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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Androgenetic Alopecia &#40;AGA&#41; is a common condition characterized by progressive hair loss and decreased hair density&#44; impacting hair color&#44; diameter&#44; and length&#46; It is a polygenic condition that affects a significant proportion of the population&#44; with up to 80&#37; of men and 50&#37; of women experiencing it at some point in life&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In men&#44; the pattern of hair loss typically involves recession in the temporal regions and thinning at the vertex&#44; resulting in a characteristic horseshoe-shaped hair pattern&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a> In contrast&#44; women tend to experience hair loss in the mid-frontal area&#44; with a delayed onset and less overall density loss&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Hair significance and its impact on individuals&#39; lives shouldn&#8217;t be underestimated&#46; Hair is one of the first characteristics the authors notice in others&#44; and studies have shown that hair loss can impact an individual&#39;s social life and overall lifestyle&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;8</span></a> The condition of our hair plays a crucial role in our self-perception and attractiveness&#44; influencing our social interactions and opportunities&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Therefore&#44; understanding hair loss and its treatment options is essential in improving quality of life&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Platelet-Rich Plasma &#40;PRP&#41; is a concentrated form of plasma obtained from a patient&#39;s own blood&#44; containing higher levels of platelets compared to baseline levels&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> Various techniques for preparing PRP exist&#44; although a consensus has yet to be reached&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> PRP has been utilized for many years in regenerative medicine&#44; particularly in osteoarthritic injury treatment and rotator cuff damage&#46; Recently&#44; its use has expanded&#44; PRP is now world widely performed by dermatologists for several indications&#44; such as skin rejuvenation&#44; and AGA treatment&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#8211;15</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">PRP action on the scalp is related to the growth factors present in the concentrated platelets&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> For example&#44; the Vascular Endothelial Growth Factor &#40;VEGF&#41; stimulates the dermal papilla cells through the VEGFR-2&#47;ERK pathway&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> Insulin-like Growth Factor 1 &#40;IGF-1&#41; and Fibroblast Growth Factor &#40;FGF&#41; promote the anagen phase of hair follicles and inhibit the transition to the catagen phase&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#8211;20</span></a> Additionally&#44; Epidermal Growth Factor &#40;EGF&#41; induces the proliferation of dermal papilla cells via the Notch signaling pathway and has been shown to promote hair growth in experimental studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21&#44;22</span></a> Platelet-Derived Growth Factor &#40;PDGF&#41; also induces and maintains hair follicles in the anagen phase in animal models&#46;<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">23&#44;24</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Systematic reviews suggest that PRP increases mean hair density in male and female pattern hair loss and on alopecia areata&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">25&#44;26</span></a> Although some were exclusively on clinical trials&#44; evidence quality is persistently low&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">27&#8211;29</span></a> Non-randomized clinical trials are indeed inferior to randomized clinical trials&#46; As such&#44; they are considered high-tiered evidence quality suppliers&#44; and&#44; if assessed separately&#44; may provide better insights on existent evidence quality&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Despite the increase in research and use of PRP for androgenetic alopecia&#44; there is currently no consensus based on substantial evidence from randomized clinical trials&#46; Accordingly&#44; this study&#8217;s objective is to evaluate the existing evidence regarding the application of PRP injections to increase hair density in patients with AGA&#44; specifically through a review of randomized clinical trials&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Study design</span><p id="par0040" class="elsevierStylePara elsevierViewall">This study employed a systematic review and meta-analysis methodology&#44; adhering to the guidelines outlined in the PRISMA &#40;Preferred Reporting Items for Systematic Reviews and Meta-Analyses&#41; checklist&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Eligibility criteria</span><p id="par0045" class="elsevierStylePara elsevierViewall">The research question was created using the PICO format&#58; among patients with androgenetic alopecia&#44; does autologous platelet-rich plasma&#44; compared to a placebo&#44; result in hair density increase in randomized clinical trials&#63;</p><p id="par0050" class="elsevierStylePara elsevierViewall">To be included in the analysis&#44; studies needed to meet the following eligibility criteria&#46; Firstly&#44; only full-length original articles reporting on randomized clinical trials were considered&#46; The intervention of interest was the administration of Platelet-Rich Plasma &#40;PRP&#41; injections&#46; PRP can either be activated or non-activated&#46; The use of PRP in combination with the platelet activator&#47;agonist allows for the release of multiple growth factors and differentiation factors upon platelet activation&#44; which can enhance the process&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> Activation can be done by adding a platelet activator&#47;agonist as topical bovine thrombin or 10&#37; calcium chloride to the PRP solution right before injection&#46; The control group consisted of individuals who received a placebo&#46; This is to control PRP efficacy&#46; Comparison with other standard therapies&#44; such as minoxidil or 5-alpha-reductase inhibitors&#44; could contaminate data and provide non-representative results&#46; If PRP doesn&#8217;t show benefit compared to placebo&#44; there is no point in comparing it to other therapies&#46; Our main outcome of interest was changes&#44; either positive or negative&#44; in hair density&#46; It refers to changes in the number of hairs per unit area &#40;cm<span class="elsevierStyleSup">2</span>&#41; on the skin surface&#46; Changes in hair diameter were secondary outcomes&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The target population comprised patients aged between 15 and 63 years diagnosed with AGA&#44; as is the most likely population to be affected by androgenetic alopecia&#44; who would potentially search for and benefit from PRP interventions&#46; Secondly&#44; women and men can be included&#44; as androgenetic alopecia can affect both genders&#46; While it&#8217;s more prevalent in men&#44; women can also experience this condition&#46; Characterization by the Norwood I&#8210;VII and Ludwig I&#8210;III classifications&#46; Some studies use inter-patient and others use intra-patient comparison&#59; in this review&#44; both could be included&#46; Studies with a sample size of fewer than ten patients&#44; those lacking information on the PRP processing method&#44; or studies that subjectively assessed increased hair density were excluded&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Furthermore&#44; patients with chronic diseases&#44; individuals on anticoagulant therapy&#44; pregnant women&#44; those with malignancies&#44; and those utilizing complementary therapies were also excluded&#46; Additionally&#44; studies focusing on other types of alopecia&#44; such as alopecia areata&#44; cicatricial alopecia&#44; or lichen planus&#44; were not considered&#46; There were no limitations regarding the PRP processing method&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Data sources</span><p id="par0065" class="elsevierStylePara elsevierViewall">The authors conducted a comprehensive search until April 1&#44; 2023&#44; in seven databases&#46; These databases included MEDLINE &#40;through PubMed&#41;&#44; Virtual Health Library &#40;BVS&#41;&#44; EMBASE&#44; Cochrane Library&#44; Web of Science&#44; Scopus&#44; and MedRxiv &#40;a source of grey literature&#44; encompassing pre-print studies&#41;&#46; The selection of these databases aimed to capture a wide range of relevant studies for inclusion in the review and meta-analysis&#46; References from studies cited in this review writing process were also screened and eligible for inclusion&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Search strategy</span><p id="par0070" class="elsevierStylePara elsevierViewall">For the search in electronic databases&#44; relevant Medical Subject Headings &#40;MeSH&#41; terms and keywords were utilized&#46; These terms were adapted based on the specific database&#46; The following terms were employed to ensure a comprehensive search&#58; &#8220;Hair regrowth&#8221;&#44; &#8220;Hair restoration&#8221;&#44; &#8220;Hair regeneration&#8221;&#44; &#8220;Hair Growth&#8221;&#44; &#8220;Alopecia&#8221;&#44; &#8220;Baldness&#8221;&#44; &#8220;Hair Loss&#8221;&#44; &#8220;Hair Losses&#8221;&#44; &#8220;Loss&#44; Hair&#8221;&#44; &#8220;Losses&#44; Hair&#8221;&#44; &#8220;Alopecia&#44; Male Pattern&#8221;&#44; &#8220;Male Pattern Alopecia&#8221;&#44; &#8220;Baldness&#44; Male Pattern&#8221;&#44; &#8220;Male Pattern Baldness&#8221;&#44; &#8220;Female Pattern Baldness&#8221;&#44; &#8220;Baldness&#44; Female Pattern&#8221;&#44; &#8220;Androgenetic Alopecia&#8221;&#44; &#8220;Pattern Baldness&#8221;&#44; &#8220;Baldness&#8221;&#44; &#8220;Pattern&#8221;&#44; &#8220;Androgenic Alopecia&#8221;&#44; &#8220;Alopecia&#44; Androgenic&#8221;&#44; &#8220;Alopecias&#44; Androgenic&#8221;&#44; &#8220;Pseudopelade&#8221;&#44; &#8220;Alopecia Cicatrisata&#8221;&#44; &#8220;Alopecia Cicatrisatas&#8221;&#44; &#8220;Platelet-Rich Plasma&#8221;&#44; &#8220;Plasma&#44; Platelet-Rich&#8221;&#44; &#8220;PRP&#8221;&#44; &#8220;thrombocyte rich plasma&#8221;&#44; and &#8220;Randomized Clinical Trial &#40;Publication Type&#41;&#8221;&#46; To improve the sensitivity for identifying randomized clinical trials&#44; recommendations from McGill University were followed&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a> Specific search strategies for each database utilized in this study can be found in the supplementary file&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study selection</span><p id="par0075" class="elsevierStylePara elsevierViewall">Two independent reviewers conducted the assessment of titles and abstracts for all identified clinical trial reports&#46; Blinding was ensured&#44; with each reviewer unaware of the decisions made by the other&#46; When possible&#44; studies that met the inclusion criteria were selected for further evaluation&#46; In cases of disagreement between reviewers&#44; a third reviewer was involved to make the final decision regarding study inclusion or exclusion&#46; The Rayyan software was utilized to facilitate the selection process&#44; particularly for reading and screening titles and abstracts&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Data extraction</span><p id="par0080" class="elsevierStylePara elsevierViewall">Each reviewer independently performed data extraction without access to the other reviewer&#39;s extraction&#46; The following data were extracted from the selected studies&#58; author&#44; year&#44; location&#44; comparator&#44; study design&#44; sample size&#44; follow-up time&#44; method of PRP preparation&#44; capillary density and diameter measurements&#44; and funding sources&#46; A predefined Excel spreadsheet was used to record the extracted data for each reviewer&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Assessment of methodological quality of selected articles for systematic review</span><p id="par0085" class="elsevierStylePara elsevierViewall">Risk of bias assessment was conducted using the RoB-2 tool provided by Cochrane&#46; This tool assesses possible biases in five domains&#44; including randomization&#44; intended intervention&#44; missing data&#44; outcome measurement&#44; and outcome reporting&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a> The GRADE method was employed to assess the strength of the recommendation for the intervention&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">33</span></a></p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Data analysis</span><p id="par0090" class="elsevierStylePara elsevierViewall">Included studies were grouped based on the characteristics provided in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; The extracted data were qualitatively synthesized and recorded in a dedicated spreadsheet&#46; For studies that provided the mean and standard deviation of the outcomes of interest&#44; a random-effects meta-analysis was conducted using the restricted maximum likelihood method&#46; When these data were absent&#44; authors were contacted&#46; When authors didn&#8217;t answer&#44; if provided sufficient data for estimating the mean and standard deviation&#44; the study would be included in the meta-analysis&#46; The effect size and 95&#37; Confidence Intervals &#40;95&#37; CI&#41; were measured by the mean difference&#46; Statistical heterogeneity was assessed using the I&#178; statistic&#44; with values below 25&#37; considered low&#44; between 25&#37; and 50&#37; considered moderate&#44; and above 50&#37; considered high&#46; Subgroup analysis and meta-regression were performed based on the use of a pre-application activator&#44; sex&#44; study design&#44; risk of bias and spin method following the aforementioned meta-analytic model&#46; Statistical package STATA&#174; version 16 was used for data analysis&#46; Funnel plots followed by Egger&#8217;s test were done to assess asymmetry and publication bias&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Data estimation</span><p id="par0095" class="elsevierStylePara elsevierViewall">Gressenberger P&#58;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a> The Interquartile Range &#40;IQR&#41; was calculated from the reported range as Range&#47;4&#46; This IQR value was then used to estimate the standard deviation according to the empirical rule relationship of IQR&#47;1&#46;349&#46; The median was used as an initial point estimate for the mean&#46; From these estimates&#44; the variance was determined as the square of the standard deviation&#46; Finally&#44; a 95&#37; CI was placed around the estimated mean using a <span class="elsevierStyleItalic">t</span>-distribution&#44; with degrees of freedom based on the sample size&#46; This process allows approximate quantification of the mean and variation based on limited summary statistics when the full dataset is not available for direct calculation&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Chuah SY&#58;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">35</span></a> Hair density values at 6 months were calculated by taking the baseline values and adding or subtracting reported difference values&#46; Standard deviations were also adjusted to account for variability in the different groups&#46; Specifically&#44; the baseline means&#44; and standard deviation were used as a starting point&#46; Then&#44; the difference in means was either added or subtracted based on whether the difference was positive or negative&#46; The difference standard deviation was also added or subtracted to the baseline standard deviation&#46; This allowed the full range of values to be determined while incorporating the variability represented by the CI&#46; Standard Deviation &#40;SD&#41; was calculated by&#58; SD &#61; &#8730;&#40;Baseline SD&#160;&#43;&#160;Difference SD&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Dubin DP&#58;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">36</span></a> The baseline range was used to estimate the standard deviation for each group according to the formula of range&#47;4 &#42; &#40;sample size&#47;&#40;sample size - 1&#41;&#41;&#46; The mean difference from the baseline was then added to the original baseline mean to calculate the estimated post-treatment mean&#46; The baseline standard deviation was assumed to apply after treatment&#46; Finally&#44; a 95&#37; CI was placed around each estimated post-treatment mean using the <span class="elsevierStyleItalic">t</span>-distribution&#44; with degrees of freedom based on the sample size and estimated standard deviation&#46; This process allowed the estimation of key metrics after the intervention based solely on summary baseline data and mean treatment differences reported for each experimental condition&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Rodrigues BL&#58;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a> The authors extracted data from <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> with WebPlotDigitizer &#40;Ankit Rohatgi&#44; version 4&#46;6&#44; 2022&#41;&#46; Then&#44; the mean and standard deviation were calculated based on Luo et al&#46; and Shi et al&#46; works to estimate mean and standard deviation from the sample size&#44; minimum value&#44; first interquartile&#44; median&#44; third interquartile&#44; and maximum&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">38&#44;39</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">The authors couldn&#8217;t estimate or retrieve data from Siah TW et al&#46;&#44; therefore this report has only been included in qualitative synthesis&#44; without participation in the meta-analysis model&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">40</span></a></p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Research protocol</span><p id="par0120" class="elsevierStylePara elsevierViewall">The research protocol was registered at PROSPERO &#40;International Prospective Register of Systematic Reviews&#41; under the registration number CRD42023407334&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Results</span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Selected studies</span><p id="par0125" class="elsevierStylePara elsevierViewall">Following a comprehensive database search&#44; 545 records were identified&#46; Among them&#44; the authors removed 227 duplicates&#44; leaving 318 papers for full-text screening&#46; After