RiteeshGrandhi/sciclaimeval-shared-task huggingface dataset:
Introduction
Historically, several small workshops in Wenzhou, including those specializing in paint, electroplating, and copper processing, have been significant sources of lead contamination. Lead exposure can have harmful effects, including impeding physical development, disrupting the hematopoietic system, altering immune responses, and affecting neuronal activity ( Nain & Kumar, 2020 ; Vorvolakos, Arseniou & Samakouri, 2016 ; Zhang et al., 2016 ). Lead poisoning can damage the hematopoietic system, affecting cerebral hemodynamics and mitochondrial function. This may disrupt brain autoregulation mechanisms, potentially leading to neurological damage ( Kallianpur et al., 2016 ; Wan et al., 2020 ). Children are particularly vulnerable to lead due to their developmental stage and behaviors like hand-to-mouth actions. Long-term effects of lead exposure in children, such as cognitive and behavioral issues, are serious and often irreversible. Studies indicate that lead’s neurotoxicity may increase the risk of criminal behavior in adulthood ( Ahmad et al., 2020 ; Wright et al., 2021 ). Considering this, it is imperative to undertake early screening and intervention measures to protect children from neurological destruction caused by lead toxicity. Since 2010, our hospital has treated over 3,000 children with lead poisoning, many exhibiting neurological symptoms such as irritability, headaches, and memory impairments.

Analyzing erythrocyte parameters such as red cell distribution width (RDW), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and MCHC has been effective in detecting various diseases, including cancer, injury, periodontitis, and venous thromboembolism ( Bruserud, Aarstad & Tvedt, 2020 ; Canet et al., 2015 ; França et al., 2019 ; Vayá & Suescun, 2013 ). These parameters are also useful in identifying neurological impairments, although most studies have focused on adults ( Gong et al., 2019 ; Kallianpur et al., 2016 ; Lee et al., 2017 ; Oh et al., 2020 ; Wan et al., 2020 ). Research on pediatric neurological conditions is more challenging due to children’s limited cooperation and the variable reliability of traditional neurological tests ( Hobart, 2006 ).

In this study, we discovered that a higher MCHC*RDW-SD interactions value indicates the presence of neurological damage in children poisoned by lead. We propose that MCHC*RDW-SD interactions value could be a promising marker for screening neurological damage in children affected by lead poisoning.
Materials & Methods
This study involved 356 children with lead poisoning (LP) and an equal number of age- and gender-matched healthy controls (HC), all of whom visited our hospital from January 1, 2015, to December 31, 2017. Participants for the LP group were selected based on two criteria: (i) a diagnosis of lead poisoning with a blood lead level of 100 µg/L or greater and (ii) being under 14 years of age. The LP group excluded patients with blood-related genetic diseases, such as hemoglobin genetic disorders, thalassemia, sickle cell anemia, or hemophilia, neurological symptoms caused by other heavy metals, such as mercury, cadmium, or chromium, and acute bacterial infection. Although initially, 360 lead-poisoned children were enrolled, three were excluded due to acute bacterial infection, and one due to hemophilia, thus resulting in a final LP group of 356 patients. We assessed neurological impairment through a retrospective review of medical records, employing the Ten Question Questionnaire for initial screening and subsequent detailed clinical and neurological examinations by pediatric specialists ( Abuga et al., 2022 ; Durkin, Hasan & Hasan, 1995 ). We also recorded demographic and lead exposure information, including age, gender, symptoms, and types of lead exposure, for the LP patients. The HC group comprised healthy children with blood lead levels <100 µg/L and no health issues detected in routine check-ups.
Conclusions
In conclusion, our study identified a significant association between increased MCHC*RDW-SD Interaction values and the commonly observed neurological impairment in children with lead poisoning. The straightforward and reliable measurement of MCHC and RDW-SD shows potential for use in the early detection of neurological damage in this vulnerable group. However, further research is necessary to fully establish the potential of these indicators in clinical screening protocols.
Figure 1: ROC analysis of the efficiency of indictors in reflecting the presence of neurological damage in lead-poisoned children.

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DOI: 10.7717/peerj.17017/fig-1
Figure 2: Comparison of the rate of neurological impairment in lead-poisoned children groups divided by MCHC*RDW-SD Interactions cut-off value.

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DOI: 10.7717/peerj.17017/fig-2
Figure 3: Spearman correlation of MCHC*RDW-SD interactions value and other parameters in lead-poisoned children.

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DOI: 10.7717/peerj.17017/fig-3
Hematologic parameters of the lead-poisoned children and the healthy controls.
Classification report of the machine learning algorithms for classifying neurological damage.
Results of logistic regression analysis: assessing the association of biomarkers with outcome variables.