Tuesday 18 March 2014

How do jets change flight paths?





  • Passenger jets flight plans are programmed before pilots arrive in the cockpit

  • But it's not unusual for pilots to change course to avoid things like bad weather

  • They do that by punching commands into the plane's flight management system

  • Authorities aren't sure exactly when Flight 370's change of course was entered




(CNN) -- You may think that pilots fly passenger jets by steering a joystick. In reality, a lot of the turns the aircraft makes are predetermined.


The disclosure that the first major change of course by missing Malaysia Airlines Flight 370 was most likely programmed through a computer in the cockpit has raised questions about how modern planes navigate.


Here's a quick primer on how it works.


Before takeoff


An airline dispatcher creates the flight plan. When the pilots arrive at the plane, their route is already set and programmed into the plane's flight management system.





Timing of plane reprogramming crucial




Watch Flight Simulator Attempt Theory




Examining MH370 conspiracy theories




Former pilot: I flew the missing plane

Malaysia Airlines Chief Executive Ahmad Jauhari Yahya says that as far as he is concerned, the missing Boeing 777-200 was programmed to fly to Beijing, its intended destination. "That's the standard procedure," he said Tuesday.


After the pilots arrive


Changing the flight path is simple, according to Mark Weiss, a former Boeing 777 pilot. He says a pilot can punch a few commands into the airplane's flight management system, which operates a little like a car's GPS.


A U.S. official told CNN that somebody programmed Flight 370 to fly off course. But it's unclear if that happened during the flight or before takeoff.


"We don't know when specifically it was entered," said Mary Schiavo, a CNN aviation analyst and former inspector general for the U.S. Department of Transportation.


In flight


Pilots often have reason to alter their flight path when they're in the air, Weiss says: "That's a very typical scenario, you may have weather in your path, you may have oncoming traffic in your path." To change the course, they type a new navigational waypoint, a kind of virtual checkpoint in the sky, into the system.


Reports, not yet confirmed by authorities, have suggested that Flight 370 followed navigational waypoints after it turned off its original route less than an hour into its journey on March 8.


Ability required


Programming waypoints into the flight management system of a Boeing 777-200 is "a task that would have been beyond the abilities of anyone but a professional pilot," according to Robert Goyer, the editor-in-chief of Flyingmagazine and a commercial jet rated pilot.


Once the pilots are in the aircraft, "anything is possible," said Ahmad Jauhari.


Notifications


The investigation into what happened to Flight 370 has focused attention on how much data airborne planes send to the ground. The information that the flight path was reprogrammed appears likely to have been transmitted by the passenger jet's Aircraft Communications Addressing and Reporting System (ACARS). That system communicates data -- such as engine reports, maintenance requirements and weather conditions -- to the ground.


The last transmission from Flight 370's ACARS was sent at 1:07 a.m., authorities say. The next update, due at 1:37 a.m, never came. A law enforcement official told CNN that the plane's programmed change in direction was entered at least 12 minutes before the plane's verbal sign off with air traffic controllers at 1:19 a.m. -- that tallies with the time of the last ACARS transmission.


READ: Experts answer #370Qs tweets


READ: Will pilot's simulator give up clues?



5 ways to experience Sri Lanka






Sri Lanka has two first-class rail choices -- ExpoRail and the Rajadhani Express. They offer one of the most scenic, and cheapest, ways to get around the country. Sri Lanka has two first-class rail choices -- ExpoRail and the Rajadhani Express. They offer one of the most scenic, and cheapest, ways to get around the country.

Vegetables are among the hundreds of different wares up for grabs at Colombo's Pettah Market, one of the most important trading centers in the capital. Vegetables are among the hundreds of different wares up for grabs at Colombo's Pettah Market, one of the most important trading centers in the capital.

Buddhist statues line the walls in Dambulla's cave temple, a UNESCO World Heritage Site that dates to the 1st century BC.Buddhist statues line the walls in Dambulla's cave temple, a UNESCO World Heritage Site that dates to the 1st century BC.

One of the oldest lighthouses in Sri Lanka can be found at the Galle Fort, another UNESCO World Heritage Site. It's a great place to catch sunsets. One of the oldest lighthouses in Sri Lanka can be found at the Galle Fort, another UNESCO World Heritage Site. It's a great place to catch sunsets.

The boundless blue sea at Tangalle, Sri Lanka -- still to be visited by mass tourism, it's a rare piece of paradise. The boundless blue sea at Tangalle, Sri Lanka -- still to be visited by mass tourism, it's a rare piece of paradise.

Sri Lanka's reputation as a surfing destination has surged in recent years. The country's Ahangama beach is famous for its waves. Sri Lanka's reputation as a surfing destination has surged in recent years. The country's Ahangama beach is famous for its waves.









  • Sri Lanka is home to historic cities, ancient religious relics and beautiful beaches

  • The Pettah Market is one of the most important trading centers in Colombo

  • Sri Lanka's 1,340-kilometer-long coastline is filled with beaches to suit various tastes




(CNN) -- Home to a gorgeous coastline, ancient cities and lush countryside, Sri Lanka is also slowly healing from the wounds of war.


But with a steadily improving infrastructure, this tiny emerald-shaped island is on the rise.


Here are five essential experiences and destinations.


1. Riding the rails


One of the easiest ways to get around the country -- not to mention the cheapest -- is via Sri Lanka's rail network.


It stretches across some of the country's most scenic landscapes, from tea gardens and paddy fields to that famed coastline.


Three of the most photogenic routes are from Colombo to Kandy, from Kandy to the tea estates of Ella and from Colombo to Galle.


Sri Lanka has two competing high-end rail services, Expo Rail and the Rajadhani Express.