careful reference screening&#44; 10 registers were also added&#46; Of these&#44; 26 papers were potentially eligible for inclusion&#46; All reports were retrieved&#46; Ultimately&#44; 14 of them were included in the qualitative synthesis&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">34&#8211;37&#44;40&#8211;49</span></a> Among the included studies&#44; 13 provided sufficient data for quantitative synthesis through meta-analysis&#46; It&#8217;s important to note that some studies had mean and standard deviation estimated as explained in the methods section&#46; Supplementary Material contains the excluded reports list&#46; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> presents the PRISMA flow diagram&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">The review included 431 participants&#44; with 319 subjects undergoing PRP intervention and 310 individuals receiving a placebo&#46; Intra-subject participants were considered in both groups&#46; Most randomized clinical trials were conducted after 2019 and utilized inter-subject comparisons&#46; Half used pre-application activators&#46; Studies included patients with all degrees of alopecia&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> summarizes the included studies&#39; characteristics&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">The majority of the studies used the trichoscan device and patient photos to aid in the analysis and measurement of capillary density as an outcome&#46; Regarding PRP application&#44; most studies administered monthly injections at a rate of 0&#46;1&#8210;0&#46;2&#160;mL&#47;cm<span class="elsevierStyleSup">2</span>&#44; although Tawfik AA et al&#46; achieved better results with weekly injections&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">41</span></a> The method of obtaining and applying PPR is presented for each study in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0140" class="elsevierStylePara elsevierViewall">Most of the included studies demonstrated a low risk of bias&#46; However&#44; Siah TW et al&#46; exhibited a high risk of bias due to the lack of explanation regarding the randomization process&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">40</span></a> Similarly&#44; Rodrigues BL et al&#46; presented some risks in domains 1 and 4 related to randomization and outcome measurement&#44; respectively&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a> Qu Q&#44; Chuah SY&#44; and Toama MA also presented some concerns related to randomization&#44; as no information from concealment was provided&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">35&#44;48&#44;49</span></a><a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> demonstrates all results from RoB-2 risk of bias&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Hair density</span><p id="par0145" class="elsevierStylePara elsevierViewall">Among the fourteen studies included in the synthesis&#44; thirteen demonstrated improved hair density compared to the pretreatment baseline&#46; However&#44; Gressenberger P et al&#46; reported worsening hair conditions without a significant difference between the groups&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a> Around 57&#37; of the studies showed a statistically significant difference in hair density between treated and placebo groups&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">The meta-analysis showed a mean difference of 27&#46;55 hairs&#47;cm<span class="elsevierStyleSup">2</span> between the groups&#44; with 95&#37; CI ranging from 14&#46;04&#8211;41&#46;06&#46; The forest plot is presented in <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0155" class="elsevierStylePara elsevierViewall">The I<span class="elsevierStyleSup">2</span> statistic indicated high heterogeneity among the studies&#44; with a value of 95&#46;99&#37; and Q&#40;12&#41;&#160;&#61;&#160;279&#46;84&#46; This result was statistically significant &#40;p&#160;&#60;&#160;0&#46;00&#41;&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">In subgroup analysis&#44; reports that used active PRP demonstrated a slightly lower mean difference of 25&#46;25 hairs&#47;cm<span class="elsevierStyleSup">2</span>&#44; with 95&#37; CI ranging from 4&#46;89 to 45&#46;61&#44; I&#178; of 96&#46;78&#37;&#44; p&#160;&#60;&#160;0&#46;05&#44; and Q&#40;6&#41;&#160;&#61;&#160;225&#46;89&#46; At the same time&#44; studies using inactive PRP showed a similar mean difference of 29&#46;79 hairs&#47;cm<span class="elsevierStyleSup">2</span>&#44; with a 95&#37; CI ranging from 11&#46;16 to 48&#46;41&#44; I<span class="elsevierStyleSup">2</span> of 85&#46;98&#37;&#44; p&#160;&#60;&#160;0&#46;05&#44; and Q&#40;5&#41;&#160;&#61;&#160;35&#46;55&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Subgroup analysis of PRP preparation related to the spin method was also conducted&#46; Both single and double-spin preparations were effective in increasing hair density &#40;p&#160;&#60;&#160;0&#46;05&#41;&#46; Subgroup analysis was also performed considering study design&#44; inter or intra-subject&#46; Inter-subject comparisons presented a mean difference of 33&#46;72 hairs&#47;cm<span class="elsevierStyleSup">2</span>&#44; I<span class="elsevierStyleSup">2</span>&#160;&#61;&#160;78&#46;19&#44; 95&#37; CI from 14&#46;04 to 49&#46;68 &#40;p&#160;&#60;&#160;0&#46;05&#41;&#44; and Q&#40;7&#41;&#160;&#61;&#160;44&#46;20&#46; Intra-subject presented worse results&#44; with a mean difference of 19&#46;20 hairs&#47;cm<span class="elsevierStyleSup">2</span>&#44; I<span class="elsevierStyleSup">2</span>&#160;&#61;&#160;98&#46;46&#37;&#44; 95&#37; CI from &#8722;4&#46;02 to 42&#46;43 &#40;p&#160;&#61;&#160;0&#46;10&#41;&#44; and Q&#40;4&#41;&#160;&#61;&#160;209&#46;61&#46; The last subgroup was gender-related studies&#46; Only two studies with only females presented sufficient data for meta-analysis&#44; which limits data pooling&#46; Male-only studies had a mean difference of 39&#46;12&#44; I&#178;&#160;&#61;&#160;53&#46;65&#37;&#44; 95&#37; CI from 24&#46;94 to 53&#46;30 &#40;p&#160;&#61;&#160;0&#46;06&#41;&#44; and Q&#40;5&#41;&#160;&#61;&#160;10&#46;64&#46; Mixed studies had a mean difference of 7&#46;39&#44; I<span class="elsevierStyleSup">2</span>&#160;&#61;&#160;73&#46;01&#37;&#44; 95&#37; CI from 1&#46;57 to 13&#46;22 &#40;p&#160;&#60;&#160;0&#46;05&#41;&#44; and Q&#40;4&#41;&#160;&#61;&#160;18&#46;96&#46; High risk of bias presented mean hair density increase&#160;&#61;&#160;7&#46;34 n&#47;cm<span class="elsevierStyleSup">2</span>&#44; I<span class="elsevierStyleSup">2</span>&#160;&#61;&#160;79&#46;77&#37;&#44; 95&#37; CI from 0&#46;96 to 13&#46;73&#44; and Q&#40;3&#41;&#160;&#61;&#160;18&#46;87&#46; Low risk of bias mean increase was 39&#46;98&#44; I<span class="elsevierStyleSup">2</span>&#160;&#61;&#160;77&#46;49&#37;&#44; 95&#37; CI from 25&#46;09 to 54&#46;87&#44; and Q&#40;8&#41;&#160;&#61;&#160;41&#46;08&#46; Both p&#160;&#60;&#160;0&#46;00&#46; Subgroup-exclusive Forest plots are available in the Supplementary Material&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Hair diameter</span><p id="par0170" class="elsevierStylePara elsevierViewall">Five studies provided sufficient data for the meta-analysis&#46; <a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a> presents the forest plot&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0175" class="elsevierStylePara elsevierViewall">Results revealed a mean difference of 2&#46;02&#160;&#956;m between treated and placebo groups&#44; with 95&#37; CI ranging from &#8722;0&#46;85&#160;&#956;m to 4&#46;88&#160;&#956;m&#44; and I<span class="elsevierStyleSup">2</span>&#160;&#61;&#160;77&#46;11&#37; &#40;p&#160;&#61;&#160;0&#46;02&#41;&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Asymmetry and publication bias</span><p id="par0180" class="elsevierStylePara elsevierViewall">Hair diameter couldn&#8217;t have publication bias assessed&#44; as there were only 5 studies&#44; and the Cochrane Handbook suggests a minimum of 10 studies&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">50</span></a> The funnel plot generated after hair density meta-analysis is available in <a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#46; Following&#44; the authors conducted Egger&#8217;s test&#44; beta1&#160;&#61;&#160;0&#46;83&#44; SE of beta1&#160;&#61;&#160;0&#46;816&#44; <span class="elsevierStyleItalic">z</span>&#160;&#61;&#160;1&#46;01&#44; Prob &#62;&#124;<span class="elsevierStyleItalic">z</span>&#124;&#160;&#61;&#160;0&#46;3115&#46;</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0185" class="elsevierStylePara elsevierViewall">Based on these results&#44; the coefficient beta1 is not statistically significant at the 5&#37; level since the p-value is greater than 0&#46;05&#46; The standard error of beta1 is also quite high relative to the coefficient value&#46; Although Egger&#8217;s test didn&#8217;t identify publication bias&#44; funnel plot asymmetry results indicate a clear presence of publication bias&#46; Supplementary Material presents specific subgroups funnel plots&#46;</p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">GradePro assessment</span><p id="par0190" class="elsevierStylePara elsevierViewall">The GRADEPro GDT analysis rated the evidence for PRP on hair density as low-quality evidence &#40;&#43;&#43;&#41;&#46; This rating was based on a low overall risk of bias&#44; high heterogeneity&#44; direct outcomes&#44; publication bias&#44; and high precision in the results&#46; As for hair diameter&#44; it was assigned a very low-quality evidence rating &#40;&#43;&#43;&#41;&#46; This rating was based on several factors&#44; including a severe overall risk of bias&#44; high heterogeneity&#44; serious inconsistency&#44; lack of direct outcomes&#44; and imprecision in the results&#46; Assessment can be seen in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Meta-regression</span><p id="par0195" class="elsevierStylePara elsevierViewall">Results from meta-regression can be found in <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0200" class="elsevierStylePara elsevierViewall">R-squared measures the proportion of total variation in the outcome variable that is explained by the predictors in the model&#46; In this case&#44; the value of 0&#46;00&#37; suggests that the predictors included in the model explain very little of the total variation&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">The Wald Chi-Square test is used to assess the overall significance of the meta-regression model&#46; In this case&#44; the Chi-Square statistic is 2&#46;68&#44; and the p-value is 0&#46;6134&#46; Since the p-value is greater than the typical significance level of 0&#46;05&#44; the authors fail to reject the null hypothesis&#44; indicating that the overall model is not statistically significant&#46;</p></span></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Discussion</span><p id="par0210" class="elsevierStylePara elsevierViewall">Despite high heterogeneity&#44; which limits data pooling by meta-analysis&#44; the findings of this study indicate that PRP therapy can significantly increase hair density compared to placebo&#46; Evidence gathered from the included studies is of low quality&#44; and reports were conducted in various locations&#44; enhancing the external validity of the findings&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">One important aspect to highlight is the safety profile of PRP therapy&#46; No intolerable or high-risk adverse effects were reported in the patients included in this research&#46; The most common adverse effect observed was short-duration local pain&#44; which is consistent with previous studies&#46; Roohaninasab M et al&#46;&#44; in a review assessing the efficacy&#44; safety&#44; and adverse effects of PRP therapy&#44; also reported high efficacy and low risks associated with the intervention&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">51</span></a></p><p id="par0220" class="elsevierStylePara elsevierViewall">These findings are encouraging as they suggest that PRP therapy for AGA is not only effective but also safe&#46; However&#44; it is essential to note that the absence of reported adverse effects in the included studies does not guarantee the absence of potential risks&#46;</p><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Platelet-rich plasma mechanism</span><p id="par0225" class="elsevierStylePara elsevierViewall">The action of PRP in treating AGA is primarily attributed to the growth factors and cytokines present in the platelet concentrate&#46; These bioactive substances play a crucial role in stimulating anti-inflammatory&#44; angiogenic&#44; and proliferative pathways&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">52</span></a> The key factors associated with hair growth include Vascular Endothelial Growth Factor &#40;VEGF&#41;&#44; which is upregulated during the anagen phase and plays a role in determining the follicular size and inducing perifollicular angiogenesis&#59; Glial Cell Line-Derived Neurotrophic Factor &#40;GDNF&#41;&#44; which suppresses the transition to the catagen phase and exhibits a decline in expression over time during the anagen phase&#59; Insulin-like Growth Factor 1 &#40;IGF-1&#41;&#44; which synergistically works with GDNF to promote the proliferation of basal Ki67&#43; keratinocytes and prolong the anagen phase&#59; and Fibroblast Growth Factor 2 &#40;FGF-2&#41;&#44; which promotes dermal papilla proliferation and can be enhanced by adenosine application or in conjunction with nanoparticles&#46;<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">53&#8211;58</span></a></p><p id="par0230" class="elsevierStylePara elsevierViewall">Considering the importance of these factors&#44; pre-application regulation of them can be crucial in achieving optimal results&#46; Two studies included in this review examined the role of growth factors in hair regrowth&#46; Siah TW et al&#46; demonstrated a significant association between GDNF and hair density&#46; Additionally&#44; they observed a tendency towards a correlation between VEGF and FGF-2&#44; although this finding may have been limited by the sample size&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">40</span></a> Rodrigues BL et al&#46;&#44; although not establishing an explicit correlation between Epidermal Growth Factor &#40;EGF&#41;&#44; Platelet-Derived Growth Factor &#40;PDGF&#41;&#44; VEGF&#44; and aesthetic outcomes&#44; demonstrated an increase in hair density and the presence of anagen phase follicles&#44; which was not observed in the group treated with saline injection alone&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a></p><p id="par0235" class="elsevierStylePara elsevierViewall">These findings further support the hypothesis of the efficacy of platelet concentrate in promoting hair growth&#46; Moreover&#44; Gentile P et al&#46;&#44; although not directly studying growth factors&#44; also observed beneficial effects following PRP application&#44; including epidermal thickening&#44; increased perifollicular vascularization&#44; and an increase in ki67&#43; keratinocytes&#44; thereby reinforcing the action of PRP&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">46</span></a></p><p id="par0240" class="elsevierStylePara elsevierViewall">Qu Q&#44; in his analysis&#44; provided important information on alternative routes after studying mice pelage&#46; He suggests that PRP treatment can activate &#946;-Catenin&#44; PDGF&#44; and AKT signaling pathways&#44; coupled with suppression of p53 levels to induce hair growth&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">48</span></a> This provides new insights into future research directions that could lead to a better understanding of hair growth with PRP&#46;</p></span><span id="sec0110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Preparation methods</span><p id="par0245" class="elsevierStylePara elsevierViewall">The optimal technique for preparing PRP remains a subject of ongoing debate and investigation&#46; In an effort to identify the most effective preparation method&#44; Stevens J et al&#46; conducted a review of the available literature&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">59</span></a> Their findings suggested several recommendations&#44; including the use of subdermal bolus injections to minimize discomfort&#44; the incorporation of an activator&#44; monthly treatment intervals&#44; and preparation using the single-spin method&#46; These suggestions aimed to enhance treatment outcomes by optimizing the PRP preparation process&#46;</p><p id="par0250" class="elsevierStylePara elsevierViewall">In contrast with this&#44; our meta-analysis revealed that the use of a pre-application activator suggested slightly lower improvements in hair density when compared to non-active&#46; These findings indicate that pre-activating PRP prior to application may decrease its efficacy in promoting hair regrowth&#46; Despite this&#44; the difference found is very small&#46; Therefore&#44; the authors recommend that future studies explore the duality between pre-activation or not of PRP as a preparation method&#46;</p><p id="par0255" class="elsevierStylePara elsevierViewall">In contrast&#44; the Tawfik AA study employed a different approach&#44; with more frequent injections at weekly intervals using the double-spin method in women with alopecia&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">41</span></a> Remarkably&#44; this study demonstrated exceptional results&#44; showing sustained hair growth even after 6 months of treatment&#46; Similarly&#44; Singh S et al&#46; achieved significant outcomes by utilizing the double-spin method while excluding Platelet-Poor Plasma &#40;PPP&#41; and adopting less frequent monthly applications&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">43</span></a> These findings suggest that shorter intervals between injections and the utilization of the double-spin method may contribute to more effective hair density improvement&#46; Despite these data&#44; our subgroup meta-analysis of the spin method revealed greater differences with double spin&#46; However&#44; the difference was small between both preparations&#46;</p><p id="par0260" class="elsevierStylePara elsevierViewall">Study design is of utmost importance&#46; It&#8217;s interesting to note that our subgroup meta-analysis considering Intra&#47;Inter-subject comparisons presented better results with inter-subject designs&#46; This may be related to PRP spread in the scalp&#44; affecting placebo areas in intra-subject comparisons&#46; Accordingly&#44; research conducted with this design may suggest smaller effects&#46;</p><p id="par0265" class="elsevierStylePara elsevierViewall">Our last subgroup meta-analysis was related