Frailty in clinical drug trials: Frailty assessments, subgroup analyses and outcomes.

With population ageing, drug trials are increasingly turning their attention to including older, frailer people. This review aimed to provide an overview of how frailty was assessed in published studies related to clinical pharmacological trials, and on the interaction of frailty on the efficacy of the treatments. We searched MEDLINE, EMBASE and Cochrane for clinical drug trials in older people. A total of 4031 abstracts were screened and 17 relevant studies were included in this review. We summarized the findings of these 17 trials into five main clinical areas: cardiovascular (eight studies), cognition (one study), vaccination (two studies), cancer (four studies) and other (two studies). Frailty was assessed retrospectively in most of the studies. Frailty was treated as an ordinal variable (with different levels of frailty) or binary variable (frail/non-frail) using cut-offs in some studies, and as a continuous in some other studies. The effect of frailty on the treatment efficacy was not consistent among the studies. While several trials, such as the Action in Diabetes and Vascular Disease-Preterax and Diamicron Modified Release Controlled Evaluation trials, the Systolic Blood Pressure Intervention Trial and the Aspirin in Reducing Events in the Elderly trial, showed some reduced effects of the treatment in frail patients, most of the trials showed that the benefits of the treatment are not affected by frailty. Some trials even showed that the benefits of the treatment were more significant in frailer patients (the Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure and the Dapagliflozin Evaluation to Improve the Lives of Patients with Preserved Ejection Fraction Heart Failure trials). The results of this review suggest that routine measurement of frailty in participants in clinical drug trials would improve our knowledge of the effect of treatment in the frail and identify those who have more or least to gain from treatment.

Multi-metallic Layered Catalysts for Stable Electrochemical CO2 Reduction to Formate and Formic Acid.

Electrochemical CO2 reduction (ECR) to value-added products such as formate/formic acid is a promising approach for CO2 mitigation. Practical ECR requires long-term stability at industrially relevant reduction rates, which is challenging due to the rapid degradation of most catalysts at high current densities. Herein, we report the development of a bismuth (Bi) gas diffusion electrode on a polytetrafluoroethylene-based electrically conductive silver (Ag) substrate (Ag@Bi), which exhibits high Faradaic efficiency (FE) for formate of over 90 % in 1 M KOH and 1 M KHCO3 electrolytes. The catalyst also shows high selectivity of formic acid above 85 % in 1 M NaCl catholyte, which has a bulk pH of 2-3 during ECR, at current densities up to 300 mA cm-2. In 1 M KHCO3 condition, Ag@Bi maintains formate FE above 90 % for at least 500 hours at the current density of 100 mA cm-2. We found that the Ag@Bi catalyst degrades over time due to the leaching of Bi in the NaCl catholyte. To overcome this challenge, we deposited a layer of Ag nanoparticles on the surface of Ag@Bi to form a multi-layer Ag@Bi/Ag catalyst. This designed catalyst exhibits 300 hours of stability with FE for formic acid ≥70 % at 100 mA cm-2. Our work establishes a new strategy for achieving the operational longevity of ECR under wide pH conditions, which is critical for practical applications.

Multimorbidity and Blood Pressure Control in Patients Attending Primary Care in Canada.

BACKGROUND: There has been conflicting evidence on the association between multimorbidity and blood pressure (BP) control. This study aimed to investigate this associations in people with hypertension attending primary care in Canada, and to assess whether individual long-term conditions are associated with BP control. METHODS: This was a cross-sectional study in people with hypertension attending primary care in Toronto between January 1, 2017 and December 31, 2019. Uncontrolled BP was defined as systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg. A list of 11 a priori selected chronic conditions was used to define multimorbidity. Multimorbidity was defined as having ≥1 long-term condition in addition to hypertension. Logistic regression models were used to estimate the association between multimorbidity (or individual long-term conditions) with uncontrolled BP. RESULTS: A total of 67 385 patients with hypertension were included. They had a mean age of 70, 53.1% were female, 80.6% had multimorbidity, and 35.7% had uncontrolled BP. Patients with multimorbidity had lower odds of uncontrolled BP than those without multimorbidity (adjusted OR = 0.72, 95% CI 0.68-0.76). Among the long-term conditions, diabetes (aOR = 0.73, 95%CI 0.70-0.77), heart failure (aOR = 0.81, 95%CI 0.73-0.91), ischemic heart disease (aOR = 0.74, 95%CI 0.69-0.79), schizophrenia (aOR = 0.79, 95%CI 0.65-0.97), depression/anxiety (aOR = 0.91, 95%CI 0.86-0.95), dementia (aOR = 0.87, 95%CI 0.80-0.95), and osteoarthritis (aOR = 0.89, 95%CI 0.85-0.93) were associated with a lower likelihood of uncontrolled BP. CONCLUSION: We found that multimorbidity was associated with better BP control. Several conditions were associated with better control, including diabetes, heart failure, ischemic heart disease, schizophrenia, depression/anxiety, dementia, and osteoarthritis.