Both are first-class carriages run by private operators attached to regular trains run by Sri Lanka Railways.


Rajadhani Express trains can be found on three routes that run on two major Sri Lanka rail lines.


ExpoRail serves more than 60 destinations on four different routes.


MORE: 7 train trips of a lifetime


2. Walking tour of Pettah, Colombo




Colombo\'s Pettah Market, one of the city\'s most important trading centers.

Colombo's Pettah Market, one of the city's most important trading centers.



Pettah is one of the most famous neighborhoods in Colombo, known for its historic buildings and markets.


A great place to start your tour of this historic area is the Pettah Market on Main Street, a hotbed of Sinhalese, Tamil and Muslim merchants.


It's one of the most important trading centers in Colombo, selling everything from spices and dried fish to textiles.


From here, you can head to Sea Street for gem shopping. South of the old Town Hall, vendors sell vegetables and fruits.


While in the area, it's worth paying a visit to the impressive Wolfendaal Church, built in 1749, and the historic Jami Ul Alfar Mosque, built in 1909.


3. Golden Temple of Dambulla


The simplicity of its façade is a false tell -- Sri Lanka's Dambulla cave temple -- also known as the Golden Temple of Dambulla -- contains wonderful painted murals and ancient artifacts.


A UNESCO World Heritage Site, this rock temple complex dates back to the 1st century BC. Towering more than 160 meters, the complex houses five main shrines.


In the second cave, known as the temple of the great kings, you'll find the most impressive and biggest of all five.


Built by Vattagamini Abhaya, it houses many Buddha statues in varying positions as well as deities from the Hindu pantheon.


At the top of the complex visitors can watch the sun setting over the countryside.


Coupling the trip to Dambulla cave with a visit to the nearby ancient city of Sigiriya makes for a spectacular experience.


The best way to do this is to base yourself in the central Sri Lankan city of Kandy, 70 kilometers from Dambulla.


For hotels, you can't go wrong with the chic Kandy House (Thekandyhouse.com , Amunugama Waluwa, Gunnepana, +94 81 492 1394; rooms from $225).


MORE: Sri Lanka's top tea experiences: Sips of history


4. Glamorous Galle




One of the oldest lighthouses in Sri Lanka can be found at the Galle Fort, a UNESCO World Heritage Site.

One of the oldest lighthouses in Sri Lanka can be found at the Galle Fort, a UNESCO World Heritage Site.



The beautiful town of Galle was built around the 16th century by the Portuguese.


A major trading post on the spice trade route, it also shifted hands between the Dutch and English.


Today, it's a delight to walk or cycle around, its quaint streets strewn with old warehouses, churches, boutiques and beautiful homes.


Galle Fort occupies roughly 130 acres.


You can start your exploration with a walk around the fort wall, moving on to the National Maritime Museum just opposite the post office.


Galle has some fabulous restored historic hotels.


It's worth spending a night or two, as you get a real sense of the place when the daily tour buses leave.


One of the best properties in town is Galle Fort Hotel (28 Church St., Galle Fort, Southern Province; +94 91 223 2870).


From a weather standpoint, December to April is the best time to visit Galle.


MORE: Sri Lanka's great elephant migration


5. Beach hopping


With its 1,340-kilometer coastline, Sri Lanka doesn't make things easy for those trying to decide which beach to bum on.


First there's Unawatuna, famed for its golden sand.


It's one of the busiest beaches in Sri Lanka, dotted with shacks, restaurants and hotels for every budget.


Among these is French Lotus (Yaheddimulla Road, Unawatuna, Gall; +94 77 152 28 67; rooms from $38), a modest colonial house with cheap rates.


For surfers, the waters of Ahangama have the best waves in Sri Lanka.


There are many surf schools as well as rental shops across from the beach.


Lapoint Surf Camp, situated just opposite the Ahangama beach, is renowned among surfers.


Guests stay in an ocean-side villa, while the camp offers surfing lessons for all levels.


Seven-day packages start from $443.


Secluded on the southernmost tip of Sri Lanka you'll find the most fabulous stretch of off-white sand and azure water in the country -- Tangalle.


Yet to be hit by mass tourism, it's a rare piece of paradise.


Among recommended hotels in Tangalle: the luxurious Amanwella (Boddhi Mawatha, Wella Wathuara, Godellawela, Tangalle; +94 47 224 1333; suites from $600) with its private beach and modern suites.


For whale and dolphin watching expeditions there's Mirrisa beach. But you'll first have to face a three-hour boat ride through rough waters.


Raja & the Whales (+94 77 695 3452; tours from $43 per person) is one of the most responsible tour operators running whale watching trips.


MORE: CNNGo in Sri Lanka: Spicy crabs, blue whales and Ceylon tea



World's best beach is ...






Baia do Sancho in remote Fernando de Noronha, Brazil, takes the top spot in TripAdvisor's 2014 Travelers' Choice best beaches list. Located on a volcanic archipelago, the beach jumped to the top spot from No. 4 last year.Baia do Sancho in remote Fernando de Noronha, Brazil, takes the top spot in TripAdvisor's 2014 Travelers' Choice best beaches list. Located on a volcanic archipelago, the beach jumped to the top spot from No. 4 last year.

Grace Bay in Providenciales, Turks and Caicos, held on to its No. 2 ranking for the second year.Grace Bay in Providenciales, Turks and Caicos, held on to its No. 2 ranking for the second year.

Flamenco Beach in Culebra, Puerto Rico, jumped two spots from No. 5 to No. 3.Flamenco Beach in Culebra, Puerto Rico, jumped two spots from No. 5 to No. 3.