to gender&#44; in order to explain the high heterogeneity present&#46; Although it was capable of reducing heterogeneity&#44; the findings were not statistically significant&#46; Additionally&#44; the authors couldn&#8217;t ascertain individual-by-individual changes&#44; limiting our analysis capability&#46; More studies should be conducted exclusively on men and women for this issue to be answered&#46;</p><p id="par0270" class="elsevierStylePara elsevierViewall">Considering these findings&#44; it&#8217;s apparent that various preparation methods for PRP can yield positive results&#46; Further research is warranted to determine the optimal preparation technique for PRP in hair regrowth treatments&#46; Factors such as injection frequency&#44; activation protocols&#44; and the specific centrifugation method employed may all influence the efficacy of PRP treatment&#46; Future studies should aim to compare different preparation methods and evaluate their impact on hair regrowth outcomes to establish more precise guidelines for clinical practice&#46;</p></span><span id="sec0115" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Current therapy comparison</span><p id="par0275" class="elsevierStylePara elsevierViewall">Globally&#44; the treatment approach for AGA often involves the use of 5-alpha reductase inhibitors&#44; such as finasteride and dutasteride&#44; as well as topical solutions containing minoxidil&#44; an adenosine 5&#39;-triphosphate-sensitive potassium channel opener&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;60&#8211;62</span></a> Adil A and Godwin M conducted a systematic review and meta-analysis comparing the effects of these medications against placebo&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">63</span></a> The analysis revealed mean differences in hair density compared to placebo as follows&#58; finasteride 1&#160;mg&#160;&#61;&#160;18&#46;37 hairs&#47;cm<span class="elsevierStyleSup">2</span>&#44; minoxidil 5&#37;&#160;&#61;&#160;14&#46;94 hairs&#47;cm<span class="elsevierStyleSup">2</span>&#44; and 2&#37; minoxidil&#160;&#61;&#160;8&#46;11 hairs&#47;cm<span class="elsevierStyleSup">2</span>&#46; Notably&#44; finasteride exhibited high heterogeneity &#40;I<span class="elsevierStyleSup">2</span>&#160;&#61;&#160;91&#37;&#41;&#44; while minoxidil demonstrated negligible heterogeneity &#40;I<span class="elsevierStyleSup">2</span>&#160;&#61;&#160;0&#37;&#41;&#46;</p><p id="par0280" class="elsevierStylePara elsevierViewall">In the present review&#44; PRP therapy showed a mean difference of 27&#46;55 hairs&#47;cm<span class="elsevierStyleSup">2</span> compared to placebo&#44; which is higher than the improvement observed with finasteride&#46; However&#44; both PRP and finasteride exhibited high heterogeneity&#46; This improvement is clinically relevant&#44; as PRP provides a notable increase in hair density without the requirement for daily use and the risk of undesired collateral effects&#46; In addition&#44; the PRP mechanism of action differs from other hair treatments&#44; meaning it could be used in a combined therapy&#44; enhancing hair growth results even more&#46; These findings are consistent with the results reported by Gentile P et al&#46;&#44; who conducted a systematic review comparing PRP therapy to conventional treatments&#44; as well as with the findings of Singh S et al&#46; and Pakhomova EE&#44; who compared PRP to minoxidil and combined therapies&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">43&#44;64&#44;65</span></a> The evidence suggests that PRP therapy is more effective than minoxidil alone&#44; and combination therapy may offer even greater efficacy&#46; This suggests that PRP could be a viable treatment option for AGA&#46;</p><p id="par0285" class="elsevierStylePara elsevierViewall">In summary&#44; PRP therapy has shown promising results in improving hair density in AGA patients&#46; It appears to be a favorable treatment option when compared to finasteride and may provide enhanced efficacy when used in combination with other therapies&#46; These findings support the growing body of evidence highlighting the potential of PRP as a valuable therapeutic approach for managing AGA&#46;</p></span></span><span id="sec0120" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Limitations</span><p id="par0290" class="elsevierStylePara elsevierViewall">Our meta-analysis integrates the most up-to-date studies accessible within the discipline&#46; By incorporating the most recent research discoveries&#44; the authors have guaranteed that our analysis mirrors the present status of comprehension&#46; This facet holds substantial significance&#44; especially in swiftly developing domains where novel evidence can considerably influence treatment suggestions&#46; The authors have employed sophisticated statistical methods and methodological approaches to augment the exactitude and dependability of our findings&#46; Through cutting-edge meta-analytic and estimate techniques&#44; we&#8217;ve mitigated potential biases and heightened the precision of our estimations&#46;</p><p id="par0295" class="elsevierStylePara elsevierViewall">The authors have performed a thorough investigation of different subcategories within the encompassed research&#46; Through the process of categorizing the data according to pertinent variables including age&#44; gender&#44; spin&#44; and activator&#44; the authors have successfully delved into possible disparities in the impact of treatment across diverse populations&#46; This analysis of subgroups yields invaluable perspectives on the diversity of the findings and aids in the identification of particular patient attributes that might impact treatment results&#46;</p><p id="par0300" class="elsevierStylePara elsevierViewall">There&#8217;s evident huge heterogeneity in AGA severity between reports&#46; As shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#44; nine papers included high-grade AGA&#44; and five only included patients with less severe situations&#46; Heterogeneity could be attributed both to patient selection and measurement method&#44; in which there is no specification in reports if total hair density or terminal hair density was measured&#46; It&#8217;s important to note that some of the reported studies&#44; such as Rodrigues BL et al&#46;&#44; had differences in baseline hair density between groups&#46; This certainly influenced in final results&#44; as the PRP group indeed presented a better increase&#44; but couldn&#8217;t sufficiently impact to surpass the previous difference between groups&#46; In this sense&#44; Future research may focus on stratifying AGA severity groups for further evidence of PRP efficacy&#46;</p><p id="par0305" class="elsevierStylePara elsevierViewall">Despite the rigorous search process conducted in multiple databases and the inclusion of gray literature&#44; it&#8217;s possible that some relevant studies were missed&#44; which could introduce potential bias in the findings&#46;</p><p id="par0310" class="elsevierStylePara elsevierViewall">Another important limitation to consider is the inclusion of intra-subject studies&#44; which may introduce confounding factors&#46; The local-systemic spreading effect of PRP dissemination and the potential impact of regional needling on cellular regeneration pathways could influence the observed outcomes&#44; as suggested by the subgroup meta-analysis&#46; These factors should be taken into account when interpreting the results&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">42&#44;66</span></a></p><p id="par0315" class="elsevierStylePara elsevierViewall">Furthermore&#44; it is worth noting that the heterogeneity observed among the included studies&#44; as indicated by the high I&#178; values&#44; may also contribute to limitations in drawing definitive conclusions&#46; Albeit our struggle to group reports to minimize and dive into further explorations on heterogeneity&#44; included studies have small sample sizes&#44; differ in PRP protocols&#44; and present different follow-up times&#46; The variations in final platelet count after centrifugation are another spotlight topic&#44; as most spin methods don&#8217;t match in studies&#44; with numerous variations in time and revolutions per minute&#46; AGA severity in studies has deviated even in the same groups&#44; promoting more variability&#46; Our data approach may also have been intoxicated by the previous differences present in groups regarding AGA severity&#44; as reports such as Rodrigues BL et al&#46; presented an evident hair growth in the PRP group&#44; but wasn&#8217;t big enough to suppress the control group difference&#44; which didn&#8217;t present evident hair growth&#46; These variations in study designs&#44; patient characteristics&#44; and PRP preparation methods certainly influence treatment outcomes and introduce potential sources of bias&#46; Furthermore&#44; there is clear evidence of publication bias as shown by the asymmetry in the funnel plot&#46;</p><p id="par0320" class="elsevierStylePara elsevierViewall">To mitigate these limitations&#44; future research in this area should aim for larger sample sizes&#44; standardized protocols&#44; and longer follow-up periods&#46; Additionally&#44; conducting more studies with a randomized controlled trial design would enhance the quality of evidence and allow for a more comprehensive assessment of the efficacy and safety of PRP therapy for AGA&#46;</p><p id="par0325" class="elsevierStylePara elsevierViewall">Overall&#44; while this systematic review provides valuable insights into the current evidence on PRP therapy for AGA&#44; it is important to consider its limitations and interpret the findings with caution&#46;</p></span><span id="sec0125" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Conclusion</span><p id="par0330" class="elsevierStylePara elsevierViewall">Based on the available evidence from randomized clinical trials&#44; the use of PRP injections for the treatment of AGA has shown effectiveness in increasing hair density&#46; However&#44; it is important to note that the certainty of the evidence is currently at a low level&#44; and further robust studies are needed to strengthen the findings&#46; Finally&#44; this work highlights the lack of high-quality randomized clinical trials&#46; As well as the high heterogeneity and reports of low sample size claims for the need for well-conducted trials on the efficacy of PRP in AGA&#46;</p><p id="par0335" class="elsevierStylePara elsevierViewall">Recommendations for future research include using PRP preparations that exclude platelet-poor plasma&#44; pre-activating PRP before application&#44; and carefully considering confounding factors such as micro-needling or PRP diffusion&#44; when comparing results between individuals&#46; Additionally&#44; future studies should investigate the optimal frequency of PRP treatment intervals&#44; explore the effectiveness of the double-spin method for PRP preparation&#44; and evaluate the potential benefits of combining PRP therapy with other treatment modalities&#46;</p><p id="par0340" class="elsevierStylePara elsevierViewall">Overall&#44; while the current evidence supports the use of PRP injections for AGA&#44; further research is needed to enhance our understanding of its optimal use&#44; improve the certainty of the evidence&#44; and expand our knowledge of potential combination therapies&#46;</p></span><span id="sec0135" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0175">Financial support</span><p id="par0350" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0140" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0180">Authors&#8217; contributions</span><p id="par0355" class="elsevierStylePara elsevierViewall">Lucas Kieling&#58; The conception and design of the study&#59; Data collection&#44; or analysis and interpretation of data&#59; Statistical analysis&#59; Drafting the article or critically reviewing it for important intellectual content&#59; Obtaining&#44; analyzing and interpreting data&#59; Critical review of the literature&#59; Final approval of the final version of the manuscript&#46;</p><p id="par0360" class="elsevierStylePara elsevierViewall">Ana Terezinha Konzen&#58; The conception and design of the study&#59; Data collection&#44; or analysis and interpretation of data&#59; Statistical analysis&#59; Drafting the article or critically reviewing it for important intellectual content&#59; Obtaining&#44; analyzing and interpreting data&#59; Critical review of the literature&#59; Final approval of the final version of the manuscript&#46;</p><p id="par0365" class="elsevierStylePara elsevierViewall">Rafaela Koehler Zanella&#58; Drafting the article or critically reviewing it for important intellectual content&#59; Obtaining&#44; analyzing and interpreting data&#59; Critical review of the literature&#59; Final approval of the final version of the manuscript&#46;</p><p id="par0370" class="elsevierStylePara elsevierViewall">Denis Souto Valente&#58; Drafting the article or critically reviewing it for important intellectual content&#59; Obtaining&#44; analyzing and interpreting data&#59; Critical review of the literature&#59; Final approval of the final version of the manuscript&#46;</p></span><span id="sec0145" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0185">Conflicts of interest</span><p id="par0375" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentals</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Platelet-rich plasma &#40;PRP&#41; has been progressively more used in androgenetic alopecia &#40;AGA&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objectives</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">The authors aimed to evaluate PRP efficacy compared to placebo in AGA&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">A comprehensive search was conducted across seven databases&#44; until 01&#47;04&#47;2023&#46; Randomized clinical trials focusing on AGA and PRP use to increase hair density were included&#46; Patients aged between 15 and 63 years&#44; diagnosed with AGA characterized by Norwood I&#8210;VII and Ludwig I&#8210;III scales&#44; were included&#46; Studies with a sample size &#60;10&#44; lacking PRP processing method&#44; focusing on complementary therapies or other alopecias&#44; were excluded&#46; The authors conducted subgroup analysis for activator&#44; spin method&#44; study design&#44; risk of bias&#44; and gender&#46; Meta-regression was conducted for activator&#44; spin method&#44; design&#44; and gender&#46; The authors used GRADEpro to assess evidence certainty and the RoB-2 tool for risk of bias&#46; Asymmetry was measured through a Funnel plot followed by Egger&#8217;s test&#46; The protocol was registered at PROSPERO &#40;CRD42023407334&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">The authors screened 555 registers and included fourteen studies involving 431 patients for qualitative synthesis&#44; with 13 studies included in the meta-analysis&#46; Meta-analysis demonstrated a mean difference of 27&#46;55 hairs&#47;cm<span class="elsevierStyleSup">2</span> and 95&#37; CI &#40;14&#46;04&#59; 41&#46;06&#41;&#44; I<span class="elsevierStyleSup">2</span>&#160;&#61;&#160;95&#46;99&#37;&#44; p&#160;&#60;&#160;0&#46;05&#46; Hair diameter meta-analysis presented a mean difference of 2&#46;02&#160;&#956;m&#44; 95&#37; CI &#40;&#8722;0&#46;85&#160;&#956;m&#59; 4&#46;88&#160;&#956;m&#41;&#44; and I<span class="elsevierStyleSup">2</span>&#160;&#61;&#160;77&#46;11&#37; &#40;p&#160;&#61;&#160;0&#46;02&#41;&#46; That is&#44; low quality evidence&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Study limitations</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Studies were highly heterogeneous&#44; of low quality&#44; and presented evident publication bias&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusions</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Highly heterogeneous studies with publication bias suggest PRP effectively increases hair density in AGA&#44; so further high-quality randomized clinical trials are recommended to strengthen the evidence&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Study conducted at the Universidade Federal de Ci&#234;ncias da Sa&#250;de de Porto Alegre&#44; Porto Alegre&#44; RS&#44; Brazil&#46;</p>"
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            "apendice" => "<p id="par0385" class="elsevierStylePara elsevierViewall">The following is Supplementary data to this article&#58;<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
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            "titulo" => "Supplementary data"
            "identificador" => "sec0155"
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          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Rob-2 overall risk of bias&#46;</p>"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Hair density forest plot&#46;</p>"
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        "etiqueta" => "Fig&#46; 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
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        "figura" => array:1 [
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          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Hair diameter meta-analysis&#46;</p>"
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        "etiqueta" => "Fig&#46; 5"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
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        "figura" => array:1 [
          0 => array:4 [
