Abstract. Low-energy ions escape from the ionosphere and constitute a large part of the magnetospheric content, especially in the geomagnetic tail lobes. However, they are normally invisible to spacecraft measurements, since the potential of a sunlit spacecraft in a tenuous plasma in many cases exceeds the energy-per-charge of the ions, and little is therefore known about their outflow properties far from the Earth. Here we present an extensive statistical study of cold ion outflows (0-60 eV) in the geomagnetic tail at geocentric distances from 5 to 19 R E using the Cluster spacecraft during the period from 2001 to 2005. Our results were obtained by a new method, relying on the detection of a wake behind the spacecraft. We show that the cold ions dominate in both flux and density in large regions of the magnetosphere. Most of the cold ions are found to escape from the Earth, which improves previous estimates of the global outflow. The local outflow in the magnetotail corresponds to a global outflow of the order of 10 26 ions s −1 . The size of the outflow depends on different solar and magnetic activity levels.

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Non-small cell lung cancer (NSCLC) is a tumour type thought to be well-suited for proton radiotherapy. However, the lung region poses many problems related to organ motion and can for actively scanned beams induce severe interplay effects. In this study we investigate four mitigating rescanning techniques: (1) volumetric rescanning, (2) layered rescanning, (3) breath-sampled (BS) layered rescanning, and (4) continuous breath-sampled (CBS) layered rescanning. The breath-sampled methods will spread the layer rescans over a full breathing cycle, resulting in an improved averaging effect at the expense of longer treatment times. In CBS, we aim at further improving the averaging by delivering as many rescans as possible within one breathing cycle. The interplay effect was evaluated for 4D robustly optimized treatment plans (with and without rescanning) for seven NSCLC patients in the treatment planning system RayStation. The optimization and final dose calculation used a Monte Carlo dose engine to account for the density heterogeneities in the lung region. A realistic treatment delivery time structure given from the IBA ScanAlgo simulation tool served as basis for the interplay evaluation. Both slow (2.0 s) and fast (0.1 s) energy switching times were simulated. For all seven studied patients, rescanning improves the dose conformity to the target. The general trend is that the breath-sampled techniques are superior to layered and volumetric rescanning with respect to both target coverage and variability in dose to OARs. The spacing between rescans in our breath-sampled techniques is set at planning, based on the average breathing cycle length obtained in conjunction with CT acquisition. For moderately varied breathing cycle lengths between planning and delivery (up to 15%), the breath-sampled techniques still mitigate the interplay effect well. This shows the potential for smooth implementation at the clinic without additional motion monitoring equipment.