Last year's top-ranked spot, Rabbit Beach on the Sicilian island of Lampedusa, dropped to No. 4 this year.Last year's top-ranked spot, Rabbit Beach on the Sicilian island of Lampedusa, dropped to No. 4 this year.

Whitehaven Beach on Australia's Whitsunday Island dropped from No. 3 last year to this year's No. 5 spot.Whitehaven Beach on Australia's Whitsunday Island dropped from No. 3 last year to this year's No. 5 spot.

Playa de ses Illetes on Formentera in Spain's Balearic Islands broke into the top 10 this year, jumping from No. 12 to No. 6. Playa de ses Illetes on Formentera in Spain's Balearic Islands broke into the top 10 this year, jumping from No. 12 to No. 6.

Anse Lazio on Praslin Island in the Seychelles jumped 10 spots, from No. 17 last year to No. 7.Anse Lazio on Praslin Island in the Seychelles jumped 10 spots, from No. 17 last year to No. 7.

Lanikai Beach in Kailua on Oahu broke into the world's top 10 this year. Last year, the Hawaii beach was No. 5 in the United States, but it didn't make the global list.<!-- --> </br>Lanikai Beach in Kailua on Oahu broke into the world's top 10 this year. Last year, the Hawaii beach was No. 5 in the United States, but it didn't make the global list.

Rhossili Bay in Swansea, Wales, moved up to No. 9 from last year's No. 10 spot. While certainly not the warmest of the world's spectacular beaches, the rugged landscape and sweeping views are undeniably lovely.Rhossili Bay in Swansea, Wales, moved up to No. 9 from last year's No. 10 spot. While certainly not the warmest of the world's spectacular beaches, the rugged landscape and sweeping views are undeniably lovely.

Playa Norte in Isla Mujeres, Mexico, jumped from No. 14 to No. 10 this year.Playa Norte in Isla Mujeres, Mexico, jumped from No. 14 to No. 10 this year.









  • TripAdvisor announces its second annual best beaches awards

  • A remote Brazilian beach ranks No. 1

  • Rankings are based on TripAdvisor user reviews over 12 months




(CNN) -- Flip-flop weather must be right around the corner. While nearly any sun-soaked stretch of sand sounds perfect just now, some beaches clearly take the sand and surf prerequisites to a higher level.


The pinnacle for beach-goers? Baia do Sancho in Fernando de Noronha, a volcanic archipelago off the coast of Brazil.


This pristine Brazilian beach takes top honors on TripAdvisor's Travelers' Choice best beaches list, released Tuesday.


The beach rankings, in their second year, are determined by analyzing the quality and quantity of a year's worth of TripAdvisor user reviews of beaches across the globe. Baia do Sancho moved up from a No. 4 ranking last year.


Click through the gallery above to see the top 10 beaches around the world.


Overall, the best beaches awards include 322 beaches and lists of the most highly ranked beaches for Africa, Asia, the Caribbean, Europe, South America, the South Pacific and the United States.


Here's how TripAdvisor ranks U.S. beaches:


1. Lanikai Beach, Kailua, Oahu, Hawaii2. Ka'anapali Beach, Lahaina, Maui, Hawaii 3. Siesta Key Public Beach, Siesta Key, Florida4. Hanalei Beach, Hanalei, Kauai, Hawaii5. Wai'anapanapa State Park, Hana, Maui, Hawaii6. Wailea Beach, Wailea, Maui, Hawaii7. Hunting Island State Park, Beaufort, South Carolina8. Manini'owali Beach (Kua Bay), Kailua-Kona, Island of Hawaii, Hawaii9. Saint Pete Beach, Saint Pete Beach, Florida10. Hanauma Bay Nature Preserve, Honolulu, Oahu, Hawaii


MORE: 11 best ways to experience Hawaii


MORE: 29 beach photos that will make you drool


MORE: World's 100 best beaches



What happens if GOP wins the Senate







  • David Frum: GOP may regain control of both houses of Congress this year

  • Frum: Election losers talk about deficits, winners talk about what they want to do

  • He says deficits shrink not when leaders compromise, but when they squabble

  • Frum: If GOP win in November, Obama will likely invoke "fiscal responsibility"




Editor's note: David Frum, a CNN contributor, is a contributing editor at The Daily Beast. He is the author of eight books, including a new novel, "Patriots," and a post-election e-book, "Why Romney Lost." Frum was a special assistant to President George W. Bush from 2001 to 2002.


(CNN) -- Democratic hopes for 2014, never good, are fading fast. The New York Times reported on the mood of panic among Democratic senators. Forecaster Charlie Cook is speculating about a Democratic Senate wipeout. It's suddenly looking very possible that Republicans could regain control of both houses of Congress for the first time in eight years. What then?


The main thing to expect: You're going to hear a lot less about debt and deficits from Republicans and a lot more from Democrats.


It's almost a rule of American politics that the losers of the last election talk about deficits, while the winners talk about what they want to do.



David Frum


It happened after 2008: Barack Obama's triumphant Democrats announced huge new spending plans; the defeated and discarded Republicans fulminated about red ink.


It happened after the recount election of 2000. Then it was Republicans who had plans -- tax cuts, defense buildups -- and Democrats who fretted about the impact on the budget balance.


It happened after the stunning Republican sweep in the congressional elections of 1994. Abruptly, President Clinton -- who had campaigned only two years earlier on a bold program of "investments" -- reinvented himself as Mr. Fiscal Responsibility. The triumphant Republicans sent Clinton tax cut after tax cut. He vetoed most of them, but finally signed a reduction in the capital gains tax in 1997, as part of a bargain to secure spending programs that he preferred.