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Inter-subject comparison group&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">57&#46;14&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Intra-subject comparison group&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">42&#46;86&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Use of activator</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-Active PRP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#46;00&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-Non-active PRP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">50&#46;00&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Geographical location</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>America&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">35&#46;71&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Asia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">28&#46;57&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Africa&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">14&#46;29&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Oceania&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Europa&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;43&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Increased Hair density</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92&#46;86&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;14&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Increased Hair diameter</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#46;71&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46;29&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Not measured&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#46;00&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Publication Year</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Before 2019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#46;71&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>2019-2023&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&#46;29&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">High Grade alopecia &#40;Stage&#160;&#62;&#160;IV NH and&#160;&#62;&#160;II Ludwig&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Included&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&#46;29&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Excluded&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#46;71&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "leyenda" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">NSDBG&#44; Not Significant Difference Between Groups&#59; SDBG&#44; Significant Difference Between Groups&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Author and Year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Financing&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Study design&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Comparator&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sample&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Follow up time&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PRP method&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Results&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Shapiro&#44; 2020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Regen Labs SA &#40;Le Mont-sur-Lausanne&#44; Switzerland&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Randomized clinical trial&#44; Half-Scalp&#44; intra-subject&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#44; 17 female and 18 male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 application per month for 3 months&#44; results were measured a month after treatment ended&#46; 0&#46;1&#8210;0&#46;2&#160;mL&#47;cm<span class="elsevierStyleSup">2</span> of PRP used&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#160;mL of blood centrifuged at 1500&#160;g&#44; using a thixotropic gel to prepare approximately 5&#160;mL of PRP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;NSDBG&#41;&#59; &#8593; Hair diameter &#40;NSDBG&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gressenberger&#44; 2020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Single-center&#44; randomized&#44; blinded pilot study inter-subject&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 male&#46; 20 PRP and 10 placebo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Five treatments were performed with 0&#46;1&#160;mL&#47;cm<span class="elsevierStyleSup">2</span> of PRP&#44; at intervals of 4&#8211;6 weeks&#46; Hair density measured at baseline&#44; 4 weeks&#44; and 6 months after treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#160;mL of blood collected in a tube containing sodium citrate&#46; used a single spin procedure &#40;2800 RPM for 9&#160;minutes&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8595; Hair density &#40;NSDBG&#41;&#59; &#8595; Hair diameter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Siah&#44; 2020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Supported by unrestricted funds from RepliCel Life Sciences Inc&#44; Vancouver&#44; Canada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Randomized&#44; intra-subject&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44; 9 female and 1 male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Five injections with 2 weeks interval each&#44; 0&#46;1&#160;mL&#47;cm<span class="elsevierStyleSup">2</span> of PRP was used&#46; Measurement at baseline&#44; after 4 weeks &#40;prior to 3<span class="elsevierStyleSup">rd</span>application&#41; and 8 weeks after treatment end&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#160;mL of venous blood was centrifuged at 300&#160;g at 18&#160;&#176;C for 5&#160;minutes&#44; PRP1 transferred and centrifuged at 700&#160;g at 18&#160;&#176;C for 17&#160;minutes&#44; after that Platelet-Poor Plasma &#40;PPP&#41; was removed and resuspended to form PRP2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;NSDBG&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Singh&#44; 2020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Institutional Research Grant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Single-center&#44; prospective&#44; randomized&#44; double-blind control trial&#44; inter-subject&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Minoxidil 5&#37;&#44; Placebo &#40;saline&#41;&#44; Minoxidil&#160;&#43;&#160;PRP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80&#46; all male&#46; 20 Minoxidil 5&#37; &#43; PRP&#44; 20 Minoxidil 5&#37;&#44; 20 PRP&#44; and 20 saline&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;05&#8211;0&#46;1&#160;mL&#47;cm<span class="elsevierStyleSup">2</span> of prp was injected&#44; treatment done 3 times with 1 month interval between each&#46; Measurement before treatment and documented every month for 5 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#160;mL of blood collected into a 2&#160;mL tube with 2&#46;8&#37; of sodium citrate&#46; Centrifugation at 2200&#160;rpm for 12&#160;minutes&#44; separation of buffy coat and plasma to 2<span class="elsevierStyleSup">nd</span>spin at 3000&#160;rpm for 6&#160;minutes&#46; 3&#8211;3&#46;5&#160;mL of PRP was obtained&#46; PRP was added to a syringe with calcium gluconate &#40;1&#58;9&#41; as an activator&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;NSDBG&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dicle&#44; 2018&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Akdeniz University&#44; Scientific Research Projects Coordination Unit&#44; Antalya&#44; Turkey&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Randomized&#44; placebo&#8208;controlled&#44; inter-subject crossover study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 male G1&#160;&#61;&#160;10&#44; G2&#160;&#61;&#160;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Monthly application for 3 months&#44; after that&#44; there was a 3-month wash-out&#46; Then&#44; crossover happened and placebo group received PRP&#46; Patients were evaluated three times&#58; at baseline &#40;M0&#41;&#44; at 4<span class="elsevierStyleSup">th</span>month &#40;M4&#41;&#44; and 9<span class="elsevierStyleSup">th</span>month &#40;M9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">A 28-cc blood sample was collected and mixed with citrate dextrose-A &#40;ACD-A&#41;&#46; 30 cc was transferred to a PRP tube and centrifuged at 1700&#160;G for 5&#160;minutes&#46; 5&#160;mL of PRP was loaded into a syringe and activated using a bio-activator before application&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;SDBG&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Rodrigues&#44; 2019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Supported by the National Council of Technological and Scientific Development&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Double-blinded investigative pilot prospective study&#44; randomized&#44; inter-subject&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 male&#46; PRP group &#40;n&#160;&#61;&#160;15&#41; and the control group &#40;n&#160;&#61;&#160;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 applications every 15 days&#44; with a total of 20 injections&#46; 100&#160;u&#160;L of PRP or saline solution per injection&#44; total of 2&#160;mL&#46; Hair density measured before the treatment&#44; 15 days and 3 months after end of treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Blood was collected in six 8&#46;5-mL acid citrate dextrose tubes&#44; one 4-mL ethylenediaminetetraacetic acid tube&#44; and 1 tube without anticoagulant&#46; Centrifuged at 300&#160;g for 5&#160;minutes at 18&#160;&#176;C&#44; and the upper fraction &#40;PRP1&#41; was separated without disturbing the buffy coat&#46; PRP1 was centrifuged at 700&#215;g for 17&#160;minutes at 18&#160;&#176;C&#46; The platelet pellet from PRP1 was resuspended in 300&#160;&#956;L PPP &#40;PRP2&#41;&#46; 20&#160;mM of CaCl2 and 25 IU&#47;mL human thrombin or CaCl2 alone were used to activate&#46; Incubation at 37&#160;&#176;C for 1&#160;hour and at 4&#160;&#176;C for 16&#160;hours&#46; The activated PRP2 was recovered by centrifugation at 3&#44;000&#215;g for 20&#160;minutes at 18&#160;&#176;C&#46; Autologous serum was used as an activator and prepared from the tube without anticoagulant&#58; after centrifugation at 1258&#160;g for 15&#160;minutes&#44; 1&#160;mL was separated and then added to the PRP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;Group 1 NSDBG&#59; Group 2 SDBG&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gentile&#44; 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Randomized&#44; evaluator-blinded&#44; intra-subject&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1&#160;mL&#47;cm<span class="elsevierStyleSup">2</span> of PRP was applied monthly for 3 months &#40;3 injections&#41;&#46; Evaluation happened before treatment &#40;T0&#41;&#44; 2&#40;T1&#41;&#44; 6&#40;T2&#41;&#44; 12&#40;T3&#41;&#44; 16&#40;T4&#41; and 24 &#40;T5&#41; months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#160;mL of blood were taken and centrifuged in two tubes containing sodium citrate at 1&#44;100&#160;g for 10&#160;minutes&#46; Then&#44; autologous PRP that was not activated after centrifugation &#40;9&#160;mL&#41; was switched to 10-mL tubes containing Ca2&#43; extracted by the Cascade-Selphyl-Esforax&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;SDBG&#41;&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tawfik&#44; 2018&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Randomized&#44; double-blinded&#44; intra-subject&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 treatments were done on each patient&#44; every week&#46; Patients were followed up at 6 months after the last session&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#160;mL blood was collected&#44; with 1&#46;5&#160;mL of sodium citrate as an anticoagulant&#46; Then&#44; centrifuged at 1200&#160;g for 15&#160;minutes&#46; Buffy coat was separated together with platelet poor plasma and centrifuged at 2000&#160;g for 10&#160;minutes&#46; PPP was discarded and platelet concentrate was loaded into a 1-mL insulin syringes containing calcium gluconate in a 1&#58;9 ratio &#40;0&#46;1&#160;mL calcium gluconate per 0&#46;9&#160;mL of PRP&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;SDBG&#41;&#59; &#8593; Hair diameter &#40;SDBG&#41;&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alves&#44; 2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Randomized&#44; double-blinded&#44; intra-subject&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#44; 12 men and 13 women&#46; 22 of those completed the treatment &#40;11&#58;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Monthly application of 0&#46;15&#160;mL&#47;cm<span class="elsevierStyleSup">2</span> for 3 months of patients were evaluated before&#44; after second&#44; third treatment and after 6 months of treatment end&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#160;mL of blood was transferred to a tube with 2&#160;mL of 3&#46;8&#37; sodium citrate&#46; Then&#44; centrifuged at 460&#160;g for 8&#160;minutes&#46; PPP was discarded and 3&#160;mL of PRP was obtained&#46; PRP was activated with 0&#46;15&#160;mL of 10&#37; calcium chloride&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;SDBG&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Qu&#44; 2021&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">National Natural Science Foundation of China&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Randomized&#44; double-blinded&#44; intra-subject&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 Male&#59; 20 female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PRP was injected on half-head of the alopecia areas in 0&#46;05- to 0&#46;1-mL&#59; Monthly session for 3&#160;m&#59; follow up 0&#44; 3&#160;m and 6&#160;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&#160;mL of blood in the Tricell kit&#46; 310&#160;g for 4&#160;min and next 300&#160;g for 3 min&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;SDBG&#41;&#59; &#8593; Hair diameter &#40;SDBG&#41;&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Chuah&#44; 2021&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">randomized&#44; double-blind&#44; intra-subject&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 male&#44; 18 female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 sessions&#44; three weeks interval&#46; evaluation at 0&#44; 3&#160;m&#44; and 6&#160;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">centrifugated 5&#160;min at 1500&#160;g&#44; tube contained sodium citrate solution&#44; as anticoagulant&#44; Removal of PPP&#46; Activation with calcium gluconate 1&#58;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;NSDBG&#41;&#59; &#8593; Hair diameter &#40;SDBG&#41;&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Toama&#44; 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Randomized&#44; inter-patient&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;PRP &#40;11 males and 9 females&#41; SALINE &#40;8 males and 12 females&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 sessions &#40;one session every two weeks&#41;&#46; Measured at 0&#59; 3&#160;m&#44; and 6&#160;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tubes with anticoagulant Na Citrate 3&#46;8&#37;&#46; Centrifuged at 1&#44;700&#160;rpm for 15&#160;minutes&#59; centrifuged again at 3&#44;000&#160;rpm for 10&#160;minutes&#59; discard PPP&#59; activation by calcium chloride 1&#58;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;SDBG&#41;&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dubin&#44; 2020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eclipse Aesthetics&#44; LLC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Randomized&#44; double-blind&#44; inter-patient&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 female &#40;15 PRP&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#160;m evaluation&#59; 3 monthly injections&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;500 revolutions per minute for 10&#160;minutes&#46; PPP removed&#46; The remaining 4&#46;0&#160;mL of supernatant was gently inverted in the vacutainer 7 times to re-suspend the platelets within the plasma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;SDBG&#41;&#59; &#8593; Hair diameter &#40;SDBG&#41;&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gentile&#44; 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Randomized&#44; double-blind&#44; intra-patient&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 male &#40;9 PRP&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#160;m evaluation&#59; 3 monthly injections&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Centrifugation &#40;1200&#160;rpm for 10&#160;min&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;SDBG&#41;&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">On androgenetic alopecia&#44; does autologous platelet-rich plasma&#44; compared to placebo&#44; increases hair density and hair thickness&#44; in randomized clinical trials&#63;</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Patient or population&#58;</span> Androgenetic alopecia<span class="elsevierStyleBold">Setting&#58;</span><span class="elsevierStyleBold">Intervention&#58;</span> Platelet-rich Plasma<span class="elsevierStyleBold">Comparison&#58;</span> Placebo</td></tr></tbody></table>
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowgroup " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Outcomes</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowgroup " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&#8470; of participants &#40;studies&#41; Follow-up</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowgroup " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Certainty of the evidence &#40;GRADE&#41;</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowgroup " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Relative effect &#40;95&#37; CI&#41;</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Anticipated absolute effects</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Risk with Placebo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Risk difference with Platelet-rich Plasma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Incresead Hair Density assessed with&#58; n&#47;cm<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">609 &#40;13 RCTs&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#10753;&#10753;&#9711;&#9711; Low<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">MD <span class="elsevierStyleBold">27&#46;55 hairs&#47;cm&#178; higher</span> &#40;14&#46;04 higher to 41&#46;06 higher&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hair Thickness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">294 &#40;5 RCTs&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#10753;&#9711;&#9711;&#9711; Very low<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">MD <span class="elsevierStyleBold">2&#46;02&#160;&#181;m more</span> &#40;0&#46;85 fewer to 4&#46;88 more&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#42;<span class="elsevierStyleBold">The risk in the intervention group</span> &#40;and its 95&#37; confidence interval&#41; is based on the assumed risk in the comparison group and the <span class="elsevierStyleBold">relative effect</span> of the intervention &#40;and its 95&#37; CI&#41;&#46; <span class="elsevierStyleBold">CI&#58;</span> confidence interval&#59; <span class="elsevierStyleBold">MD&#58;</span> mean difference</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
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Original Article
Is autologous platelet-rich plasma capable of increasing hair density in patients with androgenic alopecia? A systematic review and meta-analysis of randomized clinical trials
Lucas Kielinga,
Corresponding author
lucas.kieling@ufcspa.edu.br
kieling_lucas@hotmail.com

Corresponding author.