Lower Energy Excitation of Water Soluble Near-Infrared Emitting Mixed-Ligand Metallacrowns.

By combining advantages of two series of lanthanide(III)/zinc(II) metallacrowns (MCs) assembled using pyrazine- (pyzHA2- ) and quinoxaline- (quinoHA2- ) hydroximate building blocks ligands, we created here water-soluble mixed-ligand MCs with extended absorption to the visible range. The YbIII analogue demonstrated improved photophysical properties in the near-infrared (NIR) range in cell culture media, facilitating its application for NIR optical imaging in living HeLa cells.

On the Physical Layer Security of Federated Learning Based IoMT Networks.

Internet of Medical Things (IoMT) connects different medical devices, health sensors and hospital records to data platforms using wireless communications. Federated Learning (FL) is an emerging collaborative learning technique that can be beneficial for IoMT due to reduced communication overhead and enhanced security. This paper provides an overview of different architectures used in FL and potential approaches for FL based IoMT. We also discuss how Physical Layer Security (PLS) can be used for efficient privacy preservation of data in FL based IoMT. We highlight the recent work in this area and major research challenges related to PLS assisted FL in IoMT. We also provide a case study demonstrating that clustering of IoMT devices (such that a single device in each cluster acts as a cluster head) enhances the secrecy rate of the FL based IoMT network as compared to its non-clustered counterpart. Finally, we also discuss future opportunities and open research questions related to PLS assisted FL in IoMT.

A Cascaded Mutliresolution Ensemble Deep Learning Framework for Large Scale Alzheimer's Disease Detection using Brain MRIs.

Alzheimer's is progressive and irreversible type of dementia, which causes degeneration and death of cells and their connections in the brain. AD worsens over time and greatly impacts patients' life and affects their important mental functions, including thinking, the ability to carry on a conversation, and judgment and response to environment. Clinically, there is no single test to effectively diagnose Alzheimer disease. However, computed tomography (CT) and magnetic resonance imaging (MRI) scans can be used to help in AD diagnosis by observing critical changes in the size of different brain areas, typically parietal and temporal lobes areas. In this work, an integrative mulitresolutional ensemble deep learning-based framework is proposed to achieve better predictive performance for the diagnosis of Alzheimer disease. Unlike ResNet, DenseNet and their variants proposed pipeline utilizes PartialNet in a hierarchical design tailored to AD detection using brain MRIs. The advantage of the proposed analysis system is that PartialNet diversified the depth and deep supervision. Additionally, it also incorporates the properties of identity mappings which makes it powerful in better learning due to feature reuse. Besides, the proposed ensemble PartialNet is better in vanishing gradient, diminishing forward-flow with low number of parameters and better training time in comparison to its counter network. The proposed analysis pipeline has been tested and evaluated on benchmark ADNI dataset collected from 379 subjects patients. Quantitative validation of the obtained results documented our framework's capability, outperforming state-of-the-art learning approaches for both multi-and binary-class AD detection.

Catalyst Regeneration via Chemical Oxidation Enables Long-Term Electrochemical Carbon Dioxide Reduction.

