RECIFE, Brazil – Costa Rica produced another huge upset to reach the knockout stages of the World Cup for the second time Friday with a 1-0 Group D win over Italy that also ensured England was eliminated. Bryan Ruiz headed powerfully home a minute before halftime to leave Costa Rica fans dancing in the sunshine at Recife's Pernambuco arena, while Mario Balotelli missed Italy's best efforts. Costa Rica moved top of the group with six points, having already beaten Uruguay in its first game, while Italy, three points adrift, now needs at least a draw from its final game against Uruguay, also on three points, to go through on goal difference. In making the last 16 for the first time in 24 years, the Central Americans ensured England became the latest team to make a surprise early exit, leaving at the group stages for the first time since 1958. The midday sun reduced the early stages to shadow boxing, with Italy hogging the ball but strolling round the pitch at walking pace while Costa Rica was busy but cautious. Costa Rica's back-five pushed high up the pitch to compress the space as Italy sat back and looked to hit on the break, a tactic which almost paid dividends on the half-hour mark as Balotelli was sent clear by a superb through ball from Andrea Pirlo. But the striker, who headed the winner in Italy's opening win over England, could not control the ball with his first touch and then tried and failed to lob keeper Kaylor Nevas with his second. As the first half was drawing to a close, Costa Rica showed why it can pose such a threat. In the space of three minutes, Oscar Duarte headed fractionally over, Joel Campbell had a penalty appeal waved away by Chilean referee Enrique Osses and Ruiz headed it in front. Junior Diaz floated a beautiful cross to the far post and Ruiz arrived to head it in off the underside of the bar and over the line, with the decision to award a goal confirmed on the big screen. Italy brought on Antonio Cassano at halftime, but Costa Rica expertly took the sting out of the match, reducing their opponents only to glimpses of goal, while it continued to look threatening on the counter. FIFPro criticizes handling of Pereira concussion incident Players who suffer suspected concussion during a game should be temporarily substituted while their condition is evaluated, the world players' union FIFPro said Friday. Following Thursday's incident at the World Cup involving Uruguay fullback Alvaro Pereira, who played on despite being knocked out in their game with England, FIFPro said independent doctors were needed to decide whether a player could continue. Pereira was clattered in the face by England forward Raheem Sterling's knee an hour into the Group D match in Sao Paulo and lay unconscious as medical staff rubbed his chest and tried to revive him. When he got up, staggering along the touchline, Pereira furiously pushed away medical staff who wanted him substituted and forced his way back on to the pitch in what he admitted was a “moment of madness.” FIFPro called on soccer's world governing body FIFA to conduct “a thorough investigation into its own competition concussion protocol which failed to protect Uruguayan footballer Alvaro Pereira” and said it was seeking urgent talks. FIFA drops linesman who ruled out Mexico ‘goals' A linesman who ruled out two goals for Mexico in its opening World Cup match against Cameroon has been taken off the refereeing team for an upcoming game, world soccer's governing body FIFA said Friday. Colombian assistant referee Humberto Clavijo controversially disallowed two first-half ‘goals' for Mexico for offside in a game they eventually won 1-0. A FIFA spokeswoman said the decision to replace Clavijo for Sunday's Group H match between South Korea and Algeria had been taken by the organization's refereeing committee. He will be replaced by Ecuadorean Christian Lescano. — Agencies