, Ana Terezinha Konzena, Rafaela Koehler Zanellab, Denis Souto Valentea
a Division of Surgical Clinics, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
b Graduate Program in Medicine and Health Sciences, Faculdade de Medicina da Pontifícia, Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
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women tend to experience hair loss in the mid-frontal area&#44; with a delayed onset and less overall density loss&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Hair significance and its impact on individuals&#39; lives shouldn&#8217;t be underestimated&#46; Hair is one of the first characteristics the authors notice in others&#44; and studies have shown that hair loss can impact an individual&#39;s social life and overall lifestyle&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;8</span></a> The condition of our hair plays a crucial role in our self-perception and attractiveness&#44; influencing our social interactions and opportunities&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Therefore&#44; understanding hair loss and its treatment options is essential in improving quality of life&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Platelet-Rich Plasma &#40;PRP&#41; is a concentrated form of plasma obtained from a patient&#39;s own blood&#44; containing higher levels of platelets compared to baseline levels&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> Various techniques for preparing PRP exist&#44; although a consensus has yet to be reached&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> PRP has been utilized for many years in regenerative medicine&#44; particularly in osteoarthritic injury treatment and rotator cuff damage&#46; Recently&#44; its use has expanded&#44; PRP is now world widely performed by dermatologists for several indications&#44; such as skin rejuvenation&#44; and AGA treatment&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#8211;15</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">PRP action on the scalp is related to the growth factors present in the concentrated platelets&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> For example&#44; the Vascular Endothelial Growth Factor &#40;VEGF&#41; stimulates the dermal papilla cells through the VEGFR-2&#47;ERK pathway&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> Insulin-like Growth Factor 1 &#40;IGF-1&#41; and Fibroblast Growth Factor &#40;FGF&#41; promote the anagen phase of hair follicles and inhibit the transition to the catagen phase&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#8211;20</span></a> Additionally&#44; Epidermal Growth Factor &#40;EGF&#41; induces the proliferation of dermal papilla cells via the Notch signaling pathway and has been shown to promote hair growth in experimental studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21&#44;22</span></a> Platelet-Derived Growth Factor &#40;PDGF&#41; also induces and maintains hair follicles in the anagen phase in animal models&#46;<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">23&#44;24</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Systematic reviews suggest that PRP increases mean hair density in male and female pattern hair loss and on alopecia areata&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">25&#44;26</span></a> Although some were exclusively on clinical trials&#44; evidence quality is persistently low&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">27&#8211;29</span></a> Non-randomized clinical trials are indeed inferior to randomized clinical trials&#46; As such&#44; they are considered high-tiered evidence quality suppliers&#44; and&#44; if assessed separately&#44; may provide better insights on existent evidence quality&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Despite the increase in research and use of PRP for androgenetic alopecia&#44; there is currently no consensus based on substantial evidence from randomized clinical trials&#46; Accordingly&#44; this study&#8217;s objective is to evaluate the existing evidence regarding the application of PRP injections to increase hair density in patients with AGA&#44; specifically through a review of randomized clinical trials&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Study design</span><p id="par0040" class="elsevierStylePara elsevierViewall">This study employed a systematic review and meta-analysis methodology&#44; adhering to the guidelines outlined in the PRISMA &#40;Preferred Reporting Items for Systematic Reviews and Meta-Analyses&#41; checklist&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Eligibility criteria</span><p id="par0045" class="elsevierStylePara elsevierViewall">The research question was created using the PICO format&#58; among patients with androgenetic alopecia&#44; does autologous platelet-rich plasma&#44; compared to a placebo&#44; result in hair density increase in randomized clinical trials&#63;</p><p id="par0050" class="elsevierStylePara elsevierViewall">To be included in the analysis&#44; studies needed to meet the following eligibility criteria&#46; Firstly&#44; only full-length original articles reporting on randomized clinical trials were considered&#46; The intervention of interest was the administration of Platelet-Rich Plasma &#40;PRP&#41; injections&#46; PRP can either be activated or non-activated&#46; The use of PRP in combination with the platelet activator&#47;agonist allows for the release of multiple growth factors and differentiation factors upon platelet activation&#44; which can enhance the process&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> Activation can be done by adding a platelet activator&#47;agonist as topical bovine thrombin or 10&#37; calcium chloride to the PRP solution right before injection&#46; The control group consisted of individuals who received a placebo&#46; This is to control PRP efficacy&#46; Comparison with other standard therapies&#44; such as minoxidil or 5-alpha-reductase inhibitors&#44; could contaminate data and provide non-representative results&#46; If PRP doesn&#8217;t show benefit compared to placebo&#44; there is no point in comparing it to other therapies&#46; Our main outcome of interest was changes&#44; either positive or negative&#44; in hair density&#46; It refers to changes in the number of hairs per unit area &#40;cm<span class="elsevierStyleSup">2</span>&#41; on the skin surface&#46; Changes in hair diameter were secondary outcomes&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The target population comprised patients aged between 15 and 63 years diagnosed with AGA&#44; as is the most likely population to be affected by androgenetic alopecia&#44; who would potentially search for and benefit from PRP interventions&#46; Secondly&#44; women and men can be included&#44; as androgenetic alopecia can affect both genders&#46; While it&#8217;s more prevalent in men&#44; women can also experience this condition&#46; Characterization by the Norwood I&#8210;VII and Ludwig I&#8210;III classifications&#46; Some studies use inter-patient and others use intra-patient comparison&#59; in this review&#44; both could be included&#46; Studies with a sample size of fewer than ten patients&#44; those lacking information on the PRP processing method&#44; or studies that subjectively assessed increased hair density were excluded&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Furthermore&#44; patients with chronic diseases&#44; individuals on anticoagulant therapy&#44; pregnant women&#44; those with malignancies&#44; and those utilizing complementary therapies were also excluded&#46; Additionally&#44; studies focusing on other types of alopecia&#44; such as alopecia areata&#44; cicatricial alopecia&#44; or lichen planus&#44; were not considered&#46; There were no limitations regarding the PRP processing method&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Data sources</span><p id="par0065" class="elsevierStylePara elsevierViewall">The authors conducted a comprehensive search until April 1&#44; 2023&#44; in seven databases&#46; These databases included MEDLINE &#40;through PubMed&#41;&#44; Virtual Health Library &#40;BVS&#41;&#44; EMBASE&#44; Cochrane Library&#44; Web of Science&#44; Scopus&#44; and MedRxiv &#40;a source of grey literature&#44; encompassing pre-print studies&#41;&#46; The selection of these databases aimed to capture a wide range of relevant studies for inclusion in the review and meta-analysis&#46; References from studies cited in this review writing process were also screened and eligible for inclusion&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Search strategy</span><p id="par0070" class="elsevierStylePara elsevierViewall">For the search in electronic databases&#44; relevant Medical Subject Headings &#40;MeSH&#41; terms and keywords were utilized&#46; These terms were adapted based on the specific database&#46; The following terms were employed to ensure a comprehensive search&#58; &#8220;Hair regrowth&#8221;&#44; &#8220;Hair restoration&#8221;&#44; &#8220;Hair regeneration&#8221;&#44; &#8220;Hair Growth&#8221;&#44; &#8220;Alopecia&#8221;&#44; &#8220;Baldness&#8221;&#44; &#8220;Hair Loss&#8221;&#44; &#8220;Hair Losses&#8221;&#44; &#8220;Loss&#44; Hair&#8221;&#44; &#8220;Losses&#44; Hair&#8221;&#44; &#8220;Alopecia&#44; Male Pattern&#8221;&#44; &#8220;Male Pattern Alopecia&#8221;&#44; &#8220;Baldness&#44; Male Pattern&#8221;&#44; &#8220;Male Pattern Baldness&#8221;&#44; &#8220;Female Pattern Baldness&#8221;&#44; &#8220;Baldness&#44; Female Pattern&#8221;&#44; &#8220;Androgenetic Alopecia&#8221;&#44; &#8220;Pattern Baldness&#8221;&#44; &#8220;Baldness&#8221;&#44; &#8220;Pattern&#8221;&#44; &#8220;Androgenic Alopecia&#8221;&#44; &#8220;Alopecia&#44; Androgenic&#8221;&#44; &#8220;Alopecias&#44; Androgenic&#8221;&#44; &#8220;Pseudopelade&#8221;&#44; &#8220;Alopecia Cicatrisata&#8221;&#44; &#8220;Alopecia Cicatrisatas&#8221;&#44; &#8220;Platelet-Rich Plasma&#8221;&#44; &#8220;Plasma&#44; Platelet-Rich&#8221;&#44; &#8220;PRP&#8221;&#44; &#8220;thrombocyte rich plasma&#8221;&#44; and &#8220;Randomized Clinical Trial &#40;Publication Type&#41;&#8221;&#46; To improve the sensitivity for identifying randomized clinical trials&#44; recommendations from McGill University were followed&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a> Specific search strategies for each database utilized in this study can be found in the supplementary file&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study selection</span><p id="par0075" class="elsevierStylePara elsevierViewall">Two independent reviewers conducted the assessment of titles and abstracts for all identified clinical trial reports&#46; Blinding was ensured&#44; with each reviewer unaware of the decisions made by the other&#46; When possible&#44; studies that met the inclusion criteria were selected for further evaluation&#46; In cases of disagreement between reviewers&#44; a third reviewer was involved to make the final decision regarding study inclusion or exclusion&#46; The Rayyan software was utilized to facilitate the selection process&#44; particularly for reading and screening titles and abstracts&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Data extraction</span><p id="par0080" class="elsevierStylePara elsevierViewall">Each reviewer independently performed data extraction without access to the other reviewer&#39;s extraction&#46; The following data were extracted from the selected studies&#58; author&#44; year&#44; location&#44; comparator&#44; study design&#44; sample size&#44; follow-up time&#44; method of PRP preparation&#44; capillary density and diameter measurements&#44; and funding sources&#46; A predefined Excel spreadsheet was used to record the extracted data for each reviewer&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Assessment of methodological quality of selected articles for systematic review</span><p id="par0085" class="elsevierStylePara elsevierViewall">Risk of bias assessment was conducted using the RoB-2 tool provided by Cochrane&#46; This tool assesses possible biases in five domains&#44; including randomization&#44; intended intervention&#44; missing data&#44; outcome measurement&#44; and outcome reporting&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a> The GRADE method was employed to assess the strength of the recommendation for the intervention&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">33</span></a></p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Data analysis</span><p id="par0090" class="elsevierStylePara elsevierViewall">Included studies were grouped based on the characteristics provided in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; The extracted data were qualitatively synthesized and recorded in a dedicated spreadsheet&#46; For studies that provided the mean and standard deviation of the outcomes of interest&#44; a random-effects meta-analysis was conducted using the restricted maximum likelihood method&#46; When these data were absent&#44; authors were contacted&#46; When authors didn&#8217;t answer&#44; if provided sufficient data for estimating the mean and standard deviation&#44; the study would be included in the meta-analysis&#46; The effect size and 95&#37; Confidence Intervals &#40;95&#37; CI&#41; were measured by the mean difference&#46; Statistical heterogeneity was assessed using the I&#178; statistic&#44; with values below 25&#37; considered low&#44; between 25&#37; and 50&#37; considered moderate&#44; and above 50&#37; considered high&#46; Subgroup analysis and meta-regression were performed based on the use of a pre-application activator&#44; sex&#44; study design&#44; risk of bias and spin method following the aforementioned meta-analytic model&#46; Statistical package STATA&#174; version 16 was used for data analysis&#46; Funnel plots followed by Egger&#8217;s test were done to assess asymmetry and publication bias&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Data estimation</span><p id="par0095" class="elsevierStylePara elsevierViewall">Gressenberger P&#58;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a> The Interquartile Range &#40;IQR&#41; was calculated from the reported range as Range&#47;4&#46; This IQR value was then used to estimate the standard deviation according to the empirical rule relationship of IQR&#47;1&#46;349&#46; The median was used as an initial point estimate for the mean&#46; From these estimates&#44; the variance was determined as the square of the standard deviation&#46; Finally&#44; a 95&#37; CI was placed around the estimated mean using a <span class="elsevierStyleItalic">t</span>-distribution&#44; with degrees of freedom based on the sample size&#46; This process allows approximate quantification of the mean and variation based on limited summary statistics when the full dataset is not available for direct calculation&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Chuah SY&#58;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">35</span></a> Hair density values at 6 months were calculated by taking the baseline values and adding or subtracting reported difference values&#46; Standard deviations were also adjusted to account for variability in the different groups&#46; Specifically&#44; the baseline means&#44; and standard deviation were used as a starting point&#46; Then&#44; the difference in means was either added or subtracted based on whether the difference was positive or negative&#46; The difference standard deviation was also added or subtracted to the baseline standard deviation&#46; This allowed the full range of values to be determined while incorporating the variability represented by the CI&#46; Standard Deviation &#40;SD&#41; was calculated by&#58; SD &#61; &#8730;&#40;Baseline SD&#160;&#43;&#160;Difference SD&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Dubin DP&#58;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">36</span></a> The baseline range was used to estimate the standard deviation for each group according to the formula of range&#47;4 &#42; &#40;sample size&#47;&#40;sample size - 1&#41;&#41;&#46; The mean difference from the baseline was then added to the original baseline mean to calculate the estimated post-treatment mean&#46; The baseline standard deviation was assumed to apply after treatment&#46; Finally&#44; a 95&#37; CI was placed around each estimated post-treatment mean using the <span class="elsevierStyleItalic">t</span>-distribution&#44; with degrees of freedom based on the sample size and estimated standard deviation&#46; This process allowed the estimation of key metrics after the intervention based solely on summary baseline data and mean treatment differences reported for each experimental condition&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Rodrigues BL&#58;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a> The authors extracted data from <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> with WebPlotDigitizer &#40;Ankit Rohatgi&#44; version 4&#46;6&#44; 2022&#41;&#46; Then&#44; the mean and standard deviation were calculated based on Luo et al&#46; and Shi et al&#46; works to estimate mean and standard deviation from the sample size&#44; minimum value&#44; first interquartile&#44; median&#44; third interquartile&#44; and maximum&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">38&#44;39</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">The authors couldn&#8217;t estimate or retrieve data from Siah TW et al&#46;&#44; therefore this report has only been included in qualitative synthesis&#44; without participation in the meta-analysis model&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">40</span></a></p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Research protocol</span><p id="par0120" class="elsevierStylePara elsevierViewall">The research protocol was registered at PROSPERO &#40;International Prospective Register of Systematic Reviews&#41; under the registration number CRD42023407334&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Results</span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Selected studies</span><p id="par0125" class="elsevierStylePara elsevierViewall">Following a comprehensive database search&#44; 545 records were identified&#46; Among them&#44; the authors removed 227 duplicates&#44; leaving 318 papers for full-text screening&#46; After careful reference screening&#44; 10 registers were also added&#46; Of these&#44; 26 papers were potentially eligible for inclusion&#46; All reports were retrieved&#46; Ultimately&#44; 14 of them were included in the qualitative