Plagiarized Journal Article - No. 1

The article titled "Obstructive sleep apnea - diagnosis, medical management and dental implications" by K.R.Magliocca  and J.I.Melman was published in the Journal of the American Dental Association (JADA) in Aug 2005 [Vol 136(8): pages1121-9]. However, I found a miniaturised and plagiarised version of this paper published in the Hong Kong Medical Diary (Vol.15, Issue No.3, March 2010) by Prof. Lim Cheung and Dr. Hannah Chua. This article is available online at www.fmshk.org/database/articles/03db1.pdf

 
Please find a side by side comparisons of the similarities between the 2 articles at the end. Incidentally this is the same article in which Dr. Chua tried to pretend as an Assistant Professor (the related newspaper reports can be accessed at
 http://www.hotjetso.com/thread-11311-1-1.html

http://www1.hk.apple.nextmedia.com/template/apple/art_main.php?iss_id=20101004&sec_id=4104&subsec_id=11867&art_id=14516496)
 The journal has corrected Dr. Chua's academic designation after these news reports. However, it would not be possible to correct the plagiarism in this article as its quite widespread.

Article by Chua and Cheung	JADA article by Magliocca and Melman
Obstructive sleep apnoea (OSA) is a disturbance in normal sleep patterns.	Obstructive sleep apnea (OSA) is a disturbance in normal sleep patterns
The common morbidities of OSA are hypertension,1 depression,2 stroke,3 angina,4 cardiac dysrhythmia,5……..	……comorbid disease in connection with untreated OSA such as systemic hypertension,1–3 depression,4 stroke,5,6 angina7 and cardiac dysrhythmias.8
Untreated OSA is also associated with motor vehicle accidents,6 poor work performance, occupational accidents and reduced quality of life.4	Untreated OSA also is associated with motor vehicle accidents,9 poor work performance, occupational accidents and reduced quality of life.10,11
Epidemiology OSA occurs in 2 to 4 percent of the adult population between the ages of 30 to 60 years, though evidence suggests that many more patients remain undiagnosed.	EPIDEMIOLOGY OSA occurs in 2 to 4 percent of the adult population between the ages of 30 to 60 years,16 though evidence suggests that many more patients remain undiagnosed.
Signs and Symptoms The common signs and symptoms associated with OSA are: loud, habitual snoring, apnoeic events witnessed by the spouse or others, daytime sleepiness, restless sleep, choking sensation or gasping during the night, morning headache, personality and mood changes, sexual dysfunction (impotence and decreased libido) and gastro-oesophageal reflux.	SIGNS AND SYMPTOMS Some of the signs and symptoms listed in Box. 1 have been copied including Excessive sleepiness Sleep restlessness Choking or gasping Morning headaches Decreased libido Impotence Gastroesophageal reflux disease
The most common orofacial characteristic encountered include retrognathic mandible, narrow palate, long soft palate, hypertrophic tonsils, nasal septal deviation and relative macroglossia.	The most common orofacial characteristics encountered include a retrognathic mandible, narrow palate, large neck circumference, long soft palate (which leads to dentists’ being unable to visualize the entire length of the uvula when the patient’s mouth is open wide), tonsillar hypertrophy, nasal septal deviation and relative macroglossia.
The gold standard for diagnosing OSA is by polysomnography (PSG), which needs to be conducted at a sleep laboratory.	The gold standard for diagnosing OSA involves having the patient complete polysomnography (an overnight sleep study) conducted in a laboratory.
The aims of polysomnography are to evaluate any abnormal sleep breathing, sleep architecture and oxygen saturation. A typical hours nocturnal laboratory PSG involves measurements of multiple physiological functions including electro-oculography, chin or leg movement via electromyography, electrocardiography, sleep positioning, respiratory activity and oxygen saturation.	The polysomnogram records parameters including (brain waves), electro-oculography (eye movement), electrocardiography, electromyography (chin and leg movement), sleep positioning, respiratory activity and oxygen saturations.
the apnoea-hypopnoea index (AHI) which is the number of apnoeas and hypopnoeas per hour of sleep.	The apnea-hypopnea index (AHI) is the average number of apneas and hypopneas per hour of sleep.
Apnoea is defined as the cessation of air flow (complete obstruction) for at least 10 seconds with a concomitant 2 to 4 percent drop in arterial oxygen saturation. Hypopnoea is defined as a reduction in airflow of at least 30 to 50 percent with a drop in oxygen saturation.	Apnea is defined as the cessation of airflow—a complete obstruction for at least 10 seconds—with a concomitant 2 to 4 percent drop in arterial oxygen saturation.26 The definition of hypopnea is more variable, but it commonly is thought of as a reduction in airflow of at least 30 to 50 percent with a drop in oxygen saturation.
The severity of OSA is commonly classified according to a patient's AHI score: mild (AHI score between 5 to 15); Moderate (AHI score between 15 and 30); and severe (AHI score greater than 30). Other factors that also influence the severity of OSA include oxygen desaturation, quality of life and the level of daytime sleepiness	OSA severity is classified on the basis of the patient’s AHI score, into three categories: mild (AHI score between 5 and 15), moderate (AHI score between 15 and 30) and severe (AHI score greater than 30). Not all studies, however, adhere to the numerical parameters of this classification. Other factors that also influence the severity of OSA include oxygen desaturation, quality of life and the level of daytime sleepiness
