Dominick A. Leone, MPH, MS - Boston University School of Public Health - Pre-Doctoral Candidate

Dominick A. Leone

MPH, MS

Boston University School of Public Health

Pre-Doctoral Candidate

Boston, Massachusetts | United States

Main Specialties: Epidemiology, Infectious Disease, Medical Genetics, Molecular Genetic Pathology, Nephrology, Public Health

Additional Specialties: Precision Approach to Population Health: Genomic and Infectious Disease Epidemiology

ORCID logohttps://orcid.org/0000-0002-6401-2292

Dominick A. Leone, MPH, MS - Boston University School of Public Health - Pre-Doctoral Candidate

Dominick A. Leone

MPH, MS

Introduction

Primary Affiliation: Boston University School of Public Health - Boston, Massachusetts , United States

Specialties:

Additional Specialties:

Research Interests:

Education

Sep 2011 - May 2013
Boston University School of Public Health
Master of Public Health
Epidemiology
Aug 2002 - Apr 2003
Georgetown University
Master of Science
Physiology and Biophysics
May 2002
University of Central Florida
Bachelors of Science
Biology

Experience

Sep 2018
Framingham Heart Study
Graduate Research Assistant
Aug 2017
Channing Division of Network Medicine
Programmer Analyst
Presentation at ATS on Precision Medicine approach to Short Telomere syndrome
Jul 2015 - Jul 2015
Ragon Institute
Clinical Research Coordinator

Publications

18Publications

400Reads

2Profile Views

22PubMed Central Citations

Interstitial Lung Disease in Relatives of Patients with Pulmonary Fibrosis.

American journal of respiratory and critical care medicine

Rationale: Although relatives of patients with familial pulmonary fibrosis (FPF) are at an increased risk for interstitial lung disease (ILD), the risk among relatives of sporadic idiopathic pulmonary fibrosis (IPF) is not known.Objectives: To identify the prevalence of interstitial lung abnormalities (ILA) and ILD among relatives of patients with FPF and sporadic IPF.Methods: Undiagnosed first-degree relatives of patients with pulmonary fibrosis (PF) consented to participate in a screening study that included the completion of questionnaires, pulmonary function testing, chest computed tomography, a blood sample collection for immunophenotyping, telomere length assessments, and genetic testing.Measurements and Main Results: Of the 105 relatives in the study, 33 (31%) had ILA, whereas 72 (69%) were either indeterminate or had no ILA. Of the 33 relatives with ILA, 19 (58%) had further evidence for ILD (defined by the combination of imaging findings and pulmonary function testing decrements). There was no evidence in multivariable analyses that the prevalence of either ILA or ILD differed between the 46 relatives with FPF and the 59 relatives with sporadic IPF. Relatives with decrements in either total lung or diffusion capacity had a greater than 9-fold increase in their odds of having ILA (odds ratio, 9.6; 95% confidence interval, 3.1-29.8; P < 0.001).Conclusions: An undiagnosed form of ILD may be present in greater than 1 in 6 older first-degree relatives of patients with PF. First-degree relatives of patients with both familial and sporadic IPF appear to be at similar risk. Our findings suggest that screening for PF in relatives might be warranted.

https://doi.org/10.1164/rccm.201908-1571OC

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February 2020
3 Reads

Understanding the role of resilience resources, antiretroviral therapy initiation, and HIV-1 RNA suppression among people living with HIV in South Africa: a prospective cohort study.

AIDS (London, England)

