Chronic comorbidity in multiple sclerosis is associated with lower incomes and dissolved intimate relationships.

BACKGROUND AND PURPOSE: The social and economic consequences of comorbidity in multiple sclerosis (MS) are largely unexplored. Differences were investigated in income and in the rate of broken relationships between cases of MS with and without chronic comorbidity. METHODS: We conducted a nationwide cohort study including all incident cases of MS in Denmark with clinical MS onset between 1980 and 2005. The difference in income was investigated at MS onset and 5 and 10 years after MS onset. The difference in the rate of broken relationships was investigated in subjects who were in a relationship at MS onset or who entered a relationship after MS onset. We used logistic, multiple linear and Poisson regression analyses. RESULTS: Cases of MS with somatic comorbidity had increased odds of low incomes both 5 years {odds ratio (OR), 1.41 [95% confidence interval (CI), 1.19-1.67; P < 0.0005]} and 10 years [OR, 1.37 (95% CI, 1.17-1.60); P < 0.0005] after MS onset. The odds of a low income with psychiatric comorbidity was increased 10 years after MS onset [OR, 3.06 (95% CI, 1.47-6.37); P = 0.003]. The rate of broken relationships was increased in cases of MS with any somatic comorbidity [incidence rate ratio, 1.46 (95% CI, 1.32-1.61); P < 0.0005]. CONCLUSIONS: Our results underscore the burden of comorbidity in MS on patients, their partners and society.

Registers of multiple sclerosis in Denmark.

There are two nationwide population-based registers for multiple sclerosis (MS) in Denmark. The oldest register is The Danish Multiple Sclerosis Registry (DMSR), which is an epidemiological register for estimation of prevalence and incidence of MS and survival, and for identifying exposures earlier in life that may affect the risk of MS. This register has no systematic follow-up data except for survival. The DMSR has over the years published nationwide incidence- and prevalence data from Denmark and has been involved in a number of 'historical prospective' studies to elucidate the association between a number of different environmental exposures in the past and the subsequent risk of MS. Some of these studies have been able to exonerate suspected risk factors. The other register, the nationwide Danish Multiple Sclerosis Treatment Register, is a follow-up register for all patients who have received disease-modifying treatments since 1996. It has, in particular, contributed to the knowledge of the role of antibodies against the biological drugs used for the treatment of MS.

Gender effects on treatment response to interferon-beta in multiple sclerosis.

BACKGROUND: Gender appears to play a role in incidence and disease course of multiple sclerosis (MS). OBJECTIVE: The objective was to determine whether male and female patients with MS respond differently to interferon-beta treatment in terms of reduction in relapse rates. METHODS: We included all 2033 patients with relapsing-remitting MS who started treatment with interferon-beta from 1996 to 2003, identified from the Danish Multiple Sclerosis Treatment Register. We defined neutralizing antibody (NAb)-positive and NAb-negative periods in the single patient by the results of the NAb tests. Patients served as their own controls, and relapse rates were compared between NAb-negative and NAb-positive periods. RESULTS: NAbs significantly abrogated the interferon-beta treatment efficacy in both genders. The all-over women:men relapse rate ratio irrespective of NAb status was 1.47 (95%CI; 1.28-1.68). In a generalized linear Poisson models analysis with relapse counts as response variable, the main effects NAbs, sex, age at treatment start and number of relapses in 2 years before treatment start were strongly significant, but the effect of NAbs on relapse rates did not differ significantly between men and women. CONCLUSION: As NAbs influenced the on-treatment relapse rates strongly in both sexes but without statistical significant difference, there is no indication of different effects of interferon-beta in men or women.

Enzymatic generation of hydrogen peroxide shows promising antifouling effect.

The antifouling (AF) potential of hydrogen peroxide (H(2)O(2)) produced enzymatically in a coating containing starch, glucoamylase, and hexose oxidase was evaluated in a series of laboratory tests and in-sea field trials. Dissolved H(2)O(2) inhibited bacterial biofilm formation by eight of nine marine Proteobacteria, tested in microtiter plates. However, enzymatically produced H(2)O(2) released from a coating did not impede biofilm formation by bacteria in natural seawater tested in a biofilm reactor. A field trial revealed a noticeable effect of the enzyme system: after immersion in the North Sea for 97 days, the reference coating without enzymes had 35-40 barnacles, 10% area coverage by diatoms and 15% area coverage by tunicates. The enzyme containing coating had only 6-12 barnacles, 10% area coverage by diatoms and no tunicates. The enzyme system had a performance similar to a copper-based commercial coating and thus appears to have potential as a non-persistent AF agent.

