Ukraine's Poroshenko vows response to Luhansk plane crash.

 

The Il-76 transport aircraft came down overnight in a city mostly controlled by pro-Russian rebels

Ukraine's President Petro Poroshenko has vowed to retaliate after pro-Russia separatists shot down a military plane in the east, killing 49 people.

Those involved in such "cynical acts of terrorism" must be punished," said Mr Poroshenko - who summoned security officials for an emergency meeting.

The defence ministry said the transport plane came under anti-aircraft fire over the city of Luhansk overnight.

It was about to land there, carrying troops and military equipment.

It is thought to be the biggest loss of life suffered by government forces in a single incident since the Ukrainian government in Kiev began an operation to try to defeat the insurgency in the east.

"The terrorists cynically and treacherously fired with a large-calibre machinegun, hitting an Ilyushin-76 of the Ukrainian air force," the defence ministry said.

all 49 military personnel on board - nine flight crew and 40 troops - were killed. 

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Ukraine crisis

• Poroshenko, Ukraine's rescuer
• Boots on the ground?
• Poroshenko profile
• Crisis mapped

Sex apps increase risk of STIs, US researchers warn.

 

Using smartphone apps to seek out partners for casual sex poses an increased risk of sexually transmitted infections, researchers warn.

A study in Los Angeles, California, showed gonorrhoea and chlamydia were more common in gay men using apps than in those meeting in clubs or online.

Sexual health experts said technology was creating more opportunities for sex than ever before.

One of the apps, Grindr, said it was committed to promoting safe sex.

The researchers were curious about the impact of apps such as Grindr and Scruff which use a smartphone's location to help find partners.

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“Start Quote

However good the sex is, it's not worth contracting a long-term condition”

Justin Harbottle Terrence Higgins Trust

They quizzed 7,184 men attending a sexual health clinic at the LA Gay and Lesbian Centre.

The results showed men were 23% more likely to have gonorrhoea and 35% more likely to be infected with chlamydia than men using other websites or clubs to meet new partners.

There was no difference in the risk of HIV between the groups.

Their report concluded: "Technology is redefining sex on demand.

"Advances which improve the efficiency of meeting anonymous sexual partners may have the unintended effect of creating networks of individuals where users may be more likely to have sexually transmissible infections."

 Condoms

 

Chlamydia is spread through sexual contact.

 

Dr Steve Taylor, a consultant in sexual health and HIV medicine at Birmingham Heartlands Hospital, told the BBC: "Yes this is definitely something we are seeing in our sexual health and HIV clinics, both among gay men and heterosexuals.

"Without a doubt technology has facilitated rapid partner change and therefore it is a perfect environment for sexually transmitted infections and HIV to spread."

Justin Harbottle, a health promotion specialist at the Terrence Higgins Trust, said: "However good the sex is, it's not worth contracting a long-term condition.

"Gay men today have more opportunities to meet for sex than ever before.

"Part of the problem is that communication on dating apps can be brief, making it easy to cut corners on important discussions like safe sex."

He said condoms were still the best defence against infection.

Grindr told the BBC: "Grindr is highly committed to promoting safe sex within the community and strongly encourages our users to engage in safe sex practices, get tested and know their HIV status."

It added that it collaborated with a range of organisations to raise awareness about safe sex.

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Africa elephants 'face survival threat' from poaching.

 

 Elephant conservationists say demand for ivory remains high.

The survival of Africa's elephants is under threat, with estimates suggesting more than 20,000 were killed in 2013, a report says.

The office of the Convention on International Trade in Endangered Species (Cites) said poaching levels were far above the elephant birth rate.

However, the report said poaching numbers had dropped slightly compared to the previous two years.

Transnational organised crime appeared to be involved in the trade, it added.

Cites, which is based in Geneva, is responsible for regulating the international trade in more than 35,000 species of plants and animals. 

 Analysis: Matt McGrath, BBC Environment Correspondent

  

China has started to destroy seized ivory in public

 

There are a number of interesting signals in these latest figures, perhaps indicating that the tougher line being taken by Cites is bearing fruit.

For the first time, more large-scale consignments of ivory have been seized in Africa rather than in Asia.

This is down to better policing in Kenya, Tanzania and Uganda and perhaps a slight downturn in demand from the key markets such as China, which carried out the first public destruction of ivory earlier this year.

There is also the rise in demand in China for legal mammoth ivory that is mainly exported from Russia, which may also indicate a growing awareness of the connection to elephants and a willingness to look at alternatives.