OBJECTIVE:Failure to initiate antiretroviral therapy (ART) and achieve virologic suppression are significant barriers to the United Nations 90-90-90 goals. Identifying resilience resources, or modifiable strength-based factors, among people living with HIV is critical for successful HIV treatment and prevention. DESIGN:Prospective cohort study. METHODS:From July 2014 to July 2015, 500 adults presenting for voluntary counseling and HIV testing who were diagnosed with HIV and were ART-eligible in South Africa (Soweto and Gugulethu) were enrolled and surveyed. Logistic regression models assessed resilience-related predictors of ART initiation within 6 months of voluntary counseling and HIV testing for HIV, and HIV-1 plasma RNA suppression within 9 months, adjusting for sociodemographic factors. RESULTS:Within 6 months, 62% initiated ART, and within 9 months, 25% had evidence of an undetectable HIV-1 plasma RNA (<50 copies/ml). Participants who initiated ART relied less on social support from friends [adjusted odds ratio (aOR) 0.94, 95% confidence interval (CI): 0.89-0.99], coped using self-distraction (aOR 1.05, 95% CI: 1.00-1.10) and avoided coping through substance use (aOR 0.79, 95% CI: 0.65-0.97), as compared with participants who did not initiate ART. Those who achieved plasma RNA suppression relied more on social support from a significant other/partner (aOR 1.04, 95% CI: 1.02-1.07), used positive religious coping (aOR 1.03, 95% CI: 1.00-1.07), and were less likely to engage in denial coping (aOR 0.84, 95% CI: 0.77-0.92), compared with those who initiated ART but did not achieve plasma RNA suppression. CONCLUSION:Interventions optimizing resilience resources and decreasing maladaptive coping strategies (e.g., substance use, denial) may present a feasible approach to maximizing ART-based HIV treatment strategies among South African people living with HIV.

https://doi.org/10.1097/QAD.0000000000002175

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June 2019
4 Reads

Demographics, Risk Factors, and Incidence of Melanoma in Patients in the New England VA Healthcare system.

Military medicine

INTRODUCTION:A recent study found that the incidence of melanoma and melanoma-related mortality was decreasing in residents of the New England region. However, it is unknown whether this trend is conserved in Veterans of New England who constitute more than 14% of the national Veteran population. Given this, our goal was to analyze the incidence of melanoma in patients of Veteran Integrated Service Network-1 (VISN-1) (geographically consisting of VA health care facilities in Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont) and to calculate an incidence rate ratio (IRR) of melanoma in VISN-1 compared to the general population. Additional goals were to ascertain the risk/susceptibility of this patient population with a view to improve quality of care and outcomes. MATERIALS AND METHODS:Data for 523 cases of melanoma [2000-2011] were obtained from the regional branch of the Veterans Affairs Central Cancer Registry (VACCR) within the geographic area comprising VISN-1. A detailed retrospective chart review was conducted on these cases to gather demographic, risk factor, and clinical practice data. Demographic and incidence data from VISN-1 were compared to the general population via data from Surveillance, Epidemiology and End Results Program (SEER) from the same time period. Person-years (PY) were calculated for both populations to measure IRRs which was further standardized for age and gender. RESULTS:VISN-1 patients were predominantly older (94.26% >50 years), Caucasian (99.43%) males (96.75%). Compared to the general population, VISN-1 patients experienced more invasive lesions defined as stage T1 or greater (4.33% vs. 57.12%, p < 0.001), but reduced melanoma-associated mortality (40.96% vs. 19.05%, p < 0.001) although all-cause mortality was approximately doubled (52.20% vs. 26.14%, p < 0.001). Metastatic disease-rates were similar in both [approximately 4% in both]. IRR of melanoma in VISN-1 patients was 0.36 (95% CI: 0.20-0.67; p = 0.0063) which persisted in all age groups/genders. 60.92% of VISN-1 patients had recreational sun-exposure history and 72.41% of tobacco use. 95.02% of melanomas were located in continuously/intermittently sun-exposed areas, 93.28% were surgically-treated with a median treatment delay of 31 days [range 18-48]. Median lost to follow-up was 0 day [range 0-681 days]. CONCLUSIONS:Compared to the general population, melanoma incidence was lower in the VISN-1 cohort, possibly due to decreased UV index in the New England region, protective effects of past tobacco use, improved access to care through the VA and regional public health educational efforts. Yet melanomas were more often invasive in the VISN-1 cohort due to advanced age and male sex both of which are associated with more advanced disease at diagnosis. A strength of this study is the calculation of IRR using PY as this method enhances accuracy of incidence calculations. The data were limited by the fact that the population was from one geographic region and consisted mainly of elderly Caucasian males. Descriptive variable data such as sun-protective habits and risk factors from military service are limited by potential recall bias given the retrospective study design. Further study is necessary to replicate these results and to compare our data to Veteran populations from different geographic regions within the USA.

https://doi.org/10.1093/milmed/usy267

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May 2019
3 Reads

Concordance of somatic mutation profiles (BRAF,NRAS, and TERT) and tumoral PD-L1 in matched primary cutaneous and metastatic melanoma samples.

