Friday, August 29, 2025

Approximate Analytical Solutions of the Bidomain Equations for Electrical Stimulation of Cardiac Tissue With Curving Fibers

Russ Hobbie and I stress qualitative thinking, in addition to quantitative thinking, in Intermediate Physics for Medicine and Biology. What’s the difference? Qualitative thinking is the ability to guess approximately what a solution will look like. As an example, let me share the first part of one of my publications that I always liked. It is from the article “Approximate analytical solutions of the bidomain equations for electrical stimulation of cardiac tissue with curving fibers,” published in Physical Review E (Volume 67, Article number 051925) in 2003. I wrote the paper with my graduate student Debbie Langrill Beaudoin.

In the first paragraph, we wrote “Fig. 1 shows the fiber geometry throughout a sheet of tissue and the direction of the applied electric field. Can you look at Fig. 1 and predict where the tissue will be depolarized and where it will be hyperpolarized?” Figure 1 is shown below. 


Warning: Debbie and I cooked up a way to avoid polarization at the boundaries. Ordinarily you would expect a big hyperpolarization on the left and a depolarization on the right, both restricted to only a few length constants from the edge. Ignore this effect. Just consider the polarization caused by the fiber curvature.

At this point, dear reader, I ask you to stop reading and guess the distribution of polarization. Take a piece of paper, sketch the fiber distribution in Fig. 1, and then mark which areas of the tissue are depolarized and which are hyperpolarized. If you have some colored pencils handy, just color the depolarized region red and the hyperpolarized region blue. Go ahead. I’ll wait... 


 

Okay, let’s see how you did. Below is Fig. 6 of our paper, which gives the result. Depolarization is in red, hyperpolarization is in blue.


Did you get anything like this?

To help explain the polarization distribution, I’ve created two new figures not in the paper. In both, the short gray line segments show the fiber geometry. The purple arrows indicate the direction of the applied electric field. Green shows a component of the intracellular current density. The red D’s and blue H’s indicate depolarization and hyperpolarization. The first of the two figures is shown below, and illustrates what I’ll call “Mechanism 1.” 

Mechanism 1

In the region where the fibers point along the applied electric field (like along the left edge of the tissue), the current is divided approximately equally between the intracellular and extracellular spaces because they have similar conductivities in that direction. So, the green intracellular current density arrows are relatively large there. In the region where the fibers point perpendicular to the applied electric field (like in the center), the intracellular current density is less than the extracellular current density because the intracellular conductivity is smaller than the extracellular conductivity in that direction, so the green intracellular current density arrows are relatively small. Somewhere between these two regions current had to leave the intracellular space and pass out through the membrane, entering the extracellular space. This outward membrane current depolarizes the tissue (red D’s). If the fiber direction then changes back to being parallel to the electric field (like along the right edge of the tissue), some extracellular current must recross the membrane and reenter the cell, which hyperpolarizes the tissue (blue H’s). This behavior is shown in the upper small plot to the left of Fig. 6a.

The next new figure illustrates “Mechanism 2.” Consider what happens where the fibers are oriented at an angle of about 45 degrees to the electric field. In that case, even though the electric field may be horizontal the anisotropy rotates the intracellular current density to be more nearly parallel to the fibers (the direction with the highest conductivity). In other words, the electric field is horizontal, but the intracellular current density rotates counterclockwise. The extracellular current density also rotates, but not as much because the intracellular space is more anisotropic than the extracellular space. Thus, you pick up a component of the intracellular current perpendicular to the applied electric field (shown by the green arrows). If the fibers change direction so they are either parallel or perpendicular to the field, you get no rotation of the current density there, so there is no component of the intracellular current perpendicular to the electric field. At the head of one of those green arrows, the intracellular current density vector ends so the intracellular current must cross the membrane and enter the extracellular space, depolarizing the tissue. At the tail of a green arrow the intracellular current density vector begins so the extracellular current must cross the membrane and enter the intracellular space, hyperpolarizing the tissue. This results in a somewhat complicated pattern of polarization (H’s and D’s), which resembles the pattern shown in the lower small plot to the left of Fig. 6a. 