And so it will be if Republicans take full control of Congress after 2014. The debt crisis that used to present such a generational challenge? The new "red menace" -- this time of red ink rather than the Red Army? It will suddenly take a back seat to the need to accelerate economic growth by cutting tax rates.


Meanwhile the Obama Democrats -- who five years ago accepted budget deficits of nearly 10% of GDP as indispensable to economic recovery -- will suddenly decide that the country's present deficit of less than half that amount is intolerable and unacceptable. The President's latest budget proposes to reduce the deficit below 2%, thanks in large part to new tax revenues generated by the lapse of the Bush tax cuts at the end of 2012 and the new Obamacare taxes that went into effect at the same time.


If Republicans win in November 2014, they will try to send that money back home. President Obama will invoke "fiscal responsibility," Clinton style, in hope of thwarting them.


Deficit reduction is everybody's second favorite policy, after their first favorite, "Doing what I want." This may explain the seeming paradox that deficits tend to shrink during periods of divided government (like the final six years of the Clinton and Obama presidencies) and to widen during period of united government (like the first six years of the George W. Bush presidency and the first two years of Clinton and Obama).


To put it even more bluntly: Deficits don't shrink because politicians reach Grand Bargains. Deficits shrink precisely when politicians are least able to do anything grand. Deficits shrink not when leaders compromise, but when they squabble.


Right now, the deficit is shrinking at the fastest pace since the end of World War II. Much of this improvement can be explained by economic recovery; much, but not all. And that part of deficit reduction explained by public policy has been put in place (and will likely continue for at least the next two years) by political conflict, not by deal-making.


The Bush tax cuts expired at the end of 2012, as did the payroll tax holiday put in place to counter the 2009 recession. Obamacare's new taxes on high-income earners went into effect the very next day. These tax increases enrage Republicans. Yet until and unless Republicans can elect a president to sign a tax cut passed by Congress, the tax increases will remain in effect, collecting rising revenues for the government in Washington.


To end the debt ceiling fight in 2011, the parties agreed to an emergency measure -- a budget sequester that mindlessly imposes spending cuts across the federal discretionary budget. The hope was that the sheer irrationality of the sequester would force the parties to agree on a more sensible plan. So much for that. The sequester continues to hack away -- and as things stand, will continue to hack away for the remainder of the decade.


Health care cost inflation is slowing down, for reasons economists don't fully understand. Is the slowdown a rare positive effect of the Great Recession? Is Obamacare delivering as promised? Or is it just a manifestation of the old rule that nothing continues forever? Whatever the explanation, that explanation is likely to remain in force for some time to come. Obamacare can't be repealed, can't be expanded, and can't be fixed. Whatever Obamacare does, it's going to keep doing it for a long time to come.


A friendly foreign observer of U.S. politics used to joke: "It's never over till it's over -- and it's never over."


You could add a PS to that rule: "And when it's over, it's not because anybody likes the result -- but because so many different people hate it for so many different reasons."


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The opinions expressed in this commentary are solely those of David Frum.



Debunking the mammography myth


Gayle Sulik and Bonnie Spanier say the benefits of mammograms are far smaller than early evidence suggested, and the hazards have been largely ignored.


Gayle Sulik and Bonnie Spanier say the benefits of mammograms are far smaller than early evidence suggested, and the hazards have been largely ignored.






  • Writers: The old mantra of "early detection cures breast cancer and saves lives" is misleading

  • Writers: "Early" detection now means mammography finding microscopic abnormality

  • A large study found screening mammograms did not reduce the number of cancer deaths

  • Writers: Tiny abnormalities treated like full blown cancer and get excessive treatment




Editor's note: Gayle Sulik is a medical sociologist, founder of the Breast Cancer Consortium and author of "Pink Ribbon Blues: How Breast Cancer Culture Undermines Women's Health." Follow her on Twitter: @pinkribbonblues. Bonnie Spanier is a molecular microbiologist, emerita professor at the University at Albany (SUNY) and co-founder of Capital Region Action Against Cancer.


(CNN) -- Recently some friends were discussing whether early detection via screening mammography may not be the key to surviving breast cancer. Several women argued that despite the studies, they believe in mammograms, echoing many women who were treated for a screen-detected breast cancer and are alive to tell the story. Some even support it when screening clearly failed to detect their cancers or prevent the onset of advanced disease.


For decades, belief in some version of "early detection cures breast cancer and saves lives" has shaped our view. In the 1970s, when women like Betty Ford and the late Shirley Temple Black were lifting the veil of secrecy and shame surrounding breast cancer, finding the disease "early" meant being alert to symptoms to find a tumor before it got so large it poisoned the body. In this context, it was logical to try to find tumors before they got to this point.



Gayle Sulik



Bonnie Spanier


Today "early detection" means something very different. Now, "early" has shifted from feeling a lump to relying on a mammogram to detect a microscopic abnormality. Supporting the narrative that "every breast cancer is curable as long as you catch it in time," the focus shifted to the detection of smaller and smaller suspicious conditions by way of radiographic imaging.


A large Canadian study with 25 years of follow-up reported that annual screening mammograms did not reduce the number of cancer deaths any more than clinical exams and health care among the nearly 90,000 women ages 40 to 59 who took part. In fact, they contributed to harm.


When the study was released, the circling question was not: Was the study relevant, the design rational, the findings contextualized? Some radiologists even said the results were because of outdated equipment or even cheating. But staying within the realm of opinion rather than analysis, the question for many was simply: Do you believe this finding?


Consider DCIS (ductal carcinoma in situ). They can't be found by manual breast exams. They are highly localized and among the tinier suspicious cell clusters and were rarely found before mammogram screening. New cases of DCIS went from 5,000 in 1983 to more than 54,000 today, and most are treated like full-blown cancer, with surgeries, lymph node removal and other therapies.