synthesis&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">34&#8211;37&#44;40&#8211;49</span></a> Among the included studies&#44; 13 provided sufficient data for quantitative synthesis through meta-analysis&#46; It&#8217;s important to note that some studies had mean and standard deviation estimated as explained in the methods section&#46; Supplementary Material contains the excluded reports list&#46; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> presents the PRISMA flow diagram&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">The review included 431 participants&#44; with 319 subjects undergoing PRP intervention and 310 individuals receiving a placebo&#46; Intra-subject participants were considered in both groups&#46; Most randomized clinical trials were conducted after 2019 and utilized inter-subject comparisons&#46; Half used pre-application activators&#46; Studies included patients with all degrees of alopecia&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> summarizes the included studies&#39; characteristics&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">The majority of the studies used the trichoscan device and patient photos to aid in the analysis and measurement of capillary density as an outcome&#46; Regarding PRP application&#44; most studies administered monthly injections at a rate of 0&#46;1&#8210;0&#46;2&#160;mL&#47;cm<span class="elsevierStyleSup">2</span>&#44; although Tawfik AA et al&#46; achieved better results with weekly injections&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">41</span></a> The method of obtaining and applying PPR is presented for each study in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0140" class="elsevierStylePara elsevierViewall">Most of the included studies demonstrated a low risk of bias&#46; However&#44; Siah TW et al&#46; exhibited a high risk of bias due to the lack of explanation regarding the randomization process&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">40</span></a> Similarly&#44; Rodrigues BL et al&#46; presented some risks in domains 1 and 4 related to randomization and outcome measurement&#44; respectively&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a> Qu Q&#44; Chuah SY&#44; and Toama MA also presented some concerns related to randomization&#44; as no information from concealment was provided&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">35&#44;48&#44;49</span></a><a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> demonstrates all results from RoB-2 risk of bias&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Hair density</span><p id="par0145" class="elsevierStylePara elsevierViewall">Among the fourteen studies included in the synthesis&#44; thirteen demonstrated improved hair density compared to the pretreatment baseline&#46; However&#44; Gressenberger P et al&#46; reported worsening hair conditions without a significant difference between the groups&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a> Around 57&#37; of the studies showed a statistically significant difference in hair density between treated and placebo groups&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">The meta-analysis showed a mean difference of 27&#46;55 hairs&#47;cm<span class="elsevierStyleSup">2</span> between the groups&#44; with 95&#37; CI ranging from 14&#46;04&#8211;41&#46;06&#46; The forest plot is presented in <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0155" class="elsevierStylePara elsevierViewall">The I<span class="elsevierStyleSup">2</span> statistic indicated high heterogeneity among the studies&#44; with a value of 95&#46;99&#37; and Q&#40;12&#41;&#160;&#61;&#160;279&#46;84&#46; This result was statistically significant &#40;p&#160;&#60;&#160;0&#46;00&#41;&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">In subgroup analysis&#44; reports that used active PRP demonstrated a slightly lower mean difference of 25&#46;25 hairs&#47;cm<span class="elsevierStyleSup">2</span>&#44; with 95&#37; CI ranging from 4&#46;89 to 45&#46;61&#44; I&#178; of 96&#46;78&#37;&#44; p&#160;&#60;&#160;0&#46;05&#44; and Q&#40;6&#41;&#160;&#61;&#160;225&#46;89&#46; At the same time&#44; studies using inactive PRP showed a similar mean difference of 29&#46;79 hairs&#47;cm<span class="elsevierStyleSup">2</span>&#44; with a 95&#37; CI ranging from 11&#46;16 to 48&#46;41&#44; I<span class="elsevierStyleSup">2</span> of 85&#46;98&#37;&#44; p&#160;&#60;&#160;0&#46;05&#44; and Q&#40;5&#41;&#160;&#61;&#160;35&#46;55&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Subgroup analysis of PRP preparation related to the spin method was also conducted&#46; Both single and double-spin preparations were effective in increasing hair density &#40;p&#160;&#60;&#160;0&#46;05&#41;&#46; Subgroup analysis was also performed considering study design&#44; inter or intra-subject&#46; Inter-subject comparisons presented a mean difference of 33&#46;72 hairs&#47;cm<span class="elsevierStyleSup">2</span>&#44; I<span class="elsevierStyleSup">2</span>&#160;&#61;&#160;78&#46;19&#44; 95&#37; CI from 14&#46;04 to 49&#46;68 &#40;p&#160;&#60;&#160;0&#46;05&#41;&#44; and Q&#40;7&#41;&#160;&#61;&#160;44&#46;20&#46; Intra-subject presented worse results&#44; with a mean difference of 19&#46;20 hairs&#47;cm<span class="elsevierStyleSup">2</span>&#44; I<span class="elsevierStyleSup">2</span>&#160;&#61;&#160;98&#46;46&#37;&#44; 95&#37; CI from &#8722;4&#46;02 to 42&#46;43 &#40;p&#160;&#61;&#160;0&#46;10&#41;&#44; and Q&#40;4&#41;&#160;&#61;&#160;209&#46;61&#46; The last subgroup was gender-related studies&#46; Only two studies with only females presented sufficient data for meta-analysis&#44; which limits data pooling&#46; Male-only studies had a mean difference of 39&#46;12&#44; I&#178;&#160;&#61;&#160;53&#46;65&#37;&#44; 95&#37; CI from 24&#46;94 to 53&#46;30 &#40;p&#160;&#61;&#160;0&#46;06&#41;&#44; and Q&#40;5&#41;&#160;&#61;&#160;10&#46;64&#46; Mixed studies had a mean difference of 7&#46;39&#44; I<span class="elsevierStyleSup">2</span>&#160;&#61;&#160;73&#46;01&#37;&#44; 95&#37; CI from 1&#46;57 to 13&#46;22 &#40;p&#160;&#60;&#160;0&#46;05&#41;&#44; and Q&#40;4&#41;&#160;&#61;&#160;18&#46;96&#46; High risk of bias presented mean hair density increase&#160;&#61;&#160;7&#46;34 n&#47;cm<span class="elsevierStyleSup">2</span>&#44; I<span class="elsevierStyleSup">2</span>&#160;&#61;&#160;79&#46;77&#37;&#44; 95&#37; CI from 0&#46;96 to 13&#46;73&#44; and Q&#40;3&#41;&#160;&#61;&#160;18&#46;87&#46; Low risk of bias mean increase was 39&#46;98&#44; I<span class="elsevierStyleSup">2</span>&#160;&#61;&#160;77&#46;49&#37;&#44; 95&#37; CI from 25&#46;09 to 54&#46;87&#44; and Q&#40;8&#41;&#160;&#61;&#160;41&#46;08&#46; Both p&#160;&#60;&#160;0&#46;00&#46; Subgroup-exclusive Forest plots are available in the Supplementary Material&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Hair diameter</span><p id="par0170" class="elsevierStylePara elsevierViewall">Five studies provided sufficient data for the meta-analysis&#46; <a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a> presents the forest plot&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0175" class="elsevierStylePara elsevierViewall">Results revealed a mean difference of 2&#46;02&#160;&#956;m between treated and placebo groups&#44; with 95&#37; CI ranging from &#8722;0&#46;85&#160;&#956;m to 4&#46;88&#160;&#956;m&#44; and I<span class="elsevierStyleSup">2</span>&#160;&#61;&#160;77&#46;11&#37; &#40;p&#160;&#61;&#160;0&#46;02&#41;&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Asymmetry and publication bias</span><p id="par0180" class="elsevierStylePara elsevierViewall">Hair diameter couldn&#8217;t have publication bias assessed&#44; as there were only 5 studies&#44; and the Cochrane Handbook suggests a minimum of 10 studies&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">50</span></a> The funnel plot generated after hair density meta-analysis is available in <a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#46; Following&#44; the authors conducted Egger&#8217;s test&#44; beta1&#160;&#61;&#160;0&#46;83&#44; SE of beta1&#160;&#61;&#160;0&#46;816&#44; <span class="elsevierStyleItalic">z</span>&#160;&#61;&#160;1&#46;01&#44; Prob &#62;&#124;<span class="elsevierStyleItalic">z</span>&#124;&#160;&#61;&#160;0&#46;3115&#46;</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0185" class="elsevierStylePara elsevierViewall">Based on these results&#44; the coefficient beta1 is not statistically significant at the 5&#37; level since the p-value is greater than 0&#46;05&#46; The standard error of beta1 is also quite high relative to the coefficient value&#46; Although Egger&#8217;s test didn&#8217;t identify publication bias&#44; funnel plot asymmetry results indicate a clear presence of publication bias&#46; Supplementary Material presents specific subgroups funnel plots&#46;</p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">GradePro assessment</span><p id="par0190" class="elsevierStylePara elsevierViewall">The GRADEPro GDT analysis rated the evidence for PRP on hair density as low-quality evidence &#40;&#43;&#43;&#41;&#46; This rating was based on a low overall risk of bias&#44; high heterogeneity&#44; direct outcomes&#44; publication bias&#44; and high precision in the results&#46; As for hair diameter&#44; it was assigned a very low-quality evidence rating &#40;&#43;&#43;&#41;&#46; This rating was based on several factors&#44; including a severe overall risk of bias&#44; high heterogeneity&#44; serious inconsistency&#44; lack of direct outcomes&#44; and imprecision in the results&#46; Assessment can be seen in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Meta-regression</span><p id="par0195" class="elsevierStylePara elsevierViewall">Results from meta-regression can be found in <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0200" class="elsevierStylePara elsevierViewall">R-squared measures the proportion of total variation in the outcome variable that is explained by the predictors in the model&#46; In this case&#44; the value of 0&#46;00&#37; suggests that the predictors included in the model explain very little of the total variation&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">The Wald Chi-Square test is used to assess the overall significance of the meta-regression model&#46; In this case&#44; the Chi-Square statistic is 2&#46;68&#44; and the p-value is 0&#46;6134&#46; Since the p-value is greater than the typical significance level of 0&#46;05&#44; the authors fail to reject the null hypothesis&#44; indicating that the overall model is not statistically significant&#46;</p></span></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Discussion</span><p id="par0210" class="elsevierStylePara elsevierViewall">Despite high heterogeneity&#44; which limits data pooling by meta-analysis&#44; the findings of this study indicate that PRP therapy can significantly increase hair density compared to placebo&#46; Evidence gathered from the included studies is of low quality&#44; and reports were conducted in various locations&#44; enhancing the external validity of the findings&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">One important aspect to highlight is the safety profile of PRP therapy&#46; No intolerable or high-risk adverse effects were reported in the patients included in this research&#46; The most common adverse effect observed was short-duration local pain&#44; which is consistent with previous studies&#46; Roohaninasab M et al&#46;&#44; in a review assessing the efficacy&#44; safety&#44; and adverse effects of PRP therapy&#44; also reported high efficacy and low risks associated with the intervention&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">51</span></a></p><p id="par0220" class="elsevierStylePara elsevierViewall">These findings are encouraging as they suggest that PRP therapy for AGA is not only effective but also safe&#46; However&#44; it is essential to note that the absence of reported adverse effects in the included studies does not guarantee the absence of potential risks&#46;</p><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Platelet-rich plasma mechanism</span><p id="par0225" class="elsevierStylePara elsevierViewall">The action of PRP in treating AGA is primarily attributed to the growth factors and cytokines present in the platelet concentrate&#46; These bioactive substances play a crucial role in stimulating anti-inflammatory&#44; angiogenic&#44; and proliferative pathways&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">52</span></a> The key factors associated with hair growth include Vascular Endothelial Growth Factor &#40;VEGF&#41;&#44; which is upregulated during the anagen phase and plays a role in determining the follicular size and inducing perifollicular angiogenesis&#59; Glial Cell Line-Derived Neurotrophic Factor &#40;GDNF&#41;&#44; which suppresses the transition to the catagen phase and exhibits a decline in expression over time during the anagen phase&#59; Insulin-like Growth Factor 1 &#40;IGF-1&#41;&#44; which synergistically works with GDNF to promote the proliferation of basal Ki67&#43; keratinocytes and prolong the anagen phase&#59; and Fibroblast Growth Factor 2 &#40;FGF-2&#41;&#44; which promotes dermal papilla proliferation and can be enhanced by adenosine application or in conjunction with nanoparticles&#46;<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">53&#8211;58</span></a></p><p id="par0230" class="elsevierStylePara elsevierViewall">Considering the importance of these factors&#44; pre-application regulation of them can be crucial in achieving optimal results&#46; Two studies included in this review examined the role of growth factors in hair regrowth&#46; Siah TW et al&#46; demonstrated a significant association between GDNF and hair density&#46; Additionally&#44; they observed a tendency towards a correlation between VEGF and FGF-2&#44; although this finding may have been limited by the sample size&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">40</span></a> Rodrigues BL et al&#46;&#44; although not establishing an explicit correlation between Epidermal Growth Factor &#40;EGF&#41;&#44; Platelet-Derived Growth Factor &#40;PDGF&#41;&#44; VEGF&#44; and aesthetic outcomes&#44; demonstrated an increase in hair density and the presence of anagen phase follicles&#44; which was not observed in the group treated with saline injection alone&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a></p><p id="par0235" class="elsevierStylePara elsevierViewall">These findings further support the hypothesis of the efficacy of platelet concentrate in promoting hair growth&#46; Moreover&#44; Gentile P et al&#46;&#44; although not directly studying growth factors&#44; also observed beneficial effects following PRP application&#44; including epidermal thickening&#44; increased perifollicular vascularization&#44; and an increase in ki67&#43; keratinocytes&#44; thereby reinforcing the action of PRP&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">46</span></a></p><p id="par0240" class="elsevierStylePara elsevierViewall">Qu Q&#44; in his analysis&#44; provided important information on alternative routes after studying mice pelage&#46; He suggests that PRP treatment can activate &#946;-Catenin&#44; PDGF&#44; and AKT signaling pathways&#44; coupled with suppression of p53 levels to induce hair growth&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">48</span></a> This provides new insights into future research directions that could lead to a better understanding of hair growth with PRP&#46;</p></span><span id="sec0110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Preparation methods</span><p id="par0245" class="elsevierStylePara elsevierViewall">The optimal technique for preparing PRP remains a subject of ongoing debate and investigation&#46; In an effort to identify the most effective preparation method&#44; Stevens J et al&#46; conducted a review of the available literature&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">59</span></a> Their findings suggested several recommendations&#44; including the use of subdermal bolus injections to minimize discomfort&#44; the incorporation of an activator&#44; monthly treatment intervals&#44; and preparation using the single-spin method&#46; These suggestions aimed to enhance treatment outcomes by optimizing the PRP preparation process&#46;</p><p id="par0250" class="elsevierStylePara elsevierViewall">In contrast with this&#44; our meta-analysis revealed that the use of a pre-application activator suggested slightly lower improvements in hair density when compared to non-active&#46; These findings indicate that pre-activating PRP prior to application may decrease its efficacy in promoting hair regrowth&#46; Despite this&#44; the difference found is very small&#46; Therefore&#44; the authors recommend that future studies explore the duality between pre-activation or not of PRP as a preparation method&#46;</p><p id="par0255" class="elsevierStylePara elsevierViewall">In contrast&#44; the Tawfik AA study employed a different approach&#44; with more frequent injections at weekly intervals using the double-spin method in women with alopecia&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">41</span></a> Remarkably&#44; this study demonstrated exceptional results&#44; showing sustained hair growth even after 6 months of treatment&#46; Similarly&#44; Singh S et al&#46; achieved significant outcomes by utilizing the double-spin method while excluding Platelet-Poor Plasma &#40;PPP&#41; and adopting less frequent monthly applications&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">43</span></a> These findings suggest that shorter intervals between injections and the utilization of the double-spin method may contribute to more effective hair density improvement&#46; Despite these data&#44; our subgroup meta-analysis of the spin method revealed greater differences with double spin&#46; However&#44; the difference was small between both preparations&#46;</p><p id="par0260" class="elsevierStylePara elsevierViewall">Study design is of utmost importance&#46; It&#8217;s interesting to note that our subgroup meta-analysis considering Intra&#47;Inter-subject comparisons presented better results with inter-subject designs&#46; This may be related to PRP spread in the scalp&#44; affecting placebo areas in intra-subject comparisons&#46; Accordingly&#44; research conducted with this design may suggest smaller effects&#46;</p><p id="par0265" class="elsevierStylePara elsevierViewall">Our last subgroup meta-analysis was related to gender&#44; in