While these may be positive indicators, the report highlights continuing bad news.

The slaughter of elephants is rising in countries like the Central African Republic, where local populations remain on the verge of extinction.

'Large seizures'

"Africa's elephants continue to face an immediate threat to their survival from high levels of poaching for their ivory," said Cites Secretary-General John E Scanlon.

The report also documented an increase in the number of large seizures of ivory - of shipments over 500kg (1,100 pounds), in 2013.

  

The report says elephants could face extinction if the current rate of poaching continues

 

For the first time, there were more such seizures in Africa than Asia, with Kenya, Tanzania and Uganda accounting for 80% of the seizures, the report said.

"Large-scale ivory seizures are indicative of transnational organised crime being involved in the illicit ivory trade," a Cites press release said.

While elephant conservationists do believe that increased ivory confiscation is a sign that law enforcement is improving, they also point out that demand for ivory remains very high, says the BBC's Imogen Foulkes in Geneva.

Conservationists say that even in some of the monitored elephant populations, poaching is actually increasing, our correspondent adds.

The Cites poaching estimates were based on data from 51 sites across Africa, which accounted for 30-40% of the continent's elephant population.

Figures from those site were extended to estimate the total numbers killed in Africa.

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Kiev says three Russian tanks entered east Ukraine.

A Ukrainian tank is seen here firing during a clash with rebels in Sloviansk earlier this month.

Ukraine's interior minister has said three tanks have crossed the border from Russia into rebel areas of the east and that fighting is under way.

The tanks entered Ukraine along with other armour through a checkpoint controlled by rebels in the Luhansk region, Arsen Avakov said.

The army engaged two of them and destroyed part of the column, he said.

Russia has rejected Mr Avakov's statement as "another fake piece of information".

Meanwhile, Ukrainian President Petro Poroshenko, who was elected last month, and his Russian counterpart Vladimir Putin had a "substantial" conversation by phone on Kiev's plan of peaceful settlement in the east, Ukraine's presidency said in a statement.

Mr Poroshenko said that it was "unacceptable" for the tanks to be crossing into Ukraine, his press secretary said.

Pro-Russian separatists in the Donetsk and Luhansk regions declared independence after holding referendums last month which were deemed illegal by the government in Kiev.

Ukraine and the West accuse Russia of supporting and arming the rebels - a claim denied by Moscow.

The rebellion began amid the turmoil which followed February's ousting of President Viktor Yanukovych, whose last-minute decision not to sign a landmark treaty with the European Union in November sparked mass street protests in Kiev. 

 'Fight under way'

 

Rebel fighters could be seen in Snizhne on Thursday

Mr Avakov said the tanks had crossed the border from Russia along with armoured personnel carriers and artillery pieces in the Dyakove area of Luhansk region, before moving into the neighbouring Donetsk region.

There, Ukraine's interior minister said, the tanks headed for the town of Snizhne on Thursday morning. Two then proceeded to the town of Horlivka and were attacked by government forces.

"The fight is under way," Mr Avakov said. "I cannot say about its final outcome, but part of this column has been destroyed."

Unverified video has been posted on YouTube of a battle tank rolling down a street said to be in Snizhne. The footage was shot from a flat overlooking the street.

 

A second clip, also said to have been recorded in Snizhne, shows a similar tank passing a roundabout.

The Russian foreign ministry told the BBC that Mr Avakov "was inventive and that the statement about Russian tanks and APCs crossing the border into Ukraine was another fake piece of information".

There was no confirmation about the tanks from the insurgents.

A rebel spokesman told Russia's Ria-Novosti news agency that they were fighting a force of 40 Ukrainian tanks north of the city of Luhansk.

The tanks had been stopped at the village of Makarovo, the spokesman said.

Red meat 'linked to breast cancer'.

 

 Eating large quantities of red and processed meat has been linked to bowel cancer.

Eating a lot of red meat in early adult life may slightly increase the risk of breast cancer, according to a US study.Harvard researchers say replacing red meat with a combination of beans, peas and lentils, poultry, nuts, and fish may reduce the risk in younger women.But UK experts urge caution, saying other studies have shown no clear link between red meat and breast cancer.Past research has shown that eating a lot of red and processed meat probably increases the risk of bowel cancer.

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“Start Quote

Women can reduce their breast cancer risk by maintaining a healthy weight, reducing alcohol consumption and increasing the amount of physical activity they do”

Sally Greenbrook Breakthrough Breast Cancer

The new data comes from a US study tracking the health of 89,000 women aged 24 to 43.