But the assumption that DCIS was an early expression of life-threatening cancer was inaccurate, so much so that there are efforts to reclassify DCIS as a precancer. What's more, finding smaller abnormalities did not translate to a decline in more advanced disease as would be expected. With a more cautious approach, thousands of women who were told they had breast cancer might have avoided invasive overtreatment. Yet the general belief that finding the smallest abnormalities will prevent breast cancer deaths remains.


Focusing on beliefs -- mammograms always save lives -- primes us to rely on opinions that may not be based on reliable evidence. Presenting those beliefs as facts manipulates our emotions. This persuasive strategy is prevalent in health and medical advertising, celebrity spots, and health news.


Consider these trusted, but misleading, persuaders:


Susan G. Komen for the Cure often treats screening mammography as a sure thing for saving lives. Komen's "Get Screened Now" campaign compared a 98% five-year survival rate for breast cancers "caught early" to a 23% five-year survival rate for those caught late. Being alive today, or for a few years, is not the same as "not dying" from a disease. Among other errors, these misleading statistics mix apples and oranges, in this case stage zero DCIS with the most advanced cancers.


The American Cancer Society argues that despite the limitations of screening, including documented overdiagnosis and overtreatment, women 40 and older should have a mammogram every year and continue to do so for as long as they are in good health.


Ignoring the mounting evidence of the limited value of screening for women of average risk, particularly for women in their 40s, the society (and radiology associations) continue to promote early detection via screening.


Health care delivery systems send false messages too. Advertising the story of a 32-year-old woman -- eight years younger than the earliest recommended age to start screening -- to spread a message that regular mammograms greatly increase survival is misleading. It sells a product, but does not necessarily deliver on the promise.


Indeed, no matter how state-of-the-art the mammography machine, technician, and radiologists are, screening mammograms miss at least 10% of invasive breast cancers -- and the worst ones. After 25 years of follow-up, the Canadian study confirmed its earlier findings that the women who received annual screening mammograms died at similar rates as the women who did not -- and far too many got unnecessary overtreatment. Truth in advertising would fully explain these caveats.


A celebrity on prime time who is being treated for a screen-detected breast cancer publicly announces that a mammogram saved her life. But regardless of when or how a "breast cancer" is identified, it is the inherent qualities of the cancer that matter most with regard to a course of treatment and the probability of a successful outcome. Yet the "I got lucky by catching it early" so "every woman should get a mammogram" message continues to spread like wildfire.


It doesn't stop there -- it is spread in campaigns by the National Football League, Kohl's department store, propane gas trucks with messages on the side, pink lemonade, early detection goody bags. The false narrative propagates in a pink ribbon marketplace.


Belief in untested assumptions is much too common. Think back to the extreme and disfiguring Halsted "radical" mastectomy, which removed the breast, lymph nodes and two major chest muscles. It was standard breast cancer treatment by 1915 and remained so for nearly 100 years.


The surgery was not protocol because it saved lives, as many assumed, but because of Halsted's prestige and certainty. Scrutiny of his studies eventually revealed that Halsted's beliefs about breast cancer lacked evidence to support his claims about treatment, but randomized, controlled trials did not confirm the benefit of alternatives until the 1970s.


Eight randomized, controlled trials of mammography screening have found that the benefits are far smaller than early evidence suggested, and the hazards have been largely ignored.


Let's not wait 100 years to move beyond belief in the unequivocal power of this screening tool. We need to understand its strengths, risks and limitations and allow that understanding to inform our beliefs and our practices.


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The opinions expressed in this commentary are solely those of the writers.



Daredevil sailor's 'most stupid' stunt






Whatever you do, don't try this...Whatever you do, don't try this...

Yachtsman Alex Thomson decided to undertake the stunt of running up the mast of his boat and diving off the top of it into the ocean on a whim.Yachtsman Alex Thomson decided to undertake the stunt of running up the mast of his boat and diving off the top of it into the ocean on a whim.

The climb itself to the very top took just 16 seconds.The climb itself to the very top took just 16 seconds.

A helicopter overview shot shows Thomson charging up the mast, the boat at a 60-degree angle for his alternative voyage.A helicopter overview shot shows Thomson charging up the mast, the boat at a 60-degree angle for his alternative voyage.

Thomson hurtles up the mast aware that the boat can keel at any moment and fling him onto the deck or the water below.Thomson hurtles up the mast aware that the boat can keel at any moment and fling him onto the deck or the water below.

Thomson reaches the top of the sail on his mast walk and gets ready to dive into the ocean beneath him.Thomson reaches the top of the sail on his mast walk and gets ready to dive into the ocean beneath him.

Thomson launches himself off the mast and into the water below having never performed a dive of such magnitude in his life before.Thomson launches himself off the mast and into the water below having never performed a dive of such magnitude in his life before.

Waves crash against Thomson, bedecked in only a water-resistant designer suit, which is worn for the entire stunt, as he returns to shore.Waves crash against Thomson, bedecked in only a water-resistant designer suit, which is worn for the entire stunt, as he returns to shore.









  • Sailor takes on death-defying stunt of charging to the top of his boat's mast and diving off

  • Alex Thomson decided to do the stunt on a whim but later called it "stupid"

  • The feat was carried out without a harness and with him wearing only a designer suit

  • As for the future, he has no idea what stunt he might next perform... watch this space




(CNN) -- It's like a stunt from the latest James Bond movie, only this isn't a movie.


Adorned in a designer suit and sunglasses, a sailor sprints up the 30-meter mast of a boat as it plows ahead at a 60-degree angle.