Electrochemical CO2 reduction (ECR) with industrially relevant current densities, high product selectivity, and long-term stability has been a long-sought goal. Unfortunately, copper (Cu) catalysts for producing valuable multicarbon (C2+) products undergo structural and morphological changes under ECR conditions, especially at high current densities, resulting in a rapid decrease in product selectivity. Herein, we report a catalyst regeneration strategy, one that employs an electrolysis method comprising alternating "on" and "off" operating regimes, to increase the operating stability of a Cu catalyst. We find that it increases operating lifetime many times, maintaining ethylene selectivity ≥40% for at least 200 h of electrolysis in neutral pH media at a current density of 150 mA cm-2 using a flow cell. We also demonstrate ECR to ethylene at a current density of 1 A cm-2 with ethylene selectivity ≥40% using a three-dimensional Cu gas diffusion electrode, finding that this system under these conditions is rendered stable for greater than 36 h. This work illustrates that Cu-based catalysts, once they have entered into the state conventionally considered to possess degraded catalytic activity, may be recovered to deliver high C2+ selectivity. We present evidence that the combination of short periods of electrolysis, which minimizes the morphological changes during "on" segments, with the progressive chemical oxidation of Cu atoms on the catalyst surface during "off" segments, united with the added effects of washing the accumulated salt and decreasing the catholyte temperature prolong together the catalyst's operating lifetime.

Tuning the photophysical properties of lanthanide(iii)/zinc(ii) 'encapsulated sandwich' metallacrowns emitting in the near-infrared range.

A family of Zn16Ln(HA)16 metallacrowns (MCs; Ln = YbIII, ErIII, and NdIII; HA = picoline- (picHA2-), pyrazine- (pyzHA2-), and quinaldine- (quinHA2-) hydroximates) with an 'encapsulated sandwich' structure possesses outstanding luminescence properties in the near-infrared (NIR) and suitability for cell imaging. Here, to decipher which parameters affect their functional and photophysical properties and how the nature of the hydroximate ligands can allow their fine tuning, we have completed this Zn16Ln(HA)16 family by synthesizing MCs with two new ligands, naphthyridine- (napHA2-) and quinoxaline- (quinoHA2-) hydroximates. Zn16Ln(napHA)16 and Zn16Ln(quinoHA)16 exhibit absorption bands extended into the visible range and efficiently sensitize the NIR emissions of YbIII, ErIII, and NdIII upon excitation up to 630 nm. The energies of the lowest singlet (S1), triplet (T1) and intra-ligand charge transfer (ILCT) states have been determined. LnIII-centered total (Q L Ln) and intrinsic (Q Ln Ln) quantum yields, sensitization efficiencies (η sens), observed (τ obs) and radiative (τ rad) luminescence lifetimes have been recorded and analyzed in the solid state and in CH3OH and CD3OD solutions for all Zn16Ln(HA)16. We found that, within the Zn16Ln(HA)16 family, τ rad values are not constant for a particular LnIII. The close in energy positions of T1 and ILCT states in Zn16Ln(picHA)16 and Zn16Ln(quinHA)16 are preferred for the sensitization of LnIII NIR emission and η sens values reach 100% for NdIII. Finally, the highest values of Q L Ln are observed for Zn16Ln(quinHA)16 in the solid state or in CD3OD solutions. With these data at hand, we are now capable of creating MCs with desired properties suitable for NIR optical imaging.

Appendicular Lean Mass and Frailty among Geriatric Outpatients.

The objective of this observational study was to examine the association between appendicular lean mass and frailty in adults aged 60 years and older. This study was conducted in the Outpatient Department of the National Geriatric Hospital in Hanoi, Vietnam. Appendicular lean mass (kg) was assessed by using Dual energy X-ray absorptiometry scans. Frailty was defined according to Fried's frailty criteria. A total of 560 outpatients were included in the study, with a mean age of 70 years. The prevalence of frailty was 12.0%. Frail patients had significantly lower appendicular lean mass compared with non-frail outpatients (9.6 ± 2.0 kg vs. 11.7 ± 3.1 kg, p<0.001). On multivariable logistic regression models, higher appendicular lean mass was associated with significantly reduced odds for frailty (adjusted OR = 0.74, 95%CI 0.59 - 0.93). These findings suggest that the assessment of appendicular lean mass should be considered in older patients attending outpatient geriatric clinics.

Coordinating Health Care With Artificial Intelligence-Supported Technology for Patients With Atrial Fibrillation: Protocol for a Randomized Controlled Trial.