Lactic acid bacteria associated with a heat-processed pork product and sources of variation affecting chemical indices of spoilage and sensory characteristics.

AIMS: To evaluate the potential for developing a quality index for a Danish modified atmosphere packaged (MAP) heat-processed and naturally contaminated pork meat product stored at 5 degrees C. METHODS AND RESULTS: The composition of the predominating microflora and changes in contents of tyramine, arginine, organic acids and sensory characteristics were analysed. The microflora was predominated by Lactobacillus sakei, Leuconostoc carnosum and Carnobacterium divergens. The presence of each species varied between products and batches resulting in limited usefulness of the concentrations of these bacteria or their metabolites as indices of quality. Furthermore, the three species differed in their metabolic activities as shown by use of a model meat extract. However, when MAP storage of the processed pork product was followed by aerobic storage then acetic acid showed some potential as a chemical indicator of sensory quality. CONCLUSION: Variation in processing parameters and spoilage microbiota limited the usefulness of concentrations of micro-organisms and their metabolites as indices of spoilage for the studied processed MAP pork product. SIGNIFICANCE AND IMPACT OF THE STUDY: The present study contributes to an understanding of the difficulties experienced in developing quality indices to be used in the control of microbial spoilage of processed MAP meat products.

ZP120 causes relaxation by pre-junctional inhibition of noradrenergic neurotransmission in rat mesenteric resistance arteries.

BACKGROUND AND PURPOSE: ZP120 (Ac-RYYRWKKKKKKK-NH(2)), is a new partial nociceptin/orphanin FQ (NOP) receptor agonist with sodium-potassium sparing aquaretic effects. The mechanisms of vasodilatation of ZP120 were examined in rat mesenteric resistance arteries. EXPERIMENTAL APPROACH: Arterial segments (internal diameters 206+/-4 microm, n=224) were mounted in microvascular myographs for isometric tension recordings and electrical field stimulation (EFS). KEY RESULTS: ZP120 and the endogenous NOP receptor ligand, N/OFQ, did not relax arteries contracted with noradrenaline or adenosine-triphosphate. EFS-evoked contractions were inhibited by a purinoceptor antagonist, suramin, and the alpha(1)-adrenoceptor antagonist prazosin. N/OFQ inhibited, concentration-dependently, EFS-evoked contractions with a maximal effect of 52+/-3% (n=8) at 1 microM. The maximal effect of 1 microM ZP120 was lower (27+/-5%, P<0.05, n=9) than for N/OFQ. Endothelial removal or pretreatment with capsaicin did not influence the vasodilator effects of ZP120 and N/OFQ. ZP120 and N/OFQ responses were preserved in the presence of suramin. The alpha(2)-adrenoceptor antagonist, rauwolscine, antagonized the effect of clonidine and brimonidine, but ZP120 and N/OFQ inhibition of EFS-evoked contraction was unaltered. The competitive NOP receptor antagonist, UFP-101 (10 microM), prevented the inhibitory effect of N/OFQ, but not ZP120 suggesting that N/OFQ and ZP120 have distinct modes of interaction with the NOP receptor. CONCLUSIONS AND IMPLICATIONS: Our findings suggest that the vasodilator effect of ZP120 and N/OFQ in rat mesenteric resistance arteries is mediated by prejunctional inhibition of adrenergic neurotransmission. These properties, that promote diuresis and attenuate the cardiovascular consequences of increased sympathetic nerve activity, make ZP120 a promising drug candidate.

Design, synthesis, and time-gated cell imaging of carbon-bridged triangulenium dyes with long fluorescence lifetime and red emission.

Time-resolved fluorescence offers many advantages over normal steady-state detection and becomes increasingly important in bioimaging. However, only very few fluorophores with emission in the visible range and fluorescence lifetimes above 5 ns are available. In this work, we prepare a series of new aza/oxa-triangulenium dyes where one of the usual oxa or aza bridges is replaced by an isopropyl bridge. This leads to a significant redshift of fluorescence with only moderate reductions of quantum yields and a unique long fluorescence lifetime. The fluorescence of the isopropyl bridged diazatriangulenium derivative CDATA+ is red-shifted by 50 nm (1400 cm-1) as compared to the oxygen-bridged DAOTA+ chromophore and has intense emission in the red region (600-700 nm) with a quantum yield of 61%, and a fluorescence lifetime of 15.8 ns in apolar solution. When the CDATA+ dye is used as cell stain, high photostability and efficient time-gated cell imaging is demonstrated.

