Recently went to check items in misconfig /startup and noticed duplicate entries for

Em-exec (mouse software) and Mad-exe (Dell Resolution Assistant). How do I 1) remove these duplicate entries? 2) How do I know which one is safe to remove ?(I previously had these items not load at startup so they were unchecked and the duplicate entries now have a check to load at start up) 3) Are there any concerns regarding system registry which I should be aware of? 4)How did the duplicate entries get there?

Thanks in advance for any advice.