The US Preventive Services Task Force (USPSTF), an independent panel of experts that receives federal funding, previously said that women in their 40s should make an individual decision about when to start mammograms based on their health history and reserved its mandatory recommendation for people turning 50.

Its new guidance was based on a review of evidence and a modeling study published in the Journal of the American Medical Association (JAMA), and updates final guidelines last issued in 2016.

"More women in their 40s have been getting breast cancer, with rates increasing about two percent each year, so this recommendation will make a big difference for people across the country," Task Force chair Wanda Nicholson said in a statement.

"By starting to screen all women at age 40, we can save nearly 20 percent more lives from breast cancer overall."

Breast cancer is the second most common cancer overall and the second most common cause of cancer death for women in the United States, with more than 43,000 deaths last year.

Black women are 40 percent more likely to die of the disease than white women, and so ensuring they start screening at 40 "has even greater potential benefit for Black women," said Nicholson.

- Welcomed by doctors -

The US guidance goes beyond that of other wealthy countries with advanced health care systems, including Britain, France and Germany, which recommend routine screening begin at 50.

Medical oncologist Nancy Chan, director of breast cancer clinical research at NYU Langone's Perlmutter Cancer Center, told AFP that in practice, US health care providers were already shifting to screening women starting at 40.

"That's been the trend so far, but it is always important to actually have the guidelines appropriately reflect what we've been clinically practicing as well," said Chan, adding the recommendation may increase the likelihood of insurance carriers paying for screening if they did not previously.

"Diagnosing breast cancer early stage means better prognosis, higher cure rate -- we're talking more breast cancer survival."

Beyond the generalized recommendation, Chan also urged women in their 40s to also consult with their doctors who could provide them tools to assess their personal lifetime risk of getting breast cancer, based on family history and other factors, and whether they can make lifestyle changes to lower it.

- More research needed -

The new recommendation applies to nearly all women -- those who are at average risk of breast cancer, as well as those with a family history of breast cancer, and those with dense breasts.

Nearly half of all women have what's known as dense breast tissue, which they generally only find out during their first mammogram. Dense breast tissue increases their risk for breast cancer and means that mammograms may not work as well for them.

"Unfortunately, there is not yet enough evidence for the Task Force to recommend for or against additional screening with breast ultrasound or MRI," the panel said, urgently calling for more research.

The guidance also doesn't apply to those with a personal history of the disease, or those at very high rise due to certain genetic markers, or who have a lesion detected on previous biopsies. These individuals could benefit from more regular screening, in consultation with their doctor.

While the recommendation is for those from the ages of 40 to 74, the experts said they were uncertain about how the benefit-to-risk may shift after the age of 75, and more research was needed here too.

While screening is a powerful tool in the fight against cancer, there are also limits, the task force said, explaining why it is not recommending annual mammograms, which some experts have called for.

Over-testing increases the potential for harms, such as false positives, or receiving treatment that wasn't required, the USPSTF said.

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But is it still?

The country of Pele, Garrincha and Ronaldinho, which once wowed the world with its 'samba' style, has not won the World Cup since 2002. Nor has it produced a Ballon d'Or winner since Kaka in 2007.

With the "Selecao" currently struggling to book its place at the 2026 World Cup, many in Brazil and beyond wonder why.

"We're at a low point. We used to have more top-quality athletes," the late Pele's eldest son, Edinho, told AFP recently.

Even President Luiz Inacio Lula da Silva has joined the national soul-searching, admitting Brazil "doesn't play the greatest football in the world anymore".

So what happened?

- Disappearing pitches -

One answer could be the decline of street football, where some of Brazil's all-time greats started out, such as Rivellino, Zico and Romario.

"Nobody plays in the street anymore. You don't hear stories about that kick that broke somebody's window," says amateur footballer Lauro Nascimento, his jersey stained with orange mud after playing on one of the few dirt pitches left on Sao Paulo's north side.

Nascimento, a 52-year-old finance professional who plays for local side Aurora, broke several toes playing football barefoot as a boy.

Today, the district of Vila Aurora, is covered in concrete sprawl. Two buildings stand on what was once open pasture used as a football pitch.

"Any open space used to be enough for kids to get their start in football. Now, they're seen as prime development real estate," says sports historian Aira Bonfim.

Nascimento and his friends pay $160 a month to rent the battered scrap of land where they play matches but that kind of money is a barrier for working class families.

To access a pitch today, poor kids in Brazil often depend on school, social programs or a football academy.

Just one in five such academies is free, according to a 2021 study.

And many of those pitches are synthetic, a surface some say develops players' technique less than the rough, rocky fields of yesterday.

- 'Mechanical' style -

The decline in time spent playing the sport has had "a giant impact on our football", says researcher Euler Victor.

"We have a huge number of Brazilians playing in Europe but very few stars."