The effect of pneumococcal conjugate vaccines on incidence and microbiology associated with complicated acute otitis media.

OBJECTIVES: The objectives of this study were to investigate the incidence of complicated acute otitis media (cAOM) as well as the associated microbiology before and after introduction of the 7- and 13-valent pneumococcal conjugate vaccines (PCV-7 and -13), respectively. CAOM comprises "heavy" AOM (AOM demanding hospitalization), mastodismus (M) and acute mastoiditis (AM). METHODS: A retrospective cohort study of the incidence and microbiology associated with cAOM during the non-PCV era, the PCV-7 and 13 eras, respectively. Clinical and microbiological data were prospectively registered in a local database. The incidences of cAOM as well as the distribution of various bacterial strains in the three eras were compared. RESULTS: A total of 246 cases of cAOM (125 in the pre-vaccine period (2001-2006), 50 in the PCV-7 period (2007-2010) and 71 in the PCV-13 period (2011-2015)) were identified. The incidence of hAOM decreased by 62% in the PCV7-era but increased to almost pre-vaccine levels in the PCV-13 era. In the M + AM group, a decrease by almost 21% in the PCV7-era was found compared to the pre vaccine era, whereas the decrease was only 12% in the PCV13-era. The three most common findings in both hAOM and M + AM were Streptococcus pneumonia (SP), group A streptococcus (GAS) and "no growth". In the hAOM group, SP decreased from 38% in the pre-vaccine era to 31% in the PCV7-era and further to 16% in the PCV13-era. GAS decreased from 17% in the pre-vaccine era to 0% in the PCV7-era and 16% in the PCV13-era. The percentage of "no growth" increased from 12% to 38% and 44%, respectively. In the M + AM group, SP decreased to 10% in the PCV13-era compared with 44% in the pre-vaccine era and 41% in the PCV7-era. An increase in GAS from 15% in the pre-vaccine era and PCV7-era to 30% in the PCV13-era was observed. The "no growth" percentage increased from 13% in the pre-vaccine era to 26% in the PCV7-era and 33% in the PCV13-era. CONCLUSION: Introduction of PCV7 and PCV13 has been associated with an overall reduction of cAOM in Central Region Denmark. Pneumococci were still one of the two most common bacteria species related to cAOM though a decrease in pneumococci positive cases was observed. We found an increase in M + AM induced by GAS and a relatively large increase in "no growth", which might be caused by a more aggressive pre-hospital approach to treatment with antibiotics. Consequently, it is not evident whether the reduction of incidences is caused by the vaccines or a more aggressive antimicrobial attitude to manage AOM. The shift to GAS from SP is worrisome, and therefore continuous surveillance of the microbiology associated with AOM is warranted.

Injury patterns in children with frequent emergency department visits.

OBJECTIVES: To compare injury patterns in children with many and few emergency department (ED) visits in order to reveal the causes for the frequent visits. METHODS: Three cohorts of Danish children (total 579 721 children) were followed for three years when their ages were 0-2, 6-8, and 12-14 years. Information on all ED visits was obtained from the Danish National Patient Registry. Injury type, place of accident, injury mechanism, admission, and distance to ED were compared between children with frequent ED visits (five or more during the three years) and children with only one visit. RESULTS: Children with frequent visits had a different injury pattern with 0-46% more superficial injuries and 25-82% more dislocations, sprains, and strains. There was 20-30% fewer fractures and 12% fewer falls from a higher level. 15-51% fewer were admitted. CONCLUSIONS: Children with many ED visits had less severe injuries and more dislocations, sprains, and strains.

Educational achievements of children of parents with multiple sclerosis: A nationwide register-based cohort study.

