Project Summary and Abstract This supplement requests support of effort for key individuals that will allow Temple University Clinical Research Hub for the Strategies to Innovate Emergency Care Clinical Trials Network (Temple-SIREN) to continue operations for recruiting participants into emergency care research and to help implement SIREN trials at local and regional Temple-SIREN performance sites. 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 Hub will ensure successful enrollment of participants into the ongoing SIREN trials: ICECAP, BOOST-3, and HOBIT. We will continue to support the ancillary studies for these trials: PRECICECAP and Bio-BOOST at eligible sites. Administrative supplemental funding will allow us better fulfill the specific aims of the project. Two major aims of the Temple-SIREN award are to 1) to provide site and project management to expedite SIREN study start-up and to optimize patient recruitment and protocol adherence at Temple-SIREN sites and 2) develop a regional system of biomedical researchers to compete for future NIH grants and to study.