Brazil's latest great hope, Neymar, shone at Barcelona, but struggled to lead the national team to championships in a career bogged down by controversy and injury.

Brazilians now have their hopes pinned on 23-year-old Vinicius Junior and young phenomenon Endrick, who is set to join Vinicius at Real Madrid when he turns 18 in July.

Brazil is still the world's top exporter of footballers but they are bringing in less money.

According to FIFA figures, clubs paid $935.3 million in transfer fees for 2,375 Brazilian players last year, down nearly 20 percent from 2018, when the number of players was smaller -- 1,753.

Part of the drop is because teams are paying less to hire free agents and younger players.

But there is also a shortage of standout stars.

"Our technique has suffered," says Victor Hugo da Silva, a coach at Flamengo's youth academy in Sao Goncalo, outside Rio de Janeiro.

"The playing style changed and that ended up taking away some of our creativity. Our football used to be so joyful. Now it's become more mechanical."

On a synthetic pitch, he trains seven to 10-year-olds dreaming of following in the footsteps of Vinicius, the academy's most famous graduate.

The next generation still has football in its veins, but has "difficulties" with training, a problem Da Silva attributes to their sedentary lifestyles and "addiction" to screens.

Brazil, population 203 million, has more cell phones than people. More than one-third of children aged five to 19 are overweight or obese, according to the World Obesity Atlas.

Robson Zimerman, a talent scout for Sao Paulo club Corinthians, says emerging footballers today face tougher conditions, including the ability to play multiple positions and outsize expectations from family and the media.

"Before, they just had to worry about playing football," he says.

But Leila Pereira, president of cross-town rivals Palmeiras, the reigning league champions, insists Brazil will never stop being the country of football.

Brazilian teams have claimed the past five Copa Libertadores titles with Palmeiras claiming two of those.

The club is the cradle of Endrick -- whose sale to Real Madrid brought in a reported $65 million with bonuses -- as well as rising prospects Estevao and Luis Guilherme.

"I disagree with those who think (Brazilian players) have lost quality. Look at the astronomical sums they bring in," says Pereira.

- Favela party -

For many people, Pereira, one of Brazil's wealthiest people, is the face of a new brand of Brazilian football -- more like Europe's, with lavish salaries, by South American standards, and expensive ticket prices.

"With the absurd salaries they pay the players, clubs have to raise ticket prices, which excludes fans like me," says Flamengo supporter David Santos.

In 2019, he founded a fan club for Flamengo die-hards like himself from the impoverished favelas.

From atop the hillside slum that overlooks the trendy beach neighborhoods of Copacabana and Ipanema, they recreate the ambiance of the Maracana on match days, decorating an old pitch with flags, grilling barbecue and belting out chants as the match plays on a giant screen.

"The 'country of football' thing -- we're losing that," says one attendee, 38-year-old Vasco fan Pablo Igor.

"Football is what you see here. It's a game of the people. But street kids like I was don't have access to it anymore."

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The club's membership is a closely guarded secret but is known to include leading figures from the civil service, the law, journalism, publicly funded institutions and the arts.

BBC world affairs editor John Simpson last week tweeted: "Various Garrick Club members including Sting, Mark Knopfler and leading actors and producers have reportedly written to the club chairman saying they'll resign if the membership doesn't vote to accept women next Tuesday."

He added: "Many others like me would also find it impossible to stay."

In March, the head of Britain's spy service Richard Moore resigned after a list of the club's membership was made public for the first time.

Moore sent a message to MI6 employees acknowledging the reputational hit that news of his membership posed to the service -- in particular the risk of it undermining its work to attract more women to join MI6.

Prime Minister Rishi Sunak's most senior policy adviser, the civil service leader Simon Case, also quit his membership.

Founded in 1831 for actors and "men of refinement and education", the Garrick is one of the last such clubs not to allow women in, except as guests of men.

A petition launched in 2021 backing the admission of women attracted the support of Cherie Blair, a leading barrister and wife of former prime minister Tony Blair.

She recalled that in 1976 as a trainee lawyer she was left standing outside while her future husband Tony was allowed in for dinner.

"It's outrageous that so little progress has been made since then," she wrote.

Organisers of the petition said that the large number of judges and senior lawyers who were members deprived women of networking opportunities in a profession in which women were under-represented, particularly in the higher echelons.

A previous vote in 2015 on allowing female members saw the narrowest of majorities -- 50.5 percent -- back continuing the ban on female membership.

The Garrick, located in Covent Garden in central London, offers members overnight accommodation, a restaurant, bars and a library.

Other high-profile figures reported to be members include  "Sherlock" star Benedict Cumberbatch and senior minister Michael Gove.

An early member was Charles Dickens.