Little is known about the impact of parental multiple sclerosis (MS) on offspring's educational attainment. The objective of the study was to examine educational achievements in offspring of parents with MS compared with matched children of parents without MS in a nationwide register-based cohort study. Children of all Danish-born residents with onset between 1950 and 1986 were identified by linking the Danish Multiple Sclerosis Registry with the Civil Registration System. Twins, children with MS, and emigrated persons were excluded. The reference cohort consisted of randomly drawn individuals from the Civil Registration System without parental MS matched 8:1 to the MS offspring by sex and year of birth. Information about education was linked to the cohorts from nationwide educational registries. We included 4177 children of MS parents and 33,416 reference persons. Children of MS parents achieved statistically significant higher average grades than the reference cohort in their final exam of basic school with a mean grade difference of 0.46 (95 % CI 0.22-0.69; p = 0.0002). We found no difference in achievement of educational level above basic school (OR 1.04; 95 % CI 0.98-1.10; p = 0.20). There was a trend toward more MS offspring attaining health-related educations (OR 1.10; 95 % CI 1.00-1.21; p = 0.06). In conclusion, children of MS parents showed a small advantage in grade point average in final examinations in basic school, and they more often tended toward health-related educations. This study revealed no negative consequences of parental MS on grades and highest educational level achieved.

Prevalence and predictors of distress in women taking part in surgical continuity of care for breast cancer: A cohort study.

PURPOSE: Women with breast cancer often experience distress. This cohort study investigated the prevalence of distress, predictors of distress, and changes in distress during surgical continuity of care for breast cancer (from diagnosis to commencement of adjuvant treatment). METHODS: The participants were 1079 women with breast cancer who were recruited between April 2013 and May 2014 from 11 breast surgery departments in Denmark. Distress was evaluated using the Distress Thermometer (DT) and predictors of distress were assessed with a self-administered questionnaire at the time of diagnosis (T1), at discharge (T2), and by the start of adjuvant treatment or follow-up (T3). Repeated measures ANOVA, simple and multiple linear regression, and mixed effects regression models were used to identify predictors and estimate changes in distress. RESULTS: At T1, 249 (24.3%) women reported no or minimal distress, 298 (29.1%) moderate distress, and 407 (39.8%) severe distress. The mean distress was 5.5 points on the DT, which decreased by 0.70 (95% confidence interval (CI) -0.80, -0.54) points from T1 to T3. Predictors of distress were time since diagnosis, age, prior or concurrent intake of antidepressants or sedative medicine, prior emotional status, children living at home, feelings regarding femininity and attractiveness, and hospital. CONCLUSIONS: More than two-thirds of women with breast cancer experienced moderate or severe distress. Mean distress decreased slightly during surgical continuity of care. However, for some women, distress remained unchanged or even worsened. These findings highlight the need to identify the individual women with distress and offer them adequate support and care.

Shift work at young age is associated with increased risk of multiple sclerosis in a Danish population.

BACKGROUND: Epidemiological studies suggest an important role for environmental factors in developing multiple sclerosis (MS). Furthermore several studies have indicated that the effect of environmental factors may be especially pronounced in adolescents. Recently only one study investigated and found that shift work at young age is associated with an increased risk of developing MS. In this study we focused on the effect of shift work in the vulnerable period between 15-19 years. OBJECTIVE: The aim of this study was to investigate the association between shift work at young age and the risk of developing MS. METHODS: We performed a large case-control study including 1723 patients diagnosed with MS and 4067 controls. MS patients were recruited from the Danish Multiple Sclerosis Biobank and controls from The Danish Blood Donor Study. Information on working patterns and lifestyle factors was obtained using a comprehensive lifestyle-environmental factor questionnaire with participants enrolled between 2009 and 2014. Logistic regression models were used to investigate the association between shift work at age 15-19 years and the subsequent risk of MS and were controlled for effects due to established MS risk factors. RESULTS: We found a statistically significant association when total numbers of night shifts were compared with non-shift workers. For every additional 100 night shifts the odds ratio (OR) for MS was 1.20 (95% confidence interval (CI), 1.08-1.34, p=0.001). Increasing intensity of shift work also increased MS risk. For every additional night per month the OR was 1.04 (95% CI, 1.01-1.06, p=0.002). Duration of shift work in years was not associated with risk of MS. CONCLUSION: This study supports a statistically significant association between shift work at age 15-19 years and MS risk.

The experience of distress in relation to surgical treatment and care for breast cancer: An interview study.