Mechanism 2

Both of these mechanisms operate simultaneously, so the net polarization is the sum of those two small plots. This results in the Yin-Yang pattern of depolarization and hyperpolarization of Fig. 6a. (Stare at Fig. 6a long enough until you realize this is correct.) Below it, in Fig. 6b, is the result you get if you just mindlessly solve the bidomain equations numerically. (Actually, Debbie solved them, and she did nothing mindlessly, but you know what I mean). The two are qualitatively the same, although there are quantitative differences.

So, how many of you guessed the Yin-Yang pattern? To tell you the truth, I’m not sure I did when Debbie and I first started this analysis. It’s difficult. But at least now I have a way to understand this pretty but nonintuitive pattern. I’ve found that being able to do these hand-waving types of explanations is useful. It lets you understand what is going on, rather than just putting a calculation into a black-box computer program and getting out an answer with no insight. Remember: the purpose of computing is insight, not numbers!

Finally, I really enjoyed starting a research paper off with a puzzle like that in Fig. 1 and ending it with the solution like in Fig. 6. I think you should consider using this trick in your next article.

Friday, August 22, 2025

The Cardiac Bidomain Model in Twelve Publications

Recently I wrote a review of the bidomain model of cardiac tissue. Russ Hobbie and I discuss the bidomain model in Section 7.9 of Intermediate Physics for Medicine and Biology. It’s a mathematical description of heart muscle that keeps track of the voltages and currents both inside and outside the myocardial cells. What I wrote is not really an academic review article, it’s not a history, and it’s not a memoir. To tell you the truth, I’m not sure what it is. I originally thought I’d try and publish it, but I’m not sure who would accept such an unusual article. So, I decided it would be best to distribute it on my blog. There is little I can do for my dear readers, but I can give them this review.

The format is to describe the bidomain model by considering twelve publications. Below is a list of the articles I chose. Each article is meant to feature one researcher, whose names are listed in bold.

Tung L (1978) A bi-domain model for describing ischemic myocardial dc potentials. PhD Dissertation, Massachusetts Institute of Technology.

Plonsey R, Barr RC (1984) Current flow patterns in two-dimensional anisotrpic bisyncytia with normal and extreme conductivities. Biophys J 45:557–571.

Sepulveda NG, Roth BJ, Wikswo JP, Jr (1989) Current injection into a two-dimensional anisotropic bidomain. Biophys J, 55:987-999. 

Henriquez CS, Plonsey R (1990b) Simulation of propagation along a cylindrical bundle of cardiac tissue. II. Results of the simulation. IEEE Trans Biomed Eng 37:861–875.

Neu JC, Krassowska W (1993) Homogenization of syncytial tissue. Crit Rev Biomed Eng 21:137–199.

Wikswo JP Jr, Lin SF, Abbas RA (1995) Virtual electrodes in cardiac tissue: A common mechanism for anodal and cathodal stimulation. Biophys J 69:2195–2210.

Trayanova N, Skouibine K, Aguel F (1998) The role of cardiac tissue structure in defibrillation. Chaos 8:221–233.

Knisley SB, Trayanova N, Aguel F (1999) Roles of electric field and fiber structure in cardiac electric stimulation. Biophys J 77:1404–1417.

Efimov IR, Cheng Y, van Wagoner DR, Mazgalev T, Tchou PJ (1998) Virtual electrode-induced phase singularity: A basic mechanism of defibrillation failure. Circ Res 82:918–925.

Entcheva E, Eason J, Efimov IR, Cheng Y, Malkin R, Claydon F (1998) Virtual electrode effects in transvenous defibrillation-modulation by structure and interface: Evidence from bidomain simulations and optical mapping. J Cardiovasc Electrophysiol 9:949–961.

Rodriguez B, Li L, Eason JC, Efimov IR, Trayanova NA (2005) Differences between left and right ventricular chamber geometry affect cardiac vulnerability to electric shocks. Circ Res 97:168–175.

Bishop MJ, Boyle PM, Plank G, Welsh DG, Vigmond EJ (2010) Modeling the role of the coronary vasculature during external field stimulation. IEEE Trans Biomed Eng 57:2335–2345.

My biggest worry is that I’ve left too much out. For instance, I could easily have featured other researchers, such as Rick Gray, Jamey Eason, Roger Barr, Marc Lin, Felipe Aguel, David Geselowitz, and others. Also, I suspect there are many researchers who, if they read this review, will be hurt because they are completely ignored. All I can say is, I’m sorry. I tried to relate the story as best as I can remember it, but I may have remembered some things wrong.