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The poolside show featuring the work of Moroccan designer Yasmina Qanzal included mostly one-piece suits in shades of red, beige and blue. Most models had exposed shoulders and some had their midriffs partially visible.

"It's true that this country is very conservative but we tried to show elegant swimsuits which represent the Arab world," Qanzal told AFP.

"When we came here, we understood that a swimsuit fashion show in Saudi Arabia is a historic moment, because it is the first time to have such event," she said, adding it was "an honour" to be involved.

The show took place on the second day of the inaugural Red Sea Fashion Week at the St Regis Red Sea Resort, situated off Saudi Arabia's western coast.

The resort is part of Red Sea Global, one of the so-called giga-projects at the heart of Saudi Arabia's Vision 2030 social and economic reform programme overseen by Crown Prince Mohammed bin Salman.

Prince Mohammed, who became first in line to the throne in 2017, has initiated a series of dramatic social reforms in a bid to soften Saudi Arabia's austere image stemming from its historical championing of a purist form of Islam known as Wahhabism.

Those changes have included sidelining stick-wielding religious police who used to chase men out of malls to pray, re-introducing cinemas and organising mixed-gender music festivals.

They have coincided with ramped-up repression targeting dissent, including from conservative clerics who might protest such moves.

Shouq Mohammed, a Syrian fashion influencer who attended Friday's show, said it was not surprising given Saudi Arabia's attempt to open up to the world and grow its fashion and tourism sectors.

The fashion industry in 2022 accounted for $12.5 billion, or 1.4 percent of national GDP, and employed 230,000 people, according to a report published last year by the official Saudi Fashion Commission.

"It's the first time to have a swimsuit fashion show in Saudi Arabia, but why not? Seriously why not?" Mohammed said.

"It's possible and we have it here."

Raphael Simacourbe, a French influencer who also attended on Friday, said there was nothing risque to his eyes but in the Saudi context it was a major achievement.

"That's very brave from them to do that today, so I am very happy to be part of it," he said.

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The ever-bubbling alphabet soup of boxing sanctioning bodies -- the winner in Riyadh becoming the first four-belt heavyweight champion -- means that becoming, and remaining, undisputed champion requires not just skill and toughness in the ring, but acumen outside it.

Usyk joined a select group. Here AFP Sport picks six of the undisputed best.

Jack Dempsey (Undisputed champion from Jan 1921 to Sept 1926, 3 defences)

The hard-hitting and aggressive Jack Dempsey became the first official world champion at the start of 1921 when the American National Boxing Association and the powerful New York State Athletic Commission agreed to recognise a world champion. The "Manassa Mauler", with a right nicknamed "Iron Mike" and a left hook dubbed "Big Bertha" had become 'lineal' world champion, in boxing parlance "Beating The Man to become The Man" when he bludgeoned Jess Willard in 1919. But the newly-minted official status helped turn his first sanctioned defence, against Frenchman Georges Carpentier, into the first "million-dollar fight". He defended his title twice more, before losing twice to Gene Tunney and retiring.

Joe Louis (June 1937 to March 1949, 26 defences)

After the first African American heavyweight champion, Jack Johnson, lost to Willard in 1915, no black boxer fought for the title until 1937, because Joe Louis, who had just lost to Max Schmeling was a more palatable challenger for Cinderella Man James Braddock's title than the German. Louis knocked out Braddock to claim a title he held for record 26 defences over more than 12 years. The most famous was the first-round revenge demolition of Schmeling at Yankee Stadium in 1938. Louis was smart, calm, technically sound, and packed a ferocious punch. "Everyone has a plan until they've been hit," he said.

Rocky Marciano (Sept 1952 to April 1956, 6 defences)

After war service, an undistinguished amateur career and a baseball tryout with the Chicago Cubs, the boxer, who changed his name from Rocco Marchegiano, turned professional just before his 25th birthday in 1948. He fought 49 times as a pro, winning every fight, 43 of them by knockout. Only 5ft 10in tall (1.78m), Marciano was relentless, resilient and a thunderous puncher. He was 29 when he got his title shot, flooring Jersey Joe Walcott in the last round with a straight right: his "Suzie Q". Having pummelled an ageing Louis on his way up, knocked out the 39-year-old Walcott in the first round of their rematch, Marciano quit for good at 32 after stopping 42-year-old Archie Moore.