PURPOSE: A diagnosis of breast cancer is a key turning point in a woman's life that may lead to her experiencing severe and persistent distress and potentially presaging a psychiatric disorder, such as major depression. In Denmark an increased standardization of care and a short hospital stay policy minimize the time of medical and nursing surveillance. Consequently, there is the potential risk that distress goes unnoticed, and therefore, untreated. Therefore, the purpose of this study was to explore the experience of distress in Danish women taking part in surgical continuity of care for breast cancer. METHODS AND SAMPLE: A phenomenological-hermeneutic approach inspired by the French philosopher Paul Ricoeur was conducted to explore the experience of distress in relation to surgical treatment and care for breast cancer. Semi-structured interviews were conducted with 12 women who recently had surgery for breast cancer at six departments of breast surgery in Denmark from May 2013 to November 2013. KEY RESULTS: The understanding of the experience of distress in the period of surgical continuity of care for breast cancer is augmented and improved through a discussion related to four identified themes: A time of anxiety, loss of identities, being treated as a person and being part of a system, drawing on theory and other research findings. CONCLUSION: Distress experienced by women in the period following diagnosis arises from multiple sources. Support and care must be based on the woman's individual experience of distress.

Development of a questionnaire encompassing indicators of distress: a tool for use with women in surgical continuity of care for breast cancer.

PURPOSE: Women with breast cancer often experience significant distress. Currently, there are no questionnaires aimed at identifying women's unique and possible changing indicators for distress in surgical continuity of care for breast cancer. We developed and tested three questionnaires specifically for this use. METHODS AND SAMPLE: We first searched PubMed, CINAHL and PsycINFO to retrieve information on previously described indicators. Next, we conducted a focus group interview with 6 specialised nurses, who have extensive experience about consequences of breast cancer for women in surgical continuity of care. The questionnaire was tested on 18 women scheduled for breast cancer surgery. Subsequently, the women were debriefed to gain knowledge about comprehensibility, readability and relevance of items, and the time needed to complete the questionnaire. After adjustment, the questionnaires were field-tested concomitantly with a clinical study, which both consisted of a survey and an interview study. KEY RESULTS: Three multi-item questionnaires were developed specific to different time points in surgical continuity of care. The questionnaires share a core of statements divided into seven sub-scales: emotional and physical situation, social condition, sexuality, body image, religion and organisational factors. Besides the core of statements, each questionnaire has different statements depending on the time point of surgical continuity of care when it was to be responded to. CONCLUSION: The questionnaires contain comprehensive items that can identify indicators for distress in individual women taking part in surgical continuity of care. The items were understandable and the time used for filling in the questionnaires was reasonable.

Interpersonal conflict during adolescence.

Interpersonal conflict is considered within various frameworks of adolescent development. Conflict, defined as behavioral opposition, is distinguished from related constructs. Differences between adolescent relationships and across age groups are reviewed in the incidence and intensity, resolution, and outcome of conflict. Influences of setting on conflict behaviors and effects are emphasized. The evidence does not reveal dramatic shifts in conflict behavior as a function of age or maturation. Consistent differences do emerge, however, when adolescent relationships and conflict settings are considered. It is argued that a social relational model based on principles of interdependence and equity provides an alternative to psychoanalytic, sociobiological, and cognitive-developmental accounts of conflict behavior during adolescence.

Physical violence, self rated health, and morbidity: is gender significant for victimisation?

STUDY OBJECTIVE: To analyse gender differences in associations between physical violence and self rated health and self reported morbidity among a random sample of adults in Denmark. DESIGN AND SETTING: Two questions on self rated health and self reported morbidity respectively, were obtained from a cross sectional national health interview survey conducted among 12 028 adults (16 years +) in Denmark in 2000. A question on six different forms of physical violence was obtained from a supplementary self administered questionnaire given to the same sample. The reporting period for experienced physical violence was the past 12 months and for morbidity symptoms, the past 14 days. MAIN RESULTS: Men aged 16-24 years were significantly more likely to have experienced violence than women (OR = 3.2, 95% CI = 2.3 to 4.2). Female victims of physical violence were significantly more likely to rate their health as poor (OR = 2.02, 95% CI = 1.41 to 2.89) and to report anxiety (OR = 2.14, 95% CI = 1.35 to 3.37), depression (OR = 2.36, 95% CI = 1.55 to 3.60), and stomach ache (OR = 1.58, 95% CI = 1.01 to 2.47) than female non-victims. Male victims of physical violence were only significantly more likely to report stomach ache (OR = 1.73, 95% CI = 1.03 to 2.89) than male non-victims. CONCLUSIONS: Associations between physical violence and poor self rated health and self reported morbidity were found to be significant for women, but not for men. It is probable that gender differences in experiences of violence, as well as gender differences in health related self perception, contribute to a gender specific process of victimisation. Improved knowledge about the relation between gender specific violence and victimisation as a gender specific consequence is essential for targeting violence prevention.

