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Interestingly, this study featured a majority of patients with Fitzpatrick skin type IV and above, which could have partially accounted for the high incidence of longitudinal melanonychia

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This pattern holds biological significance in PD in that it suggests that disease- or treatment-related effects may exert selective pressure on the microbial network in the gut without necessarily lowering the overall number of microbial species present, thereby exerting an influence on GBA signaling and L-DOPA metabolism

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