order to explain the high heterogeneity present&#46; Although it was capable of reducing heterogeneity&#44; the findings were not statistically significant&#46; Additionally&#44; the authors couldn&#8217;t ascertain individual-by-individual changes&#44; limiting our analysis capability&#46; More studies should be conducted exclusively on men and women for this issue to be answered&#46;</p><p id="par0270" class="elsevierStylePara elsevierViewall">Considering these findings&#44; it&#8217;s apparent that various preparation methods for PRP can yield positive results&#46; Further research is warranted to determine the optimal preparation technique for PRP in hair regrowth treatments&#46; Factors such as injection frequency&#44; activation protocols&#44; and the specific centrifugation method employed may all influence the efficacy of PRP treatment&#46; Future studies should aim to compare different preparation methods and evaluate their impact on hair regrowth outcomes to establish more precise guidelines for clinical practice&#46;</p></span><span id="sec0115" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Current therapy comparison</span><p id="par0275" class="elsevierStylePara elsevierViewall">Globally&#44; the treatment approach for AGA often involves the use of 5-alpha reductase inhibitors&#44; such as finasteride and dutasteride&#44; as well as topical solutions containing minoxidil&#44; an adenosine 5&#39;-triphosphate-sensitive potassium channel opener&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;60&#8211;62</span></a> Adil A and Godwin M conducted a systematic review and meta-analysis comparing the effects of these medications against placebo&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">63</span></a> The analysis revealed mean differences in hair density compared to placebo as follows&#58; finasteride 1&#160;mg&#160;&#61;&#160;18&#46;37 hairs&#47;cm<span class="elsevierStyleSup">2</span>&#44; minoxidil 5&#37;&#160;&#61;&#160;14&#46;94 hairs&#47;cm<span class="elsevierStyleSup">2</span>&#44; and 2&#37; minoxidil&#160;&#61;&#160;8&#46;11 hairs&#47;cm<span class="elsevierStyleSup">2</span>&#46; Notably&#44; finasteride exhibited high heterogeneity &#40;I<span class="elsevierStyleSup">2</span>&#160;&#61;&#160;91&#37;&#41;&#44; while minoxidil demonstrated negligible heterogeneity &#40;I<span class="elsevierStyleSup">2</span>&#160;&#61;&#160;0&#37;&#41;&#46;</p><p id="par0280" class="elsevierStylePara elsevierViewall">In the present review&#44; PRP therapy showed a mean difference of 27&#46;55 hairs&#47;cm<span class="elsevierStyleSup">2</span> compared to placebo&#44; which is higher than the improvement observed with finasteride&#46; However&#44; both PRP and finasteride exhibited high heterogeneity&#46; This improvement is clinically relevant&#44; as PRP provides a notable increase in hair density without the requirement for daily use and the risk of undesired collateral effects&#46; In addition&#44; the PRP mechanism of action differs from other hair treatments&#44; meaning it could be used in a combined therapy&#44; enhancing hair growth results even more&#46; These findings are consistent with the results reported by Gentile P et al&#46;&#44; who conducted a systematic review comparing PRP therapy to conventional treatments&#44; as well as with the findings of Singh S et al&#46; and Pakhomova EE&#44; who compared PRP to minoxidil and combined therapies&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">43&#44;64&#44;65</span></a> The evidence suggests that PRP therapy is more effective than minoxidil alone&#44; and combination therapy may offer even greater efficacy&#46; This suggests that PRP could be a viable treatment option for AGA&#46;</p><p id="par0285" class="elsevierStylePara elsevierViewall">In summary&#44; PRP therapy has shown promising results in improving hair density in AGA patients&#46; It appears to be a favorable treatment option when compared to finasteride and may provide enhanced efficacy when used in combination with other therapies&#46; These findings support the growing body of evidence highlighting the potential of PRP as a valuable therapeutic approach for managing AGA&#46;</p></span></span><span id="sec0120" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Limitations</span><p id="par0290" class="elsevierStylePara elsevierViewall">Our meta-analysis integrates the most up-to-date studies accessible within the discipline&#46; By incorporating the most recent research discoveries&#44; the authors have guaranteed that our analysis mirrors the present status of comprehension&#46; This facet holds substantial significance&#44; especially in swiftly developing domains where novel evidence can considerably influence treatment suggestions&#46; The authors have employed sophisticated statistical methods and methodological approaches to augment the exactitude and dependability of our findings&#46; Through cutting-edge meta-analytic and estimate techniques&#44; we&#8217;ve mitigated potential biases and heightened the precision of our estimations&#46;</p><p id="par0295" class="elsevierStylePara elsevierViewall">The authors have performed a thorough investigation of different subcategories within the encompassed research&#46; Through the process of categorizing the data according to pertinent variables including age&#44; gender&#44; spin&#44; and activator&#44; the authors have successfully delved into possible disparities in the impact of treatment across diverse populations&#46; This analysis of subgroups yields invaluable perspectives on the diversity of the findings and aids in the identification of particular patient attributes that might impact treatment results&#46;</p><p id="par0300" class="elsevierStylePara elsevierViewall">There&#8217;s evident huge heterogeneity in AGA severity between reports&#46; As shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#44; nine papers included high-grade AGA&#44; and five only included patients with less severe situations&#46; Heterogeneity could be attributed both to patient selection and measurement method&#44; in which there is no specification in reports if total hair density or terminal hair density was measured&#46; It&#8217;s important to note that some of the reported studies&#44; such as Rodrigues BL et al&#46;&#44; had differences in baseline hair density between groups&#46; This certainly influenced in final results&#44; as the PRP group indeed presented a better increase&#44; but couldn&#8217;t sufficiently impact to surpass the previous difference between groups&#46; In this sense&#44; Future research may focus on stratifying AGA severity groups for further evidence of PRP efficacy&#46;</p><p id="par0305" class="elsevierStylePara elsevierViewall">Despite the rigorous search process conducted in multiple databases and the inclusion of gray literature&#44; it&#8217;s possible that some relevant studies were missed&#44; which could introduce potential bias in the findings&#46;</p><p id="par0310" class="elsevierStylePara elsevierViewall">Another important limitation to consider is the inclusion of intra-subject studies&#44; which may introduce confounding factors&#46; The local-systemic spreading effect of PRP dissemination and the potential impact of regional needling on cellular regeneration pathways could influence the observed outcomes&#44; as suggested by the subgroup meta-analysis&#46; These factors should be taken into account when interpreting the results&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">42&#44;66</span></a></p><p id="par0315" class="elsevierStylePara elsevierViewall">Furthermore&#44; it is worth noting that the heterogeneity observed among the included studies&#44; as indicated by the high I&#178; values&#44; may also contribute to limitations in drawing definitive conclusions&#46; Albeit our struggle to group reports to minimize and dive into further explorations on heterogeneity&#44; included studies have small sample sizes&#44; differ in PRP protocols&#44; and present different follow-up times&#46; The variations in final platelet count after centrifugation are another spotlight topic&#44; as most spin methods don&#8217;t match in studies&#44; with numerous variations in time and revolutions per minute&#46; AGA severity in studies has deviated even in the same groups&#44; promoting more variability&#46; Our data approach may also have been intoxicated by the previous differences present in groups regarding AGA severity&#44; as reports such as Rodrigues BL et al&#46; presented an evident hair growth in the PRP group&#44; but wasn&#8217;t big enough to suppress the control group difference&#44; which didn&#8217;t present evident hair growth&#46; These variations in study designs&#44; patient characteristics&#44; and PRP preparation methods certainly influence treatment outcomes and introduce potential sources of bias&#46; Furthermore&#44; there is clear evidence of publication bias as shown by the asymmetry in the funnel plot&#46;</p><p id="par0320" class="elsevierStylePara elsevierViewall">To mitigate these limitations&#44; future research in this area should aim for larger sample sizes&#44; standardized protocols&#44; and longer follow-up periods&#46; Additionally&#44; conducting more studies with a randomized controlled trial design would enhance the quality of evidence and allow for a more comprehensive assessment of the efficacy and safety of PRP therapy for AGA&#46;</p><p id="par0325" class="elsevierStylePara elsevierViewall">Overall&#44; while this systematic review provides valuable insights into the current evidence on PRP therapy for AGA&#44; it is important to consider its limitations and interpret the findings with caution&#46;</p></span><span id="sec0125" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Conclusion</span><p id="par0330" class="elsevierStylePara elsevierViewall">Based on the available evidence from randomized clinical trials&#44; the use of PRP injections for the treatment of AGA has shown effectiveness in increasing hair density&#46; However&#44; it is important to note that the certainty of the evidence is currently at a low level&#44; and further robust studies are needed to strengthen the findings&#46; Finally&#44; this work highlights the lack of high-quality randomized clinical trials&#46; As well as the high heterogeneity and reports of low sample size claims for the need for well-conducted trials on the efficacy of PRP in AGA&#46;</p><p id="par0335" class="elsevierStylePara elsevierViewall">Recommendations for future research include using PRP preparations that exclude platelet-poor plasma&#44; pre-activating PRP before application&#44; and carefully considering confounding factors such as micro-needling or PRP diffusion&#44; when comparing results between individuals&#46; Additionally&#44; future studies should investigate the optimal frequency of PRP treatment intervals&#44; explore the effectiveness of the double-spin method for PRP preparation&#44; and evaluate the potential benefits of combining PRP therapy with other treatment modalities&#46;</p><p id="par0340" class="elsevierStylePara elsevierViewall">Overall&#44; while the current evidence supports the use of PRP injections for AGA&#44; further research is needed to enhance our understanding of its optimal use&#44; improve the certainty of the evidence&#44; and expand our knowledge of potential combination therapies&#46;</p></span><span id="sec0135" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0175">Financial support</span><p id="par0350" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0140" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0180">Authors&#8217; contributions</span><p id="par0355" class="elsevierStylePara elsevierViewall">Lucas Kieling&#58; The conception and design of the study&#59; Data collection&#44; or analysis and interpretation of data&#59; Statistical analysis&#59; Drafting the article or critically reviewing it for important intellectual content&#59; Obtaining&#44; analyzing and interpreting data&#59; Critical review of the literature&#59; Final approval of the final version of the manuscript&#46;</p><p id="par0360" class="elsevierStylePara elsevierViewall">Ana Terezinha Konzen&#58; The conception and design of the study&#59; Data collection&#44; or analysis and interpretation of data&#59; Statistical analysis&#59; Drafting the article or critically reviewing it for important intellectual content&#59; Obtaining&#44; analyzing and interpreting data&#59; Critical review of the literature&#59; Final approval of the final version of the manuscript&#46;</p><p id="par0365" class="elsevierStylePara elsevierViewall">Rafaela Koehler Zanella&#58; Drafting the article or critically reviewing it for important intellectual content&#59; Obtaining&#44; analyzing and interpreting data&#59; Critical review of the literature&#59; Final approval of the final version of the manuscript&#46;</p><p id="par0370" class="elsevierStylePara elsevierViewall">Denis Souto Valente&#58; Drafting the article or critically reviewing it for important intellectual content&#59; Obtaining&#44; analyzing and interpreting data&#59; Critical review of the literature&#59; Final approval of the final version of the manuscript&#46;</p></span><span id="sec0145" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0185">Conflicts of interest</span><p id="par0375" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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              "titulo" => "Hair diameter"
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          "identificador" => "sec0135"
          "titulo" => "Financial support"
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          "identificador" => "sec0140"
          "titulo" => "Authors&#8217; contributions"
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          "identificador" => "sec0145"
          "titulo" => "Conflicts of interest"
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        11 => array:1 [
          "titulo" => "References"
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    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2023-08-02"
    "fechaAceptado" => "2024-01-12"
    "PalabrasClave" => array:1 [
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1897731"
          "palabras" => array:4 [
            0 => "Alopecia"
            1 => "Meta-analysis"
            2 => "Platelet-rich plasma"
            3 => "Systematic review"
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    "resumen" => array:1 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentals</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Platelet-rich plasma &#40;PRP&#41; has been progressively more used in androgenetic alopecia &#40;AGA&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objectives</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">The authors aimed to evaluate PRP efficacy compared to placebo in AGA&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">A comprehensive search was conducted across seven databases&#44; until 01&#47;04&#47;2023&#46; Randomized clinical trials focusing on AGA and PRP use to increase hair density were included&#46; Patients aged between 15 and 63 years&#44; diagnosed with AGA characterized by Norwood I&#8210;VII and Ludwig I&#8210;III scales&#44; were included&#46; Studies with a sample size &#60;10&#44; lacking PRP processing method&#44; focusing on complementary therapies or other alopecias&#44; were excluded&#46; The authors conducted subgroup analysis for activator&#44; spin method&#44; study design&#44; risk of bias&#44; and gender&#46; Meta-regression was conducted for activator&#44; spin method&#44; design&#44; and gender&#46; The authors used GRADEpro to assess evidence certainty and the RoB-2 tool for risk of bias&#46; Asymmetry was measured through a Funnel plot followed by Egger&#8217;s test&#46; The protocol was registered at PROSPERO &#40;CRD42023407334&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">The authors screened 555 registers and included fourteen studies involving 431 patients for qualitative synthesis&#44; with 13 studies included in the meta-analysis&#46; Meta-analysis demonstrated a mean difference of 27&#46;55 hairs&#47;cm<span class="elsevierStyleSup">2</span> and 95&#37; CI &#40;14&#46;04&#59; 41&#46;06&#41;&#44; I<span class="elsevierStyleSup">2</span>&#160;&#61;&#160;95&#46;99&#37;&#44; p&#160;&#60;&#160;0&#46;05&#46; Hair diameter meta-analysis presented a mean difference of 2&#46;02&#160;&#956;m&#44; 95&#37; CI &#40;&#8722;0&#46;85&#160;&#956;m&#59; 4&#46;88&#160;&#956;m&#41;&#44; and I<span class="elsevierStyleSup">2</span>&#160;&#61;&#160;77&#46;11&#37; &#40;p&#160;&#61;&#160;0&#46;02&#41;&#46; That is&#44; low quality evidence&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Study limitations</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Studies were highly heterogeneous&#44; of low quality&#44; and presented evident publication bias&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusions</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Highly heterogeneous studies with publication bias suggest PRP effectively increases hair density in AGA&#44; so further high-quality randomized clinical trials are recommended to strengthen the evidence&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Study conducted at the Universidade Federal de Ci&#234;ncias da Sa&#250;de de Porto Alegre&#44; Porto Alegre&#44; RS&#44; Brazil&#46;</p>"
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            "apendice" => "<p id="par0385" class="elsevierStylePara elsevierViewall">The following is Supplementary data to this article&#58;<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Hair density forest plot&#46;</p>"
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        "etiqueta" => "Fig&#46; 4"
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        "figura" => array:1 [
          0 => array:4 [