You can download my review here. I hope you enjoy reading the article as much as I enjoyed writing it. It was an honor to work on this topic with so many outstanding scientists. As Randy Travis sings, these scientists are my heroes and friends.

 
 
“Heroes and Friends,” by Randy Travis

Friday, August 15, 2025

Lutetium-177

When preparing the 6th edition of Intermediate Physics for Medicine and Biology, I like to scan the literature for new medical advances. While revising the chapter on nuclear medicine, I found some fascinating information about an isotope that was not mentioned in the 5th edition of IPMB: lutetium-177.

First, the physics. Lutetium (pronouced loo-tee-shee-uhm) is element 71 in the periodic table. Below are the energy level and decay data. The primary mechanism of decay is emitting a beta-particle (an electron), transmuting into a stable isotope of hafnium. The maximum energy of this electron is about 500 keV. Two other possibilities (each happening in about one out of every ten decays) is beta decay of 177Lu to one of two excited levels of 177Hf followed by gamma decay. The two most common gamma photons have energies of 113 and 208 keV. Lutetium-177 produces few internal conversion or Auger electrons. The average energy of all the emitted electrons is about 150 keV, which have a range of about 0.25 mm. The half-life of 177Lu is roughly a week. 

Next, the biology and medicine. Lutetium can be used for imaging (using the gamma rays) or therapy (using the electrons). While the dose arising from all the electrons does not make this isotope ideal for pure imaging studies (technetium-99m might be a better choice), the gammas do provide a way to monitor 177Lu during therapy (in this way it is similar to iodine-131 used in thyroid cancer therapy and imaging). Such a combined function allows the physician to do “theranostics” (a combination of  therapy and diagnostics), a term I don’t care for but it is what it is. 177Lu can be bound to other molecules to improve its ability to target a tumor. For instance, it is sometimes attached to a molecule that binds specifically to prostate specific membrane antigen. The PSMA molecule is over-expressed in a tumor, so this allows the 177Lu to target prostate tumor cells. One advantage of using 177Lu in this way—rather than, say, using radiotherapy with x-rays directed at the prostate—is that the 177Lu will seek out and irradiate any metastasizing cancer cells as well as the main tumor. Clinical trials show that it can prolong the life of those suffering from prostate cancer


 Lutetium-177: PSMA Guided Treatment

https://www.youtube.com/watch?v=Th42pFOx0Fs

Friday, August 8, 2025

Push Back Hard

Last November, right after the Presidential election, I wrote a blog post about trusted information on public health. In that post, I featured the science communication efforts by Katelyn Jetelina (Your Local Epidemiologist) and Andrea Love (Immunologic). I didn’t realize at the time just how much I would come to rely on these two science advocates for trustworthy information, especially related to vaccines.

Today, I recommend several more science communicators. The first is Skeptical Science. That website focuses primarily on climate science. The current Republican administration has denied and mocked the very idea of climate change, describing it as a “hoax.” Skeptical Science has a simple mission: “debunk climate misinformation.” This is extraordinarily important, as climate change may be the most important issue of our time. Check out their website www.skepticalscience.com, and follow them on Facebook. I just signed up for their Cranky Uncle app on my phone. I learned about Skeptical Science from my Climate Reality mentor, John Forslin. For those more interested in doing rather than reading and listening, I recommend The Climate Reality Project (Al Gore’s group). Take their training. I did. Oh, and don’t forget Katharine Hayhoe’s website https://www.katharinehayhoe.com.

I recently leaned about the Center for Infectious Disease Research and Policy that operates out of the University of Minnesota (Russ Hobbie, the main author of Intermediate Physics for Medicine and Biology, worked there for most of his career). I can’t tell you too much about it, except that it’s director is Michael Osterholm, a leading and widely respected vaccine expert and advocate. 

Want to know more about science funding, especially to the National Institutes of Health? Check out Unbreaking. They’re documenting all the bad stuff happening to science these days. I learned about Unbreaking from Liz Neeley's weekly newsletter Meeting the Moment. Liz is married to Ed Yong, who I have written about before.