Possible treatment options for adult patients diagnosed with OSA are based on the severity of the sleep disorder, patient's preference and his/her overall health status. Positional therapy involves nocturnal aids to prevent patients from sleeping in a supine position. Sleeping in the lateral position is generally recommended, as it will displace the tongue from the posterior airway such that it is less likely to cause airway obstruction during sleep.	possible treatment options for adult patients with OSA based on the severity of the sleep disorder, patient’s preference, the patient’s overall health, and the experience and preferences of the team members. Positional therapy involves nocturnal aids (for example, having patients sew a tennis ball into the back of their pajama tops) to prevent patients from sleeping in a supine position. Sleeping in the lateral position may be effective, as it will displace the tongue from the posterior airway such that it is less likely to be a source of obstruction.
Weight loss is universally recommended for obese patients. However, it is not known how much weight loss is required to eliminate OSA, and both the patient's gender and weight distribution may contribute to his or her OSA in an unpredictable manner	Weight loss is recommended when applicable; however, not all patients with OSA are obese.29,30 It is not known how much weight loss is required to eliminate OSA, and both the patient’s sex and weight distribution may contribute to his or her OSA in an unpredictable manner
The concept of nasal CPAP is to maintain upper airway patency during sleep. This treatment can be administered via either a nasal or oral mask. Due to its effectiveness, CPAP is first-line treatment and the primary form of therapy for OSA, although its success is limited by the patient's level of compliance. About 20 to 30 percent of patients experience problems using CPAP, and the device is ineffective if it is not regularly used. The common problems associated with CPAP are nasal dryness, facial ulceration at the mask interface and claustrophobia.	The concept of nasal CPAP is to maintain upper airway patency during sleep by way of a pneumatic stent. This treatment can be administered via nasal mask, oral mask or other variations. Because of its effectiveness, CPAP is the first-line treatment and the primary form of therapy for OSA, though its success is limited by the patient’s level of compliance. Roughly 20 to 30 percent of patients experience problems while using CPAP, and the device is ineffective if it is not used regularly.35 Patients list nasal dryness, facial ulcerations at the mask interface and claustrophobia
Many commercial devices offer treatment for snoring; however a device designed to treat OSA should be fabricated by a dental practitioner or specialist familiar with device design, maintenance and therapeutic efficacy. A multitude of oral appliances for OSA are available, but not all patients find the same appliance effective. Patient's compliance with oral appliances appears to be adequate but not all studies agree. Difficulty with the device, owing to temporary or persistent occlusal disturbance, temporomandibular joint or individual tooth discomfort or perceived lack of ûcacy may cause compliance issues.	Many commercial devices offer treatment for snoring; however, a device designed to treat OSA should be fabricated by a dentist familiar with device design, maintenance and therapeutic efficacy and who has an association with and referral from a sleep team. A multitude of oral appliances for OSA are available, but not all patients will find the same appliance effective.13 Patient compliance with oral appliances appears to be adequate,37 but not all studies agree.38 Difficulty with the device owing to temporary or persistent occlusal, temporomandibular joint or individual tooth discomfort13 or a perceived lack of efficacy may cause compliance issues.
The main surgical treatments offered for OSA often target the anatomical areas of the posterior airway where collapse is suspected to occur. Treatment is designed to enlarge the posterior airway space, reduce airway collapsibility and stabilise the airway in the long term.	The main surgical treatments offered for OSA often target the anatomical areas of the posterior airway where collapse is suspected to occur. Treatment is designed to enlarge the posterior airway space, reduce airway collapsibility and, ideally, stabilize the airway for the long term.
Orthognathic surgery has the advantage of correcting any craniofacial abnormalities that may have caused the OSA.	Surgery has the advantage of correcting any craniofacial abnormalities that may have caused the OSA……
Maxillomandibular advancement surgery (MMA), which is based on conventional orthognathic surgery techniques has been proven ûective in retrospective studies for a range of OSA patients	Maxillomandibular advancement (MMA) surgery, which is based on traditional orthognathic surgery techniques, has been proven effective in retrospective studies for a range of OSA disease.