Hopping over ropes and rigging it takes him just 16 seconds to reach the mast's peak. There, he checks himself, removes his sunglasses, pops them in his top pocket and dives into the ocean nine meters below him.


"It's the most stupid thing I've ever done," is Alex Thomson's frank assessment of his stunt.


"It wasn't safe at all," adds the yachtsman more used to solo circumnavigating the globe. "Only looking back do I really appreciate how dangerous it actually was."





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The stunt was carried out without a harness, just a water resistant suit, although the risk was reduced thanks to the work of a stunt co-ordinator and two days of preparation on the water.


For Thomson's daredevil performance to succeed he also needed a wind speed of exactly 18 to 20 knots and for the boat to be traveling at 10 knots (a little under 20 kph).


The 37-year-old and his team began their search for the perfect wind speed in Palma, Mallorca, but were forced to switch to Tarifa in southern Spain because conditions weren't right before eventually shifting to Cadiz where the stunt was eventually performed.


"At the end of the first day, I had to sit down on shore and calm down," says Thomson.


"I was appreciating perhaps it wasn't safe at all, and there were some hairy moments when we were practicing. I remember one time I was halfway up when the boat suddenly tacked and I was just left hanging from the mast.


"Obviously falling from that height from the mast onto the deck isn't advisable," he quips. "The ramifications wouldn't have been great."


On the day itself, with stunning skies above, the stunt went pretty much perfectly, which had a lot to do with the man driving the boat, Ross Daniel.


"His was the harder, more nerve wracking job as he had to keep the boat just right," says Thomson. "Ross works for me and he's a good mate so obviously he was conscious he didn't want things to go wrong.


"I'm not sure if he was relieved come the end of it but he was certainly happy man with how it went."


As for Thomson's starring role in the escapade, he's conscious that he came very close to really hurting himself.


"Now the top of a mast isn't really designed for a man to dive off but I went for it and it held up," says the yachtsman.


"As for the dive itself, I slightly over-egged. There was some quite impressive editing work on that as I landed head first very close to my back.





Greatest America's Cup finale ever?








French skipper Thomas Coville is the latest yachtsman trying to tackle the round-the-world solo record in his trimaran Sodebo.French skipper Thomas Coville is the latest yachtsman trying to tackle the round-the-world solo record in his trimaran Sodebo.



In February 2009, Michel Desjoyeaux became the first -- and still only -- man to twice win the Vendee Globe, considered by many the pinnacle of ocean racing.In February 2009, Michel Desjoyeaux became the first -- and still only -- man to twice win the Vendee Globe, considered by many the pinnacle of ocean racing.



The world's leading yachtsmen marvel at the often glorious skyline on their various solo voyages -- here the sun sets on British skipper Alex Thomson.The world's leading yachtsmen marvel at the often glorious skyline on their various solo voyages -- here the sun sets on British skipper Alex Thomson.



Sailors are left to spend months at sea on their own with only satellite phones and the occasional helicopter flying overhead to keep them company.Sailors are left to spend months at sea on their own with only satellite phones and the occasional helicopter flying overhead to keep them company.



The end of each voyage is traditionally met by huge fanfare with tens of thousands of spectators. Here Francis Joyon celebrates his record of 57 days for circumnavigating the globe.The end of each voyage is traditionally met by huge fanfare with tens of thousands of spectators. Here Francis Joyon celebrates his record of 57 days for circumnavigating the globe.



Britain's Robin Knox-Johnston was the first man to perform a singlehanded nonstop circumnavigation of the globe, in 1968.Britain's Robin Knox-Johnston was the first man to perform a singlehanded nonstop circumnavigation of the globe, in 1968.



In 2007, nearly four decades after his last circumnavigation and aged 68, Knox-Johnston once again sailed solo around the world in the VELUX 5 Oceans Race, being the oldest to ever enter the event.In 2007, nearly four decades after his last circumnavigation and aged 68, Knox-Johnston once again sailed solo around the world in the VELUX 5 Oceans Race, being the oldest to ever enter the event.



Not all voyages, however, have gone to plan. Desjoyeaux's latest trip in the Transat Jacques Vabre ended up with him dismasting just 140 miles (260 kilometers) from the finish.Not all voyages, however, have gone to plan. Desjoyeaux's latest trip in the Transat Jacques Vabre ended up with him dismasting just 140 miles (260 kilometers) from the finish.



Steve White (second from right) with other Brits in the 2008-09 Vendee Globe and Knox-Johnston (second from left). White faced a battle just to fund his entry but finished a creditable eighth.Steve White (second from right) with other Brits in the 2008-09 Vendee Globe and Knox-Johnston (second from left). White faced a battle just to fund his entry but finished a creditable eighth.




Sailing on the high seas around the world

Sailing on the high seas around the world

Sailing on the high seas around the world

Sailing on the high seas around the world

Sailing on the high seas around the world

Sailing on the high seas around the world

Sailing on the high seas around the world

Sailing on the high seas around the world

Sailing on the high seas around the world



Sailing on the high seas around the worldSailing on the high seas around the world










The Extreme Sailing Series provides volatile racing action, as the Aberdeen Asset Management crew found when capsizing in Cowes, England.The Extreme Sailing Series provides volatile racing action, as the Aberdeen Asset Management crew found when capsizing in Cowes, England.



Sailors are stretched to their limit throughout the events. Here, Realteam bowman Thierry Wasem holds on by his feet as he tries to keep his crew on track.Sailors are stretched to their limit throughout the events. Here, Realteam bowman Thierry Wasem holds on by his feet as he tries to keep his crew on track.