My next recommendation is Angela Rasmussen, a virologist who publishes at the site Rasmussen Retorts on Substack. What I like about Rasmussen is that she tells it like it is, and doesn’t worry if her salty language offends anyone. I must confess, as I experience more and more of what I call the Republican War on Science, I get angrier and angrier. Rasmussen’s retorts reflect my rage. She writes “Oh, also, I swear sometimes. It’s not the most professional behavior but I believe in calling things what they are and sometimes nothing besides ‘asshole’ is accurate.” Give ’em hell, Angie! Here’s the concluding two paragraphs of her August 5 post:

There’s always a ton of talk about how public health and science have lost trust. A lot of people like to tell me that it’s our fault. Scientists didn’t show enough humility or acknowledge uncertainty during the COVID pandemic. We were wrong about masks or vaccines or variants or whatever. We didn’t communicate clearly. We overclaimed and underdelivered. I reject these arguments.

The public didn’t lose trust in science because experts are wrong sometimes, and are imperfect human beings who make mistakes. They lost trust because people like [Robert F. Kennedy, Jr.] constantly lied about science. He is constantly lying still. He’s eliminating experts so that he and his functionaries on ACIP [The CDC’s Advisory Committee on Immunization Practices] will be able to continue lying without any inconvenient pushback. We need to recognize this and push back hard.
What am I doing to push back hard? Regular readers of this blog may recall my post from this April in which I imagined what Bob Park’s newsletter What’s New would look like today. Well, I’ve made that a weekly thing. You can find them published on my Medium account (https://medium.com/@bradroth). I’ll link a few of the updates below.
https://medium.com/@bradroth/bob-parks-what-s-new-august-1-2025-5cf2c5bfc598

https://medium.com/@bradroth/bob-parks-what-s-new-july-25-2025-bc10a841cc28

https://medium.com/@bradroth/bob-parks-what-s-new-july-18-2025-eca27626c79b

https://medium.com/@bradroth/bob-parks-what-s-new-july-11-2025-68c5943218d7

You will also find these IPMB blog posts republished there, plus a few other rants. When I started writing my updated version of What’s New, I (ha, ha)… I thought (ha, ha, ha!)... I thought that I might run out of things to talk about. That hasn’t been a problem. But writing a weekly newsletter in addition to my weekly IPMB blog posts takes time, and it makes me appreciate all the more the heroic efforts of Katelyn, Andrea, Liz, and Angela. I hope they all know how much we appreciate their effort.

Is there anything else on the horizon? The book Science Under Siege, by Michael Mann and Peter Hotez, is out next month. As soon as I can get my hands on a copy and read it, I will post a review on this blog. In the meantime, I’ll keep my powder dry, waiting until RFK Jr starts in on microwave health effects (Y’all know it’s coming). Now that’s physics applied to medicine and biology, right up my alley!

“Don’t Choose Extinction.” This is one of John Forslin’s favorite videos. Enjoy!

https://www.youtube.com/watch?v=3DOcQRl9ASc

Friday, August 1, 2025

The History of the Linear No-Threshold Model and Recommendations for a Path Forward

As Gene Surdutovich and I were preparing the 6th edition of Intermediate Physics for Medicine and Biology, we decided to update the discussion about the linear no-threshold model of radiation risk. In the 5th edition of IPMB, Russ Hobbie and I had written
In dealing with radiation to the population at large, or to populations of radiation workers, the policy of the various regulatory agencies has been to adopt the linear no-threshold (LNT) model to extrapolate from what is known about the excess risk of cancer at moderately high doses and high dose rates, to low doses, including those below natural background.
In our update, we added a citation to a paper by John Cardarelli, Barbara Hamrick, Dan Sowers, and Brett Burk titled “The History of the Linear No-Threshold Model and Recommendations for a Path Forward,” (Health Physics, Volume 124, Pages 131–135, 2022). When I looked over the paper, I found that there is a video series accompanying it. I said to myself: “Brad, that sounds like just the sort of thing readers of your blog might enjoy.” I found all the videos on the Health Physics YouTube station, and I have added links to them below.

Wow! This is not a dry, technical discussion. It is IPMB meets 60 Minutes. This is a hard-hitting investigation into scientific error and even scientific fraud. It’s amazing, fascinating, and staggering.

John Cardarelli, the president of the Health Physics Society when the videos were filmed, acts as the host, introducing and concluding each of the 22 episodes. The heart of the video series is Barbara Hamrick, past president of the Health Physics Society, interviewing Edward Calabrese, a leading toxicologist and a champion of the hormesis model (low doses of radiation are beneficial).