A team, led by Harvard School of Public Health in Boston, analysed the diets of almost 3,000 women who developed breast cancer.

"Higher red meat intake in early adulthood may be a risk factor for breast cancer," they report in the British Medical Journal.

"And replacing red meat with a combination of legumes, poultry, nuts and fish may reduce the risk of breast cancer."

Dr Maryam Farvid and colleagues described the risk as "small".

Prof Tim Key, an epidemiologist at the University of Oxford, said the US study found "only a weak link" between eating red meat and breast cancer, which was "not strong enough to change the existing evidence that has found no definite link between the two".

"Women can reduce their risk of breast cancer by maintaining a healthy weight, drinking less alcohol and being physically active, and it's not a bad idea to swap some red meat - which is linked to bowel cancer - for white meat, beans or fish," he added.

 

The researchers advise replacing red meat with foods such as beans.

Prof Valerie Beral, director of the Cancer Epidemiology Unit at the University of Oxford, said dozens of studies had looked at breast cancer risk associated with diet.

"The totality of the available evidence indicates that red meat consumption has little or no effect on breast cancer risk, so results from a single study cannot be considered in isolation," she said.

Sally Greenbrook of Breakthrough Breast Cancer said the charity would welcome more research into the impact of red meat on breast cancer risk.

"It's already been proven that women can reduce their breast cancer risk by maintaining a healthy weight, reducing alcohol consumption and increasing the amount of physical activity they do," she said.

Jackie Harris, a clinical nurse specialist at Breast Cancer Care, said: "This study is interesting because it looks at young women's eating habits and supports the growing body of evidence of the importance of eating a well balanced diet.

"Doing exercise and keeping a healthy body weight can also help reduce your risk of breast cancer.

"However it is important to remember that it can't prevent it completely.

"Being female, increasing age and having a significant family history are the three main risk factors for developing breast cancer."

Red meat 'limits'

Evidence has shown that there is probably a link between eating lots of red and processed meat, and the risk of bowel cancer.

The Department of Health has advised that people who eat more than 90g (cooked weight) of red and processed meat a day cut down to 70g.

Guidelines from the American Cancer Society also suggest limiting how much processed and red meat are consumed.

Meanwhile, a separate study found that women with large numbers of moles on their skin may be at higher risk of breast cancer.

"It's not yet clear how useful asking women to report how many moles they have as part of risk estimation would be, given that there are several other, more reliable, risk factors at play such as weight, age, and genes," said Dr Matthew Lam of Breakthrough Breast Cancer.

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Scrap plan to extend statin use, say doctors.

Proposals to extend the use of statin drugs should be scrapped, a group of leading doctors and academics says.

The National Institute for Health and Care Excellence published draft guidance in February calling for their use to be extended to save more lives.

It could mean another five million people in England and Wales using them on top of seven million who already do.

But in a letter to NICE and ministers, the experts expressed concern about the medicalisation of healthy people.

The letter said the draft advice was overly reliant on industry-sponsored trials, which "grossly underestimate adverse effects".

And it added: "The benefits in a low-risk population do not justify putting approximately five million more people on drugs that will then have to be taken lifelong."

The drugs reduce levels of cholesterol in the blood, lowering the risk of a heart attack or stroke.

The signatories include Royal College of Physicians president Sir Richard Thompson and former Royal College of GPs chairwoman Clare Gerada as well as cardiologists and leading academics.

 Side-effects

Prof Simon Capewell, an expert in clinical epidemiology at Liverpool University and one of the signatories, said: "The recent statin recommendations are deeply worrying, effectively condemning all middle-aged adults to lifelong medications of questionable value.

"They steal huge funds from a cash-strapped NHS and they steal attention from the major responsibilities that government and food industry have to promote healthier life choices for ourselves and our children."

Currently, doctors are meant to offer statin tablets to the estimated seven million people who have a 20% chance of developing cardiovascular disease over 10 years, based on risk factors such as their age, sex, whether they smoke and what they weigh.

Statins and risk

• Statins are a group of medicines that can help lower rates of so-called "bad cholesterol" in the blood

• They do this by curbing the production of low-density lipoprotein cholesterol in the liver

  High rates of LDL are potentially dangerous as they can lead to hardening and narrowing of the arteries, known as atherosclerosis, which increases the risks of strokes and heart attacks

• Doctors use a risk calculator called QRisk2 to work out a person's chance of having a stroke or heart attack to decide if they should be given statins

• The calculation factors include age, weight and smoking

• If someone has a 10-year QRisk2 score of 20%, then in a crowd of 100 people like them, on average, 20 people would get cardiovascular disease over the next 10 years

But the draft guidance suggested that people with as low as a 10% risk should be offered the treatment.