BACKGROUND: Atrial fibrillation (AF) is an increasingly common chronic health condition for which integrated care that is multidisciplinary and patient-centric is recommended yet challenging to implement. OBJECTIVE: The aim of Coordinating Health Care With Artificial Intelligence-Supported Technology in AF is to evaluate the feasibility and potential efficacy of a digital intervention (AF-Support) comprising preprogrammed automated telephone calls (artificial intelligence conversational technology), SMS text messages, and emails, as well as an educational website, to support patients with AF in self-managing their condition and coordinate primary and secondary care follow-up. METHODS: Coordinating Health Care With Artificial Intelligence-Supported Technology in AF is a 6-month randomized controlled trial of adult patients with AF (n=385), who will be allocated in a ratio of 4:1 to AF-Support or usual care, with postintervention semistructured interviews. The primary outcome is AF-related quality of life, and the secondary outcomes include cardiovascular risk factors, outcomes, and health care use. The 4:1 allocation design enables a detailed examination of the feasibility, uptake, and process of the implementation of AF-Support. Participants with new or ongoing AF will be recruited from hospitals and specialist-led clinics in Sydney, New South Wales, Australia. AF-Support has been co-designed with clinicians, researchers, information technologists, and patients. Automated telephone calls will occur 7 times, with the first call triggered to commence 24 to 48 hours after enrollment. Calls follow a standard flow but are customized to vary depending on patients' responses. Calls assess AF symptoms, and participants' responses will trigger different system responses based on prespecified protocols, including the identification of red flags requiring escalation. Randomization will be performed electronically, and allocation concealment will be ensured. Because of the nature of this trial, only outcome assessors and data analysts will be blinded. For the primary outcome, groups will be compared using an analysis of covariance adjusted for corresponding baseline values. Randomized trial data analysis will be performed according to the intention-to-treat principle, and qualitative data will be thematically analyzed. RESULTS: Ethics approval was granted by the Western Sydney Local Health District Human Ethics Research Committee, and recruitment started in December 2020. As of December 2021, a total of 103 patients had been recruited. CONCLUSIONS: This study will address the gap in knowledge with respect to the role of postdischarge digital care models for supporting patients with AF. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12621000174886; https://www.australianclinicaltrials.gov.au/anzctr/trial/ACTRN12621000174886. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/34470.

Redemptive Resource Sharing and Allocation Scheme for Internet of Things-Assisted Smart Healthcare Systems.

Internet of Things assisted healthcare services grants reliable clinical diagnosis and analysis by exploiting heterogeneous communication and infrastructure elements. Communication is enabled through point-to-point or cluster-to-point between the users and the diagnosis center. In this process, the complication is the resource sharing and diagnosis swiftness invalidating multiple resources. IoT's open and ubiquitous nature results in proactive resource sharing, resulting in delayed transmissions. This manuscript introduces the Redemptive Resource Sharing and Allocation (R2SA) scheme to address this issue. The available health data is accumulated on a first-come-first-serve basis, and the transmitting infrastructure is selected. In this process, the data-to-capacity of the available infrastructure is identified for non-redemptive resource allocation. The extremity of the capacity and unavailability of the resource is then analyzed for parallel processing and allocation. Therefore, the data accumulation and exchange rely on concurrent sharing and resource allocation processes, deferring a better accumulation ratio. The concurrent redemptive selection and sharing reduces transmission delay, improves resource allocation, and reduces transmission complexity. The entire process is managed for transfer learning, data-to-capacity validation, and concurrent recommendation. The first validation knowledge base remains the same/shared for different data accumulation and sharing intervals.

Patient-Led Mass Screening for Atrial Fibrillation in the Older Population Using Handheld Electrocardiographic Devices Integrated With a Clinician-Coordinated Remote Central Monitoring System: Protocol for a Randomized Controlled Trial and Process Evaluation.

