departmental funds. These internal funds are very limited, however, and are not available to cover the cost of the continuation of our work until the next SIREN funding cycle. Thus, the supplement funds being requested will be essential for uninterrupted Minnesota Hub performance.