Cardiovascular disease develops when fatty substances build up in the arteries and narrow them, which can lead to heart attacks and stroke. 

Too much cholesterol in the blood can lead to these fatty deposits. Statin drugs work by lowering cholesterol.

Eating a healthy diet, doing regular exercise and keeping slim will also help lower cholesterol.

Like all medicines, statins have potential side-effects. They have been linked to muscle, liver and kidney problems, but just how common these are is a contentious issue.

One of the signatories to the letter is London cardiologist Dr Aseem Malhotra, who last month had to withdraw claims he made in a British Medical Journal article that a fifth of people who use statins experience side-effects.

 

 'Extremely painful'

"I was prescribed Simvastatin about nine years ago following heart problems," says John Cakebread, from Kent.

"I stopped taking the medication six years later after researching the subject on the internet and finding out about side effects.

"I have now been left with peripheral neuropathy in the feet.

"This is extremely painful.

"My GP refuses to acknowledge this condition and that it could be caused by statins.

"He still wants me to take this medication, but I have refused."

Mike Knapton, of the British Heart Foundation, said NICE was right to want to extend the use of statins.

"Evidence shows that statins are a safe, effective, cholesterol-lowering drug and proven to lower the risk of heart disease."

He added that, if anything, NICE should go further by looking at the lifetime risk rather than 10-year timeframe being proposed.

NICE has consulted on its draft proposals and is expected to publish final guidance at the end of July.

Prof Mark Baker, from NICE, said as well as the consultation the recommendations are being peer-reviewed.

He also pointed out that the guidance did not say patients had to go on these drugs - as GPs and patients can also discuss lifestyle changes to reduce risk - but just gave them the option of using them.

"This guidance does not medicalise millions of healthy people. On the contrary, it will help prevent many from becoming ill and dying prematurely," he added.

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Rwanda and DR Congo 'battle over kidnapped soldier'

Friction in between DR Congo and its neighbour has led to decades of instability in the east.

Rwandan forces and troops from DR Congo are fighting each other on their shared border, the Congolese information minister says.

Lambert Mende told the BBC the battle began when a unit of Rwandan soldiers crossed over the border and attacked early on Wednesday.

After fighting for nearly two hours, the Rwandans kidnapped an army corporal and went home, he said.

Clashes resumed when the Congolese learns the officer had been killed.

The Rwandan authorities have yet to comment on the violence.

The neighbours have had a fractious relationship since the 1994 genocide when those accused of involvement in the killings of an estimated 800,000 ethnic Tutsis and moderate Hutus set up a militia in eastern DR Congo.

 

Over the years residents near the border with Rwanda have often had to flee their homes because of conflict.

Mr Mende said the fighting was in Buhumba in North Kivu province.

The Rwandan soldiers came over the border at about 04:30 local time (03:30 GMT), he told the BBC's Focus on Africa radio programme.

He said the fighting had broken out again in the afternoon when Congolese soldiers heard the news about their captured colleague.

"There is now fighting. There are also talks - we need really to know what is happening with them," Mr Mende said.

Rwanda has been accused by the UN of playing a part in the unrest in DR Congo over the years, a charge it denies.

Most recently it was accused of backing a rebellion by the M23 - a mainly ethnic Tutsi movement, which was defeated by the Congolese military and a special UN brigade in November.

Troublesome neighbours

• April-June 1994: Genocide of Tutsis in Rwanda
• June 1994: Paul Kagame's Tutsi rebels take power in Rwanda, Hutu fighters flee into Zaire (DR Congo)
• Rwanda's army enters eastern Zaire to pursue Hutu fighters
• 1997: Laurent Kabila's AFDL, backed by Rwanda, takes power in Kinshasa
• 1998: Rwanda accuses Kabila of not acting against Hutu rebels and tries to topple him, sparking five years of conflict
• 2003: War officially ends but Hutu and Tutsi militias continue to clash in eastern DR Congo
• 2008: Tutsi-led CNDP rebels march on North Kivu capital, Goma - 250,000 people flee
• 2009: Rwanda and DR Congo agree peace deal and CNDP integrated into Congolese army
• 2012: M23 mutiny led by former CNDP leader Bosco "Terminator" Ntaganda
• 2013: M23, which Rwanda denies backing, is defeated

M23's decline raises hopes of DR Congo peace