Mechanical loading experienced by skeletal tissues plays an important role in bone formation and remodeling.Osteocytes are the most abundant bone cell type and the major mechanosensory cells of the bone. Theyorchestrate bone remodeling from their location throughout bone matrix by coordinating osteoblastic formationand osteoclastic resorption. Osteocytes are connected to neighboring osteocytes and other bone cells via gapjunction channels and to extracellular environments via hemichannels. Both types of channels are formed byconnexin (Cx) 43.

The opioid epidemic remains a serious national crisis, with deaths from opioid overdose skyrocketing over thelast 10 years. This escalation is driven by abuse of prescription opioids and heroin, indicating that improvedtreatment would reduce the incidence of abuse and the risk of overdose. A multi-modal approach that includesbehavioral and pharmacological interventions is most effective in treating abuse, and severalpharmacotherapies, including buprenorphine, are available.

This proposal seeks support for the South Texas Medical Scientist Training Program (STX MSTP) at theUniversity of Texas Health Science Center at San Antonio (UTHSCSA), a federally designated Hispanic-servinginstitution in a minority-majority city. As national leader in clinical and translational research on Hispanic,military, and Veteran health issues, UTHSCSA addresses regional health disparities that present both challengesand opportunities for medical research that are of nationwide relevance.

Postoperative complications and readmissions rates are higher in minority and low socioeconomic status (SES)patients. Low SES is associated with frailty, one of the best predictors of 30-day postoperative complicationsand early hospital readmission. Despite their influence on health outcomes, frailty and social risk factors are notconsidered in risk adjustment for reimbursement and quality measures. CMS developed financial incentive-based programs to improve quality of care.