Calabrese claims that our use of the linear no-threshold model is based on “severe scientific, ethical, and policy problems.” He reviews the history of the LNT model, starting with the work of the Nobel Prize winner Hermann Muller on the genetics of fruit flies. He reviews the evidence to support his contention that Muller and other scientists were biased in favor of the LNT model, and sometimes carried that bias to extreme lengths. At first I said to myself “this is interesting, but its all ancient history.” But as the video series progressed, it approached closer and closer to the present, and I began to appreciate how these early studies impact our current safety and regulatory standards.

I watched every minute of this gripping tale. (OK, I admit I watched it at a 2x playback speed, and I skipped Cardarelli’s introductions and conclusions after the first couple videos; there is only so much time in a day.) Anyone interested in the linear no-threshold model needs to watch this. I have to confess, I can offer no independent confirmation of Calabrese’s claims. I’m not a toxicologist, and my closest approach to radiobiology is being a coauthor on IPMB. Still, if Calabrese’s claims are even half true then the LNT assumption is based on weak data, to put it mildly.

Watch these videos. Maybe you’ll agree with them and maybe not, but I bet you’ll enjoy them. You may be surprised and even astounded by them.



https://www.youtube.com/watch?v=G5FjhgcnMjU

Episode 1: Who Is Dr. Edward Calabrese?


https://www.youtube.com/watch?v=slIylnAZsDY

Episode 2: LNT Beginnings—Extrapolation From ~100,000,000 x Background?


https://www.youtube.com/watch?v=4UxqcscXHWE

Episode 3: Muller Creates a Revolution


https://www.youtube.com/watch?v=E2WCE30_o3s

Episode 4: Muller: How Ambition Affects Science


https://www.youtube.com/watch?v=LP_eIQDa6rY

Episode 5: The Big Challenge


https://www.youtube.com/watch?v=PMCOejiERbQ

Episode 6: The Birth of the LNT Single-Hit Theory


https://www.youtube.com/watch?v=srDKPtbiLhI

Episode 7: Pursuit to Be the First to Discover Gene Mutation


https://www.youtube.com/watch?v=7hTfVMDPrcY

Episode 8: "Fly in the Ointment"


https://www.youtube.com/watch?v=34nNwqwIcbU

Episode 9: Why the First Human Risk Assessment Was Based on Flawed Fruit-Fly Research


https://www.youtube.com/watch?v=D2Tmvc8awZQ

Episode 10: The Birth of LNT Activism


https://www.youtube.com/watch?v=7f99cSK0lQc

Episode 11: Creation of the Biological Effects of Atomic Radiation (BEAR) I Committee


https://www.youtube.com/watch?v=JaDfua6mRIw

Episode 12: Was There Scientific Misconduct Among the BEAR Genetics Committee Members?


https://www.youtube.com/watch?v=GMhPFpeqjG8

Episode 13: Is Lower Always Better?


https://www.youtube.com/watch?v=i5ixKEHTFKE

Episode 14: Should the Genetics Panel Science Paper Be Retracted?


https://www.youtube.com/watch?v=paRx3SFfKXM

Episode 15: Follow the Money Trail: "We Are Just All Conspirators Here Together"


https://www.youtube.com/watch?v=NNdF1-K6my4

Episode 16: The Most Important Paper in Cancer Risk Assessment That Affects Policy in the US



https://www.youtube.com/watch?v=yHdLe5hileI

Episode 17: Studies With a Surprising Low-Dose Health Effect


https://www.youtube.com/watch?v=_CzS5I8DK6k

Episode 18: Ideology Trumps Science, Precautionary Principle Saves the LNT


https://www.youtube.com/watch?v=rdrKwVUuLGc

Episode 19: Genetic Repair Acknowledged


https://www.youtube.com/watch?v=892prKIMjvg

Episode 20: BEIR I Acknowledges Repair but Keeps LNT. Why?


https://www.youtube.com/watch?v=ZZx9SiY7wuI

Episode 21: BEIR I Mistake Revealed, LNT Challenged, Threshold Supported


https://www.youtube.com/watch?v=L3ZfL4vTPPM

Episode 22: Making Sense of History and a Path Forward by Dr. Calabrese