BACKGROUND: Atrial fibrillation (AF) is common in older people and increases the risk of stroke. The feasibility and effectiveness of the implementation of a patient-led AF screening program for older people are unknown. OBJECTIVE: This study aims to examine the feasibility and effectiveness of an AF screening program comprising patient-led monitoring of single-lead electrocardiograms (ECGs) with clinician-coordinated central monitoring to diagnose AF among community-dwelling people aged ≥75 years in Australia. METHODS: This is a nationwide randomized controlled implementation trial conducted via the internet and remotely among 200 community-dwelling adults aged ≥75 years with no known AF. Randomization will be performed in a 1:1 allocation ratio for the intervention versus control. Intervention group participants will be enrolled in the monitoring program at randomization. They will receive a handheld single-lead ECG device and training on the self-recording of ECGs on weekdays and submit their ECGs via their smartphones. The control group participants will receive usual care from their general practitioners for the initial 6 months and then commence the 6-month monitoring program. The ECGs will be reviewed centrally by trained personnel. Participants and their general practitioners will be notified of AF and other clinically significant ECG abnormalities. RESULTS: This study will establish the feasibility and effectiveness of implementing the intervention in this patient population. The primary clinical outcome is the AF detection rate, and the primary feasibility outcome is the patient satisfaction score. Other outcomes include appropriate use of anticoagulant therapy, participant recruitment rate, program engagement (eg, frequency of ECG transmission), agreement in ECG interpretation between the device automatic algorithm and clinicians, the proportion of participants who complete the trial and number of dropouts, and the impact of frailty on feasibility and outcomes. We will conduct a qualitative evaluation to examine the barriers to and acceptability and enablers of implementation. Ethics approval was obtained from the human research ethics committee at the University of Sydney (project number 2020/680). The results will be disseminated via conventional scientific forums, including peer-reviewed publications and presentations at national and international conferences. CONCLUSIONS: By incorporating an integrated health care approach involving patient empowerment, centralized clinician-coordinated ECG monitoring, and facilitation of primary care and specialist services, it is possible to diagnose and treat AF early to reduce stroke risk. This study will provide new information on how to implement AF screening using digital health technology practicably and feasibly for older and frail populations residing in the community. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12621000184875; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380877. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/34778.

The Impact of Frailty on the Effectiveness and Safety of Intensive Glucose Control and Blood Pressure-Lowering Therapy for People With Type 2 Diabetes: Results From the ADVANCE Trial.

OBJECTIVE: To develop a frailty index (FI) and explore the relationship of frailty to subsequent adverse outcomes on the effectiveness and safety of more intensive control of both blood glucose and blood pressure (BP), among participants with type 2 diabetes in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial. RESEARCH DESIGN AND METHODS: Cox proportional hazard models were used to estimate the effectiveness and safety of intensive glucose control and BP intervention according to frailty (defined as FI >0.21) status. The primary outcomes were macro- and microvascular events. The secondary outcomes were all-cause mortality, cardiovascular mortality, severe hypoglycemia, and discontinuation of BP treatment due to hypotension/dizziness. RESULTS: There were 11,140 participants (mean age, 65.8 years; 42.5% women, 25.7% frail). Frailty was an independent predictor of all primary outcomes and secondary outcomes. The effect of intensive glucose treatment on primary outcomes showed some evidence of attenuation in the frail: hazard ratios for combined major macro- and microvascular events 1.03 (95% CI 0.90-1.19) in the frail versus 0.84 (95% CI 0.74-0.94) in the nonfrail (P = 0.02). A similar trend was observed with BP intervention. Severe hypoglycemia rates (per 1,000 person-years) were higher in the frail: 8.39 (6.15-10.63) vs. 4.80 (3.84-5.76) in nonfrail (P < 0.001). There was no significant difference in discontinuation of BP treatment between frailty groups. CONCLUSIONS: It was possible to retrospectively estimate frailty in a trial population, and this FI identified those at higher risk of poor outcomes. Participants with frailty had some attenuation of benefit from intensive glucose-lowering and BP-lowering treatments.

Gas diffusion electrode design for electrochemical carbon dioxide reduction.

Anthropogenic carbon dioxide (CO2) emissions contribute to the greenhouse effect and global warming, which can lead to undesirable climate change and extinction of species. Besides the ongoing efforts to develop environmentally benign sources of energy and to advance technologies for the capture and sequestration of CO2, the transformation of emitted CO2 into valuable products is a pragmatic solution to curb its accumulation in the atmosphere. In this regard, electrochemical CO2 reduction (ECR) powered by renewable electricity provides an attractive approach because it not only converts CO2 to valuable fuels and chemicals but also offers a solution for the long-term storage of intermittent renewable energies. In ECR, the gas diffusion electrode (GDE) is the most critical component and has been the subject of intensive research in the last few years. This tutorial review provides an insightful guide to developing GDEs with high activity, selectivity, and stability, the three important performance metrics in ECR. First, we introduce critical fundamentals of ECR, including the chemical and physical phenomena at the electrodes as well as the electrochemical cell configurations. Next, we discuss recent advances in GDE design, focusing on their structure-performance correlation and fabrication techniques for each component of GDEs. Finally, we discuss the remaining challenges and propose promising research directions for the design of efficient GDEs. This review aims at promoting the development of industrially relevant ECR systems to bring this technology to practical applications.