The series is about close, stadium racing, enabling boats such as Holmatro (pictured) to get tight to rivals and spectators alike.The series is about close, stadium racing, enabling boats such as Holmatro (pictured) to get tight to rivals and spectators alike.



The margins between triumph and disaster tend to be very fine, as BT Betterworld's crew know all too well.The margins between triumph and disaster tend to be very fine, as BT Betterworld's crew know all too well.



Among the competitors are a host of well-known teams, including former America's Cup winner Alinghi.Among the competitors are a host of well-known teams, including former America's Cup winner Alinghi.



Perhaps the most high-profile entrant this year is America's Cup winner Ben Ainslie, who will skipper his own crew when the competition starts in Singapore.Perhaps the most high-profile entrant this year is America's Cup winner Ben Ainslie, who will skipper his own crew when the competition starts in Singapore.



For all his experience, though, Ainslie has been warned about the perils of the series, where crashes and damage to multimillion-dollar catamarans are not uncommon.For all his experience, though, Ainslie has been warned about the perils of the series, where crashes and damage to multimillion-dollar catamarans are not uncommon.



Unlike many other top-class sailing events, fans and spectators are able to get up close and personal with the competitors.Unlike many other top-class sailing events, fans and spectators are able to get up close and personal with the competitors.



The series travels to all manner of venues across the globe after the first "act" (as each regatta is known) in Singapore starting February 20.The series travels to all manner of venues across the globe after the first "act" (as each regatta is known) in Singapore starting February 20.



No venue is too small, apparently, with crews even battling it out on the narrow canals of Amsterdam, Holland, in recent years.No venue is too small, apparently, with crews even battling it out on the narrow canals of Amsterdam, Holland, in recent years.



The series plays host to a variety of breathtaking backdrops, such as this one in Portugal last season.The series plays host to a variety of breathtaking backdrops, such as this one in Portugal last season.



The man to beat this year is British skipper Leigh McMillan, who is targeting a hat-trick of series titles with his boat The Wave Muscat.The man to beat this year is British skipper Leigh McMillan, who is targeting a hat-trick of series titles with his boat The Wave Muscat.




Sailing's Extreme Race Series

Sailing's Extreme Race Series

Sailing's Extreme Race Series

Sailing's Extreme Race Series

Sailing's Extreme Race Series

Sailing's Extreme Race Series

Sailing's Extreme Race Series

Sailing's Extreme Race Series

Sailing's Extreme Race Series

Sailing's Extreme Race Series

Sailing's Extreme Race Series

Sailing's Extreme Race Series






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Sailing in the extremeSailing in the extreme










The world's 20 best yacht racing photographs have been shortlisted for the Mirabaud Yacht Racing Image of 2013, an eclectic mixture of photographs on the high seas.The world's 20 best yacht racing photographs have been shortlisted for the Mirabaud Yacht Racing Image of 2013, an eclectic mixture of photographs on the high seas.



In total, 82 photographers from 19 different countries entered, including American Jen Edney -- who here snaps Michele Sighel as he checks his crew on their passage from Honolulu to the Philippines.In total, 82 photographers from 19 different countries entered, including American Jen Edney -- who here snaps Michele Sighel as he checks his crew on their passage from Honolulu to the Philippines.



The shots span the globe -- in this instance Keel Week Race in Germany, where photographer Ainhoa Sanchez Vidales observed: "Feel the control of the sailor to dominate all the elements."The shots span the globe -- in this instance Keel Week Race in Germany, where photographer Ainhoa Sanchez Vidales observed: "Feel the control of the sailor to dominate all the elements."



The award is handed out on December 11 at the World Yacht Racing Forum in Gothenberg, Sweden, where all the photographs are on show -- including this dramatic drop in the ocean.The award is handed out on December 11 at the World Yacht Racing Forum in Gothenberg, Sweden, where all the photographs are on show -- including this dramatic drop in the ocean.



Competitor Biljard Guus focuses on the waves ahead during the 2.4-meter fleet racing in the World Paralympic Sailing Championships at Kinsale, Ireland.Competitor Biljard Guus focuses on the waves ahead during the 2.4-meter fleet racing in the World Paralympic Sailing Championships at Kinsale, Ireland.



Here Stefano Rizzi poses as he waits for the start of the International Moth class's Italian Open Championship at Lake Garda. He went on to win a relatively wind-less event.Here Stefano Rizzi poses as he waits for the start of the International Moth class's Italian Open Championship at Lake Garda. He went on to win a relatively wind-less event.



This overhead shot off the coast of Saint Tropez captures a crew in action away from the sun-kissed French Riviera beaches, highlighting the elegant nature of the vast yachts in action.This overhead shot off the coast of Saint Tropez captures a crew in action away from the sun-kissed French Riviera beaches, highlighting the elegant nature of the vast yachts in action.



Some pictures highlight the treacherous nature of the seas -- not that the yachtsman in question here looks unduly concerned as he appears to dip into the water on-board the sailboat Elena.Some pictures highlight the treacherous nature of the seas -- not that the yachtsman in question here looks unduly concerned as he appears to dip into the water on-board the sailboat Elena.



Photographer Max Ranchi captures one of the competitors in May's Trofeo Conde de Godo race near Barcelona, as he explains in his own words, "coming out of the weather mark, bearing away and ready to set gennaker."Photographer Max Ranchi captures one of the competitors in May's Trofeo Conde de Godo race near Barcelona, as he explains in his own words, "coming out of the weather mark, bearing away and ready to set gennaker."



Here, the vessel Virbac-Paprec MOD70 looks a nanosecond away from capsizing as she masters a course at speed during June's La Route des Princes race from Spain to France via Ireland and the UK, as taken by Josep Sanchez.Here, the vessel Virbac-Paprec MOD70 looks a nanosecond away from capsizing as she masters a course at speed during June's La Route des Princes race from Spain to France via Ireland and the UK, as taken by Josep Sanchez.