Hum Pathol 2018 12 16;82:206-214. Epub 2018 Aug 16.

Dermatopathology Section, VA Integrated Systems Network (VISN1), Department of Pathology and Laboratory Medicine, West Roxbury, MA 02132, USA. Electronic address:

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http://dx.doi.org/10.1016/j.humpath.2018.08.002DOI Listing
December 2018
24 Reads
2.770 Impact Factor

Treatment guidelines and early loss from care for people living with HIV in Cape Town, South Africa: A retrospective cohort study.

PLoS medicine

South Africa has undergone multiple expansions in antiretroviral therapy (ART) eligibility from an initial CD4+ threshold of ≤200 cells/μl to providing ART for all people living with HIV (PLWH) as of September 2016. We evaluated the association of programmatic changes in ART eligibility with loss from care, both prior to ART initiation and within the first 16 weeks of starting treatment, during a period of programmatic expansion to ART treatment at CD4+ ≤ 350 cells/μl.We performed a retrospective cohort study of 4,025 treatment-eligible, non-pregnant PLWH accessing care in a community health center in Gugulethu Township affiliated with the Desmond Tutu HIV Centre in Cape Town. The median age of participants was 34 years (IQR 28-41 years), almost 62% were female, and the median CD4+ count was 173 cells/μl (IQR 92-254 cells/μl). Participants were stratified into 2 cohorts: an early cohort, enrolled into care at the health center from 1 January 2009 to 31 August 2011, when guidelines mandated that ART initiation required CD4+ ≤ 200 cells/μl, pregnancy, advanced clinical symptoms (World Health Organization [WHO] stage 4), or comorbidity (active tuberculosis); and a later cohort, enrolled into care from 1 September 2011 to 31 December 2013, when the treatment threshold had been expanded to CD4+ ≤ 350 cells/μl. Demographic and clinical factors were compared before and after the policy change using chi-squared tests to identify potentially confounding covariates, and logistic regression models were used to estimate the risk of pre-treatment (pre-ART) loss from care and early loss within the first 16 weeks on treatment, adjusting for age, baseline CD4+, and WHO stage. Compared with participants in the later cohort, participants in the earlier cohort had significantly more advanced disease: median CD4+ 146 cells/μl versus 214 cells/μl (p < 0.001), 61.1% WHO stage 3/4 disease versus 42.8% (p < 0.001), and pre-ART mortality of 34.2% versus 16.7% (p < 0.001). In total, 385 ART-eligible PLWH (9.6%) failed to initiate ART, of whom 25.7% died before ever starting treatment. Of the 3,640 people who started treatment, 58 (1.6%) died within the first 16 weeks in care, and an additional 644 (17.7%) were lost from care within 16 weeks of starting ART. PLWH who did start treatment in the later cohort were significantly more likely to discontinue care in <16 weeks (19.8% versus 15.8%, p = 0.002). After controlling for baseline CD4+, WHO stage, and age, this effect remained significant (adjusted odds ratio [aOR] = 1.30, 95% CI 1.09-1.55). As such, it remains unclear if early attrition from care was due to a "healthy cohort" effect or to overcrowding as programs expanded to accommodate the broader guidelines for treatment. Our findings were limited by a lack of generalizability (given that these data were from a single high-volume site where testing and treatment were available) and an inability to formally investigate the effect of crowding on the main outcome.Over one-quarter of this ART-eligible cohort did not achieve the long-term benefits of treatment due to early mortality, ART non-initiation, or early ART discontinuation. Those who started treatment in the later cohort appeared to be more likely to discontinue care early, and this outcome appeared to be independent of CD4+ count or WHO stage. Future interventions should focus on those most at risk for early loss from care as programs continue to expand in South Africa.

https://europepmc.org/articles/PMC5685472

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November 2017
3 Reads

Tumoral PD-L1 expression in desmoplastic melanoma is associated with depth of invasion, tumor-infiltrating CD8 cytotoxic lymphocytes and the mixed cytomorphological variant.

