The study states that '150 fecal E. coli strains were randomly selected from those that were collected in 2009' and that these were 'isolated from asymptomatic healthy unrelated human subjects in Fuzhou, China.' However, there is no explicit description of how the original cohort of healthy subjects was identified, recruited, or whether it represents the average exposed person in the community. The derivation of the cohort is not described in sufficient detail to determine representativeness. The only information provided is the location (Fuzhou, China) and that subjects were 'asymptomatic healthy unrelated human subjects,' but the sampling frame, recruitment method, and inclusion/exclusion criteria are not specified.

Raw response parsing failed. Original content: { "judgment": "no star awarded", "scoring_rationale": "The Newcastle-Ottawa Scale criterion S2 requires explicit documentation that the non-exposed cohort was drawn from the same community as the ...

Raw response parsing failed. Original content: { "judgment": "star awarded", "scoring_rationale": "The study provides explicit and detailed descriptions of exposure ascertainment. Exposure (antimicrobial resistance and integrons in E. coli) wa...

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The Newcastle-Ottawa Scale comparability criterion requires explicit documentation that the study controlled for confounders, such as age, sex, or other relevant variables, either in the design (e.g., matching) or analysis (e.g., statistical adjustment). A thorough review of the provided text reveals no explicit mention of controlling for any confounders. There is no statement of matching, stratification, or statistical adjustment for potential confounding variables. The only population descriptor is 'asymptomatic healthy unrelated human subjects in Fuzhou, China,' but there is no indication that cohorts were made comparable on any confounding factors. Therefore, based strictly on the available evidence, no stars can be awarded for this criterion.

Raw response parsing failed. Original content: { "judgment": "no star awarded", "scoring_rationale": "The Newcastle-Ottawa Scale (NOS) outcome assessment criterion requires explicit documentation that outcome ascertainment was performed by ind...

The Newcastle-Ottawa Scale criterion O2 requires explicit documentation that the follow-up duration was clearly stated and sufficient for the outcome of interest to occur. Nowhere in the provided text is the duration of follow-up for participants described. The only temporal reference is: 'In 2009, we performed a research on the fecal E. coli strains isolated from asymptomatic healthy unrelated human subjects in Fuzhou, China.6 And in this study, 150 fecal E. coli strains were randomly selected from those that were collected in 2009.' This indicates a cross-sectional sampling of strains collected in a single year, with no mention of any follow-up period. There is no evidence that participants were followed over time, nor is there any statement about the length of observation or monitoring for outcomes. Therefore, the evidence is insufficient to award a star for this criterion.

The Newcastle-Ottawa Scale (NOS) criterion O3 requires explicit documentation of follow-up adequacy, including the proportion of subjects followed up, losses to follow-up, and whether all subjects were accounted for. In the provided text, there is no mention of any follow-up period, procedures for follow-up, the number or proportion of subjects lost to follow-up, or any description of the completeness of outcome data. The study appears to be cross-sectional in nature, as it describes the collection and analysis of 150 fecal E. coli strains from healthy subjects at a single time point, with no indication of longitudinal follow-up. Therefore, there is insufficient evidence to assess follow-up adequacy, and according to NOS guidance, a star cannot be awarded in the absence of explicit information.