A spectacular offshore picture taken of Spanish boat Desafío Mapfre near Portugal during February's bid to break the Atlantic Ocean crossing record along the "Route of Discovery" traveled by Christopher Columbus in 1492.A spectacular offshore picture taken of Spanish boat Desafío Mapfre near Portugal during February's bid to break the Atlantic Ocean crossing record along the "Route of Discovery" traveled by Christopher Columbus in 1492.



The physicality of sailing is summed up with aplomb here during August's 420 European Junior Championships in Pwllheli, Wales, with winds of 20 knots.The physicality of sailing is summed up with aplomb here during August's 420 European Junior Championships in Pwllheli, Wales, with winds of 20 knots.



It's hard to see where exactly the sea ends and the boat begins in Guillaume Grange's image taken with a Canon 5D MKIII during the Mini Transat race in Douarnenez, France.It's hard to see where exactly the sea ends and the boat begins in Guillaume Grange's image taken with a Canon 5D MKIII during the Mini Transat race in Douarnenez, France.



Dheer Singhi, of Chennai, tackles winds of 23 knots during a race at India's Topper class national championships. He went on to tie with Vishnu Sujeesh but had to settle for silver on a countback.Dheer Singhi, of Chennai, tackles winds of 23 knots during a race at India's Topper class national championships. He went on to tie with Vishnu Sujeesh but had to settle for silver on a countback.



The notorious Sydney to Hobart race has had its tragedies, but this time it was comfortably won by Wild Oats XI, owned by Bob Oatley, in a new record of one day, 18 hours, 23 minutes and 12 seconds.The notorious Sydney to Hobart race has had its tragedies, but this time it was comfortably won by Wild Oats XI, owned by Bob Oatley, in a new record of one day, 18 hours, 23 minutes and 12 seconds.



Photographer Rick Tomlinson, snapping the all-female crew of Team SCA's ocean racing venture, described it as a "photo session with many good shots, it was hard to chose which one to enter into the competition."Photographer Rick Tomlinson, snapping the all-female crew of Team SCA's ocean racing venture, described it as a "photo session with many good shots, it was hard to chose which one to enter into the competition."



A glorious blue sky is almost entirely filled by this monstrous 129-foot yacht, with its hard-working crew toiling on a big wave on an upwind leg during the Les Voiles de Saint Tropez race, which ended October 6.A glorious blue sky is almost entirely filled by this monstrous 129-foot yacht, with its hard-working crew toiling on a big wave on an upwind leg during the Les Voiles de Saint Tropez race, which ended October 6.



A boat is immediately in the thick of the action at the Celtic Regatta in Wales' Cardigan Bay, where a strong southwesterly wind over the tide caused a large swell. Photographer Andy Green piloted his own boat and took pictures at the same time.A boat is immediately in the thick of the action at the Celtic Regatta in Wales' Cardigan Bay, where a strong southwesterly wind over the tide caused a large swell. Photographer Andy Green piloted his own boat and took pictures at the same time.



An out-of-focus yellow buoy bobs on the surface of the water as, in a distance, Pachakis Ioannis glides over the water in October's Cretan Union Cup, captured on a Pentax 450mm.An out-of-focus yellow buoy bobs on the surface of the water as, in a distance, Pachakis Ioannis glides over the water in October's Cretan Union Cup, captured on a Pentax 450mm.



British sailor Mark Andrews powers upwind in the Finn class of May's Delta Lloyd Regatta at Medemblik. Andrews beat Dutch favorite Pieter-Jan Postma following a thrilling medal race.British sailor Mark Andrews powers upwind in the Finn class of May's Delta Lloyd Regatta at Medemblik. Andrews beat Dutch favorite Pieter-Jan Postma following a thrilling medal race.







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The 20 best sailing images of 2013The 20 best sailing images of 2013



"It was quite close to a back belly flop and, while I wouldn't have killed myself, I certainly would have had some nasty internal injuries.


"Diving wise, I'd always wanted to dive but wasn't sure until I got to the top whether I'd have the guts to do it.


"I'd been up a 10-meter board at a pool in training but never dived off it. So this was a first and, once I was up there, I sort of thought I might as well go for it."


As he pondered that stomach-churning dive, Thomson says he felt surprisingly calm.


"As a sailor I'm used to hoisting myself up the mast and you get well versed at reading the wind and the waves so I was quite aware if there was suddenly going to be a change in the boat's course," he explains.


There wasn't, he duly hit the water and quickly returned to the surface to the relief and cheers of his team.


Even now, Thomson, who has a penchant for being something of a daredevil, is not entirely sure why he performed the stunt.


"I did a keel walk a while ago and we did a video for that, which got over two million people watching which I was flabbergasted by," he admits.


"So we got talking about doing something else and this seemed a bit of fun really.


"I'd taken to running up the mast -- although not necessarily to the top -- for a while, mostly when entertaining people on the boat to, say, take pictures of them on the deck.


"So, going the whole way up and jumping off seemed a good idea.


"It's a bit like the Vendee Globe (the race to circumnavigate the globe). You sort of agree to it not thinking it will necessarily happen, and then suddenly the day comes for it."


Having done a keel walk two years ago and now a mast walk, Thomson is at a loss to consider what might complete a hat-trick of sailing stunts.


"That was the same after the keel walk. I'd never planned to follow that or do something like this, it just happened. So when I'm asked what I might do next, I literally have no idea."


Read: The perils of sailing solo around the world


Read: Extreme Sailing Series - F1 on water