Mod Pathol 2017 03 13;30(3):357-369. Epub 2017 Jan 13.

Dermatopathology Section, Department of Pathology and Laboratory Medicine (113), VA Integrated Service Networks (VISN1), West Roxbury, MA, USA.

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http://dx.doi.org/10.1038/modpathol.2016.210DOI Listing
March 2017
108 Reads
7 Citations
6.190 Impact Factor

BRAF and epithelial-mesenchymal transition in papillary thyroid carcinoma - challenging the roles of Snail and E-Cadherin?

Am J Transl Res 2016 15;8(11):5076-5086. Epub 2016 Nov 15.

ENT Specialists, Inc. 825 Washington St # 310, Norwood, MA 02062, UK.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5126351PMC
November 2016
22 Reads
3.230 Impact Factor

Frequency of telomerase reverse transcripter promoter mutations in desmoplastic melanoma subtypes: analyses of 76 cases.

Melanoma Res 2016 08;26(4):361-6

aDepartment of Pathology, Boston University of Medicine bBoston University School of Public Health and Ragon Institute of MGH, MIT and Harvard cDepartment of Pathology, Massachusetts General Hospital, Boston dMiraca Life Sciences, Newton Upper Falls eDepartment of Pathology, University of Massachusetts Medical School, Worcester fDermatopathology Section, VA Integrated Systems Network (VISN1), Department of Pathology and Laboratory Medicine, West Roxbury, Massachusetts gCarver College of Medicine, University of Iowa, Iowa City, Iowa hDepartment of Pathology and Dermatology, Icahn School of Medicine Mount Sinai, New York, New York iAurora Diagnostics GPA Laboratories, Greensboro, North Carolina, USA jDepartment of Pathology, Western General Hospital, Edinburgh, Scotland, UK.

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http://dx.doi.org/10.1097/CMR.0000000000000272DOI Listing
August 2016
40 Reads
2 Citations
2.282 Impact Factor

Neurofibromin protein loss in desmoplastic melanoma subtypes: implicating NF1 allelic loss as a distinct genetic driver?

Hum Pathol 2016 07 9;53:82-90. Epub 2016 Mar 9.

Dermatopathology Section, Department of Pathology and Laboratory Medicine, VA Consolidated Laboratories, West Roxbury, MA 02132. Electronic address:

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http://dx.doi.org/10.1016/j.humpath.2016.02.012DOI Listing
July 2016
27 Reads
1 Citation
2.770 Impact Factor

BRAF and epithelial-mesenchymal transition in primary cutaneous melanoma: a role for Snail and E-cadherin?

Hum Pathol 2016 06 1;52:19-27. Epub 2016 Feb 1.

Dermatopathology Section, VA Consolidated Laboratories, Department of Pathology and Laboratory Medicine (113), West Roxbury, MA 02132. Electronic address:

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http://dx.doi.org/10.1016/j.humpath.2015.12.030DOI Listing
June 2016
25 Reads
1 Citation
2.770 Impact Factor

Cervical Abnormalities in South African Women Living With HIV With High Screening and Referral Rates.