A model predicting individual shoulder muscle forces based on relationship between electromyographic and 3D external forces in static position.

To study the potentiality for developing an EMG-based model for the human shoulder, mapping of relations between static hand forces and electromyographic (EMG) activity of 13 shoulder muscles, were performed. The procedure was to perform by the hands slowly varying isometric forces up to 20% maximum voluntary force in the three-dimensional space. By combining these data with literature values on muscle physiological cross-sectional area and moment arm data, an EMG-based model was developed for estimating muscle forces in the glenohumeral joint. The model was validated for one standardized position by comparing joint moment, calculated from EMG by using the model, with moments from the external force. The highest correlation between these moments was found assuming a linear EMG/force calibration at low force level (< 20% MVC), giving correlations from 0.65 to 0.95 for the abduction/adduction moment and from 0.70 to 0.93 for the flexion/extension moment, for the six subjects. Moments calculated from EMG were for most subjects somewhat lower than the moments from the external force; the mean residual error ranged from 1.6 to 9.9 Nm. Taking this into account, the results can be used for assessment of muscle forces based on recordings of external forces at the hands during submaximal static work tasks without substantially elevated arms.

Biomechanical model predicting electromyographic activity in three shoulder muscles from 3D kinematics and external forces during cleaning work.

BACKGROUND: The shoulder region is a common site of work-related musculoskeletal disorders. Biomechanical models may reveal the relative importance of force, joint-moments, and angular velocity for predicting muscle activity, thereby contributing to identify risk factors. OBJECTIVE: The aim of the present study was to predict muscle activity patterns from joint kinetics during cleaning work and to identify the most important variables requesting muscle activity.Design. A comparative study of six cleaners performing five different floor cleaning tasks (combinations of tool and working method) in a laboratory setting. METHODS: Net forces and moments at the glenohumeral joint were estimated using a video-based 3D link segment model together with 3D force-transducers at each hand, separately. Angular velocities of the upper arm were calculated, and electromyographic activity was recorded bilaterally from the muscles trapezius, deltoideus, and infraspinatus. RESULTS: The biomechanical model revealed abduction moment in the glenohumeral joint to be the most important factor for development of muscle activity in m. deltoideus and m. infraspinatus, while for m. trapezius vertical force was most important. CONCLUSION: Muscle specific determinants for shoulder muscle activity could be identified from glenohumeral joint kinetics. RELEVANCE: This study documents that mechanical work requirements in terms of joint forces, moments of force and angular velocities can predict major fractions of muscle activity patterns in the upper extremities. The biomechanical model used for this prediction revealed different factors of importance for individual muscles. This knowledge is fundamental for work place interventions aiming at minimizing overloading of specific muscles to prevent or rehabilitate muscle disorders.

Shoulder muscle activity in young and older people during a computer mouse task.

OBJECTIVE: Assessment of the age effect in relation to computer work. BACKGROUND: Increasingly, more older people are using computers, while hardware and software are not designed with special consideration of their needs. METHODS: Eight young and nine older females performed different computer mouse tasks. Shoulder muscle activity was recorded from the right deltoid muscle, right and left upper trapezius muscle, and the neck extensor muscles. RESULTS: Mean trapezius muscle activity was significantly higher in the older people (2.8%/3.7% EMG(max) for R/L) compared to the young (1.1%/1.2% EMG(max)). There was a tendency to a higher activity in the older people for the deltoid muscle and the neck extensor muscles. There were small differences in shoulder muscle activation levels between mouse actions, target directions, and between precision demands. CONCLUSIONS: Shoulder muscle activity during computer work is affected by age, but only to a minor extent by the type of computer mouse task. The deltoid and the trapezius muscle activities are low during computer mouse use when there is efficient forearm support by the table. RelevanceAn increasing number of people use computers for hours every day. Intensive use of computers increases the risk of development of work-related musculoskeletal symptoms in the shoulder region.