A recyclable metal-organic framework for ammonia vapour adsorption.

Herein, we present a new strategy to design metal-organic frameworks (MOFs) as adsorbents for ammonia (NH3) vapour. The linking ligand is functionalized with a sterically hindered Lewis acidic boron (B) centre, allowing efficient capture of NH3 and easy recycling of the MOF by simply heating at low temperature. The recycled MOF material can be used for NH3 capture for at least 5 cycles without losing its crystallinity or its luminescence properties.

Assessment of Community Interventions for Bystander Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-analysis.

Importance: Outcomes from out-of-hospital cardiac arrests (OHCAs) remain poor. Outcomes associated with community interventions that address bystander cardiopulmonary resuscitation (CPR) remain unclear and need further study. Objective: To examine community interventions and their association with bystander CPR and survival after OHCA. Data Sources: Literature search of the MEDLINE, Embase, and the Cochrane Library databases from database inception to December 31, 2018, was conducted. Key search terms included cardiopulmonary resuscitation, layperson, basic life support, education, cardiac arrest, and survival. Study Selection: Community intervention studies that reported on comparisons with control and differences in survival following OHCA were included. Studies that focused only on in-hospital interventions, patients with in-hospital cardiac arrest, only dispatcher-assisted CPR, or provision of automated external defibrillators were excluded. Data Extraction and Synthesis: Pooled odds ratios (ORs) and 95% CIs were estimated using a random-effects model. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Main Outcomes and Measures: Thirty-day survival or survival to hospital discharge and bystander CPR rate. Results: A total of 4480 articles were identified; of these, 15 studies were included for analysis. There were broadly 2 types of interventions: community intervention alone (5 studies) and community intervention combined with changes in health services (10 studies). Four studies involved notification systems that alerted trained lay bystanders to the location of the OHCA in addition to CPR skills training. Meta-analysis of 9 studies including 21 266 patients with OHCA found that community interventions were associated with increased survival to discharge or 30-day survival (OR, 1.34; 95% CI, 1.14-1.57; I2 = 33%) and greater bystander CPR rate (OR, 1.28; 95% CI, 1.06-1.54; I2 = 82%). Compared with community intervention alone, community plus health service intervention was associated with a greater bystander CPR rate compared with community alone (community plus intervention: OR, 1.74; 95% CI, 1.26-2.40 vs community alone: OR, 1.06; 95% CI, 0.85-1.31) (P = .01). Survival rate, however, was not significantly different between intervention types: community plus health service intervention OR, 1.71; 95% CI, 1.09-2.68 vs community only OR, 1.26; 95% CI, 1.05-1.50 (P = .21). Conclusions and Relevance: In this study, while the evidence base is limited, community-based interventions with a focus on improving bystander CPR appeared to be associated with improved survival following OHCA. Further evaluations in diverse settings are needed to enable widespread implementation of such interventions.

CO2 Methanation via Amino Alcohol Relay Molecules Employing a Ruthenium Nanoparticle/Metal Organic Framework Catalyst.

Methanation of carbon dioxide (CO2 ) is attractive within the context of a renewable energy refinery. Herein, we report an indirect methanation method that harnesses amino alcohols as relay molecules in combination with a catalyst comprising ruthenium nanoparticles (NPs) immobilized on a Lewis acidic and robust metal-organic framework (MOF). The Ru NPs are well dispersed on the surface of the MOF crystals and have a narrow size distribution. The catalyst efficiently transforms amino alcohols to oxazolidinones (upon reaction with CO2 ) and then to methane (upon reaction with hydrogen), simultaneously regenerating the amino alcohol relay molecule. This protocol provides a sustainable, indirect way for CO2 methanation as the process can be repeated multiple times.