Journal of global oncology

To determine the prevalence of screening, cervical dysplasia, and malignancy on the basis of histologic diagnoses from colposcopy and large loop excision of the transformation zone among women living with HIV (WLWH) who attended an urban antiretroviral treatment (ART) clinic in KwaZulu-Natal, South Africa.We performed a retrospective cohort study to examine a random sample of 462 WLWH during a 5-year period from 2004 to 2009. Women on ART for < 3 months were excluded. Data were abstracted from electronic records and paper charts to assess rates of cervical abnormalities detected on Pap smears as well as time to colposcopy.During the study period, 432 women (93.5%) had at least one evaluable Papanicolau test. At baseline, 237 women (54.9%) had an abnormal Papanicolau test, and of these patients, 181 (76.3%) had a Papanicolau test that qualified for further colposcopic evaluation. In addition, 115 women (63.5%) received colposcopy within a median of 39 days from referral. This yielded 74 evaluable histologic samples (64.3%), of which 21.6%, 27.0%, 27.0%, and 1.4% had cervical intraepithelial neoplasia (CIN) 1, CIN2, CIN3, and invasive cervical cancer, respectively.In a large sample of WLWH who received ART in KwaZulu-Natal, South Africa, where Papanicolau test coverage and rates of referral for colposcopy and large loop excision of the transformation zone were high, > 75% of women with evaluable histologic samples had evidence of cervical dysplasia or malignancy. These findings underscore the importance of routine cervical screening upon entry into HIV care to optimize survival.

https://europepmc.org/articles/PMC5493244

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May 2016
3 Reads

Perineural invasion in cutaneous squamous cell carcinoma: role of immunohistochemistry, anatomical site, and the high-affinity nerve growth factor receptor TrkA.

Hum Pathol 2015 Aug 22;46(8):1209-16. Epub 2015 May 22.

Department of Pathology and Laboratory Medicine (113), VA Medical Center, 1400 VFW PKWY, MA 02132 USA, USA. Electronic address:

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http://dx.doi.org/10.1016/j.humpath.2015.05.003DOI Listing
August 2015
16 Reads
2 Citations
2.770 Impact Factor

Neurotrophin receptors and perineural invasion in desmoplastic melanoma.

J Am Acad Dermatol 2015 May 7;72(5):851-8. Epub 2015 Mar 7.

Dermatopathology, Section, Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2015.01.026DOI Listing
May 2015
18 Reads
4.450 Impact Factor

Microvessel density, lymphovascular density, and lymphovascular invasion in primary cutaneous melanoma-correlation with histopathologic prognosticators and BRAF status.

Hum Pathol 2015 Feb 26;46(2):304-12. Epub 2014 Nov 26.

Dermatopathology Section, Department of Dermatology, Boston University School of Medicine, Boston, MA 02118. Electronic address:

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http://dx.doi.org/10.1016/j.humpath.2014.11.006DOI Listing
February 2015
19 Reads
2 Citations
2.770 Impact Factor

Correlation of chemokine receptor CXCR4 mRNA in primary cutaneous melanoma with established histopathologic prognosticators and the BRAF status.

Melanoma Res 2014 Dec;24(6):621-5

aDivision of Graduate Medical Sciences bSchool of Public Health cBoston University School of Medicine dDepartment of Pathology eDepartment of Dermatology, Dermatopathology Section, Boston University School of Medicine, Boston, Massachusetts, USA.

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http://dx.doi.org/10.1097/CMR.0000000000000120DOI Listing
December 2014
31 Reads
2.282 Impact Factor

Protein expression of the chemokine receptor CXCR4 and its ligand CXCL12 in primary cutaneous melanoma--biomarkers of potential utility?

Hum Pathol 2014 Oct 2;45(10):2094-100. Epub 2014 Jul 2.

Dermatopathology section, Department of Dermatology, Boston University School of Medicine, Boston, MA 02118. Electronic address:

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http://dx.doi.org/10.1016/j.humpath.2014.06.018DOI Listing
October 2014
39 Reads
1 Citation
2.770 Impact Factor

Top co-authors

Meera Mahalingam
Meera Mahalingam

Boston University School of Medicine

11
Shi Yang
Shi Yang

Renji Hospital

10
Brendon Mitchell
Brendon Mitchell

University of Florida College of Medicine

6
April Deng
April Deng

University of Maryland

5
Noah Frydenlund
Noah Frydenlund

Boston University School of Medicine

5
Rajendra Singh
Rajendra Singh

Institute of Tissue Regeneration Engineering (ITREN)

5
Asok Biswas
Asok Biswas

Western General Hospital

4
Ron Yaar
Ron Yaar

Boston University School of Medicine

4
Mai P Hoang
Mai P Hoang

Massachusetts General Hospital

3