Muhammad Ali (Feb to Sept 1964, Feb to April 1967, Oct 1974 to Feb 1978, 10 unified defences)

The Greatest only fails to match Louis for total defences because he was effectively banned from boxing from March 1967 to October 1970 for his opposition to the military draft for the Vietnam war. The Louisville Lip, who later declared "I'm so mean, I make medicine sick", had already upset the American establishment by changing his "white man's name", Cassius Clay. After toppling Sonny Liston to win the title at 22 in 1962, he lost his undisputed status for taking a rematch with Liston. Ali defended his remaining titles seven times, before reunifying the division in 1966 against Ernie Terrell. At 25 he was banned. Ali was 29 by the time he got his crack at regaining his world titles, against Joe Frazier in 1971, but suffered his first loss. It took until 1974, and his victory over George Foreman in the "Rumble in the Jungle", a fight that highlighted Ali's craft, cunning and courage, to reclaim his crowns. He lost his titles to Leon Spinks in 1978, won some of them back in a rematch seven months later, but, aged 38, lost a reunification bout to Larry Holmes in 1980. By then Ali had won over all but his most determined critics.

Joe Frazier (Feb 1970 to Jan 1973, 4 defences)

Joe Frazier's often electrifying trilogy against Ali was boxing box office as two greats, with contrasting styles and personalities and opposing political views went toe-to-toe. "Smokin' Joe" preferred close-quarters attack, but his constant bobbing made him hard to hit. In their opener, "The Fight of the Century" -– a gruelling 15-rounder -- he decked Ali with the devastating left hook he called his "heat-seeking missile". By the rematch in 1974, George Foreman had taken Frazier's title. Ali not only floated like a butterfly but clinched like a crab and won on points. In the 1975 "Thrilla in Manilla" Ali unleashed a merciless barrage in the 13th. The referee stopped the fight in the next round. Frazier, 30 at the time of that bout, only fought twice more.

Mike Tyson (Aug 1987 to Feb 1990, 6 defences)

By the time he was 13, Mike Tyson had been arrested 38 times. In 1986, at the age of 20 years and four months, he was the youngest heavyweight champion in history. Even though he was only 5ft 10in (1.78m), his approach was vicious intimidation. He won his first 19 professional fights by knockout. Smart but troubled, his wild lifestyle took a toll. He was ambushed by Buster Douglas in 1990. Although he regained two belts in 1996, he immediately lost to Evander Holyfield. At his brief, snarling, sneering peak, Tyson lived up to his billing as the "baddest man on the planet".

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The five-day horticultural extravaganza, which expects over 150,000 visitors between now and Saturday, does not allow entry for under-fives and has a policy of charging older children full price, which is enough to deter most families.

But the tide appears to be turning with school children this year invited to design their own garden.

King Charles III, a passionate environmentalist, and Queen Camilla on Monday got a preview of the "RHS No Adults Allowed Garden", where the amused monarch was presented with a "King of the Compost" badge while Camilla received one with "Queen of the Bees".

"There's nothing more fun than eating the things you have grown... It tastes so much better," Charles said as he toured the feature.

Designed by 29 pupils from a west London primary school with the help of landscaper Harry Holding, the garden will be partially reinstalled at their school after the show ends.

Holding, 30, said he believed gardening should be part of the school curriculum.

"Bringing children into that conversation is absolutely vital... in a rapidly changing world where horticulture, gardening and environmentally conscious activities to do with landscape are more and more important," he said.

Working alongside nine and 10 year olds with their powers of imagination going at full throttle, however, also brought its challenges.

Some of their ideas were "very fantastical, very magical", he said.

"Some sort of den, with hidden doors, trap doors and tree houses... They wanted a crocodile... a lot of ideas were very big, like rivers and lakes," he recalled.

The body of water came into being, in a much more compact form. The crocodile, thankfully perhaps, remains a project for another day.

- Joyful creativity -

"The great thing about working with children is that they are really uninhibited by industry norms and how you should do things that really allows the creativity just to run wild," he said.

From this joyful creativity came a garden with a slide descending into a small pool, a tree house resembling a den at water level, rocks to climb on, a mini woodland, meadow and wetland.

Also featured were oversized tropical plants in bright colours and carnivorous ones in which the children were very interested.

The garden was created without the use of cement or concrete and with an emphasis on biodiversity and sustainable development.

Initially the children leaned towards a strict interpretation of the no adults theme but "some tough negotiation" resulted in a compromise acceptable to all, according to Clare Matterson, director of the Royal Horticultural Society which organises the annual event.

Adults can now enter if they commit to planting a tree, find a plant starting with the first letter of their name in the garden, or make a donation to school gardening projects.

Ever vigilant, a child kept watch shouted "Intruder! Intruder!" when an adult approached.

Around 70 children from nine London primary schools were also invited for the second year running for a picnic.

The practice was inspired by Catherine, the Princess of Wales -- wife of heir to the throne Prince William who is currently being treated for cancer.

As part of their visit, the children were asked to take part in judging the show's first ever Children's Choice award.

The six largest gardens in the competition were judged on criteria including interest for the visitor, attractiveness for wildlife, and feelings of well-being they produced.

The award went to the Octavia Hill garden by garden designer Ann-Marie Powell, whose work also focuses on adapting to new conditions linked to climate change.

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