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Characteristics&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sample &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Inter-subject comparison group&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57&#46;14&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Intra-subject comparison group&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">42&#46;86&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Use of activator</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-Active PRP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#46;00&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-Non-active PRP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">50&#46;00&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Geographical location</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>America&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">35&#46;71&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Asia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">28&#46;57&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Africa&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">14&#46;29&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Oceania&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Europa&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;43&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Increased Hair density</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92&#46;86&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;14&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Increased Hair diameter</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#46;71&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46;29&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Not measured&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#46;00&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Publication Year</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Before 2019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#46;71&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>2019-2023&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&#46;29&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">High Grade alopecia &#40;Stage&#160;&#62;&#160;IV NH and&#160;&#62;&#160;II Ludwig&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Included&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&#46;29&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Excluded&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#46;71&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "leyenda" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">NSDBG&#44; Not Significant Difference Between Groups&#59; SDBG&#44; Significant Difference Between Groups&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Author and Year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Financing&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Study design&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Comparator&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sample&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Follow up time&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PRP method&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Results&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Shapiro&#44; 2020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Regen Labs SA &#40;Le Mont-sur-Lausanne&#44; Switzerland&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Randomized clinical trial&#44; Half-Scalp&#44; intra-subject&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#44; 17 female and 18 male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 application per month for 3 months&#44; results were measured a month after treatment ended&#46; 0&#46;1&#8210;0&#46;2&#160;mL&#47;cm<span class="elsevierStyleSup">2</span> of PRP used&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#160;mL of blood centrifuged at 1500&#160;g&#44; using a thixotropic gel to prepare approximately 5&#160;mL of PRP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;NSDBG&#41;&#59; &#8593; Hair diameter &#40;NSDBG&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gressenberger&#44; 2020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Single-center&#44; randomized&#44; blinded pilot study inter-subject&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 male&#46; 20 PRP and 10 placebo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Five treatments were performed with 0&#46;1&#160;mL&#47;cm<span class="elsevierStyleSup">2</span> of PRP&#44; at intervals of 4&#8211;6 weeks&#46; Hair density measured at baseline&#44; 4 weeks&#44; and 6 months after treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#160;mL of blood collected in a tube containing sodium citrate&#46; used a single spin procedure &#40;2800 RPM for 9&#160;minutes&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8595; Hair density &#40;NSDBG&#41;&#59; &#8595; Hair diameter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Siah&#44; 2020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Supported by unrestricted funds from RepliCel Life Sciences Inc&#44; Vancouver&#44; Canada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Randomized&#44; intra-subject&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44; 9 female and 1 male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Five injections with 2 weeks interval each&#44; 0&#46;1&#160;mL&#47;cm<span class="elsevierStyleSup">2</span> of PRP was used&#46; Measurement at baseline&#44; after 4 weeks &#40;prior to 3<span class="elsevierStyleSup">rd</span>application&#41; and 8 weeks after treatment end&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#160;mL of venous blood was centrifuged at 300&#160;g at 18&#160;&#176;C for 5&#160;minutes&#44; PRP1 transferred and centrifuged at 700&#160;g at 18&#160;&#176;C for 17&#160;minutes&#44; after that Platelet-Poor Plasma &#40;PPP&#41; was removed and resuspended to form PRP2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;NSDBG&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Singh&#44; 2020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Institutional Research Grant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Single-center&#44; prospective&#44; randomized&#44; double-blind control trial&#44; inter-subject&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Minoxidil 5&#37;&#44; Placebo &#40;saline&#41;&#44; Minoxidil&#160;&#43;&#160;PRP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80&#46; all male&#46; 20 Minoxidil 5&#37; &#43; PRP&#44; 20 Minoxidil 5&#37;&#44; 20 PRP&#44; and 20 saline&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;05&#8211;0&#46;1&#160;mL&#47;cm<span class="elsevierStyleSup">2</span> of prp was injected&#44; treatment done 3 times with 1 month interval between each&#46; Measurement before treatment and documented every month for 5 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#160;mL of blood collected into a 2&#160;mL tube with 2&#46;8&#37; of sodium citrate&#46; Centrifugation at 2200&#160;rpm for 12&#160;minutes&#44; separation of buffy coat and plasma to 2<span class="elsevierStyleSup">nd</span>spin at 3000&#160;rpm for 6&#160;minutes&#46; 3&#8211;3&#46;5&#160;mL of PRP was obtained&#46; PRP was added to a syringe with calcium gluconate &#40;1&#58;9&#41; as an activator&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;NSDBG&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dicle&#44; 2018&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Akdeniz University&#44; Scientific Research Projects Coordination Unit&#44; Antalya&#44; Turkey&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Randomized&#44; placebo&#8208;controlled&#44; inter-subject crossover study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 male G1&#160;&#61;&#160;10&#44; G2&#160;&#61;&#160;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Monthly application for 3 months&#44; after that&#44; there was a 3-month wash-out&#46; Then&#44; crossover happened and placebo group received PRP&#46; Patients were evaluated three times&#58; at baseline &#40;M0&#41;&#44; at 4<span class="elsevierStyleSup">th</span>month &#40;M4&#41;&#44; and 9<span class="elsevierStyleSup">th</span>month &#40;M9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">A 28-cc blood sample was collected and mixed with citrate dextrose-A &#40;ACD-A&#41;&#46; 30 cc was transferred to a PRP tube and centrifuged at 1700&#160;G for 5&#160;minutes&#46; 5&#160;mL of PRP was loaded into a syringe and activated using a bio-activator before application&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;SDBG&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Rodrigues&#44; 2019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Supported by the National Council of Technological and Scientific Development&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Double-blinded investigative pilot prospective study&#44; randomized&#44; inter-subject&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 male&#46; PRP group &#40;n&#160;&#61;&#160;15&#41; and the control group &#40;n&#160;&#61;&#160;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 applications every 15 days&#44; with a total of 20 injections&#46; 100&#160;u&#160;L of PRP or saline solution per injection&#44; total of 2&#160;mL&#46; Hair density measured before the treatment&#44; 15 days and 3 months after end of treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Blood was collected in six 8&#46;5-mL acid citrate dextrose tubes&#44; one 4-mL ethylenediaminetetraacetic acid tube&#44; and 1 tube without anticoagulant&#46; Centrifuged at 300&#160;g for 5&#160;minutes at 18&#160;&#176;C&#44; and the upper fraction &#40;PRP1&#41; was separated without disturbing the buffy coat&#46; PRP1 was centrifuged at 700&#215;g for 17&#160;minutes at 18&#160;&#176;C&#46; The platelet pellet from PRP1 was resuspended in 300&#160;&#956;L PPP &#40;PRP2&#41;&#46; 20&#160;mM of CaCl2 and 25 IU&#47;mL human thrombin or CaCl2 alone were used to activate&#46; Incubation at 37&#160;&#176;C for 1&#160;hour and at 4&#160;&#176;C for 16&#160;hours&#46; The activated PRP2 was recovered by centrifugation at 3&#44;000&#215;g for 20&#160;minutes at 18&#160;&#176;C&#46; Autologous serum was used as an activator and prepared from the tube without anticoagulant&#58; after centrifugation at 1258&#160;g for 15&#160;minutes&#44; 1&#160;mL was separated and then added to the PRP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;Group 1 NSDBG&#59; Group 2 SDBG&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gentile&#44; 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Randomized&#44; evaluator-blinded&#44; intra-subject&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1&#160;mL&#47;cm<span class="elsevierStyleSup">2</span> of PRP was applied monthly for 3 months &#40;3 injections&#41;&#46; Evaluation happened before treatment &#40;T0&#41;&#44; 2&#40;T1&#41;&#44; 6&#40;T2&#41;&#44; 12&#40;T3&#41;&#44; 16&#40;T4&#41; and 24 &#40;T5&#41; months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#160;mL of blood were taken and centrifuged in two tubes containing sodium citrate at 1&#44;100&#160;g for 10&#160;minutes&#46; Then&#44; autologous PRP that was not activated after centrifugation &#40;9&#160;mL&#41; was switched to 10-mL tubes containing Ca2&#43; extracted by the Cascade-Selphyl-Esforax&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;SDBG&#41;&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tawfik&#44; 2018&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Randomized&#44; double-blinded&#44; intra-subject&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 treatments were done on each patient&#44; every week&#46; Patients were followed up at 6 months after the last session&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#160;mL blood was collected&#44; with 1&#46;5&#160;mL of sodium citrate as an anticoagulant&#46; Then&#44; centrifuged at 1200&#160;g for 15&#160;minutes&#46; Buffy coat was separated together with platelet poor plasma and centrifuged at 2000&#160;g for 10&#160;minutes&#46; PPP was discarded and platelet concentrate was loaded into a 1-mL insulin syringes containing calcium gluconate in a 1&#58;9 ratio &#40;0&#46;1&#160;mL calcium gluconate per 0&#46;9&#160;mL of PRP&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;SDBG&#41;&#59; &#8593; Hair diameter &#40;SDBG&#41;&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alves&#44; 2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Randomized&#44; double-blinded&#44; intra-subject&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#44; 12 men and 13 women&#46; 22 of those completed the treatment &#40;11&#58;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Monthly application of 0&#46;15&#160;mL&#47;cm<span class="elsevierStyleSup">2</span> for 3 months of patients were evaluated before&#44; after second&#44; third treatment and after 6 months of treatment end&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#160;mL of blood was transferred to a tube with 2&#160;mL of 3&#46;8&#37; sodium citrate&#46; Then&#44; centrifuged at 460&#160;g for 8&#160;minutes&#46; PPP was discarded and 3&#160;mL of PRP was obtained&#46; PRP was activated with 0&#46;15&#160;mL of 10&#37; calcium chloride&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;SDBG&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Qu&#44; 2021&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">National Natural Science Foundation of China&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Randomized&#44; double-blinded&#44; intra-subject&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 Male&#59; 20 female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PRP was injected on half-head of the alopecia areas in 0&#46;05- to 0&#46;1-mL&#59; Monthly session for 3&#160;m&#59; follow up 0&#44; 3&#160;m and 6&#160;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&#160;mL of blood in the Tricell kit&#46; 310&#160;g for 4&#160;min and next 300&#160;g for 3 min&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;SDBG&#41;&#59; &#8593; Hair diameter &#40;SDBG&#41;&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Chuah&#44; 2021&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">randomized&#44; double-blind&#44; intra-subject&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 male&#44; 18 female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 sessions&#44; three weeks interval&#46; evaluation at 0&#44; 3&#160;m&#44; and 6&#160;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">centrifugated 5&#160;min at 1500&#160;g&#44; tube contained sodium citrate solution&#44; as anticoagulant&#44; Removal of PPP&#46; Activation with calcium gluconate 1&#58;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;NSDBG&#41;&#59; &#8593; Hair diameter &#40;SDBG&#41;&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Toama&#44; 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Randomized&#44; inter-patient&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;PRP &#40;11 males and 9 females&#41; SALINE &#40;8 males and 12 females&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 sessions &#40;one session every two weeks&#41;&#46; Measured at 0&#59; 3&#160;m&#44; and 6&#160;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tubes with anticoagulant Na Citrate 3&#46;8&#37;&#46; Centrifuged at 1&#44;700&#160;rpm for 15&#160;minutes&#59; centrifuged again at 3&#44;000&#160;rpm for 10&#160;minutes&#59; discard PPP&#59; activation by calcium chloride 1&#58;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;SDBG&#41;&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dubin&#44; 2020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eclipse Aesthetics&#44; LLC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Randomized&#44; double-blind&#44; inter-patient&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 female &#40;15 PRP&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#160;m evaluation&#59; 3 monthly injections&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;500 revolutions per minute for 10&#160;minutes&#46; PPP removed&#46; The remaining 4&#46;0&#160;mL of supernatant was gently inverted in the vacutainer 7 times to re-suspend the platelets within the plasma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;SDBG&#41;&#59; &#8593; Hair diameter &#40;SDBG&#41;&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gentile&#44; 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Randomized&#44; double-blind&#44; intra-patient&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Placebo-controlled &#40;saline&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 male &#40;9 PRP&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#160;m evaluation&#59; 3 monthly injections&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Centrifugation &#40;1200&#160;rpm for 10&#160;min&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8593; Hair density &#40;SDBG&#41;&#59;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">On androgenetic alopecia&#44; does autologous platelet-rich plasma&#44; compared to placebo&#44; increases hair density and hair thickness&#44; in randomized clinical trials&#63;</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead colgroup " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Patient or population&#58;</span> Androgenetic alopecia<span class="elsevierStyleBold">Setting&#58;</span><span class="elsevierStyleBold">Intervention&#58;</span> Platelet-rich Plasma<span class="elsevierStyleBold">Comparison&#58;</span> Placebo</td></tr></tbody></table>
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            1 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowgroup " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Outcomes</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowgroup " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&#8470; of participants &#40;studies&#41; Follow-up</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowgroup " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Certainty of the evidence &#40;GRADE&#41;</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowgroup " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Relative effect &#40;95&#37; CI&#41;</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Anticipated absolute effects</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Risk with Placebo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Risk difference with Platelet-rich Plasma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Incresead Hair Density assessed with&#58; n&#47;cm<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">609 &#40;13 RCTs&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#10753;&#10753;&#9711;&#9711; Low<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">MD <span class="elsevierStyleBold">27&#46;55 hairs&#47;cm&#178; higher</span> &#40;14&#46;04 higher to 41&#46;06 higher&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hair Thickness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">294 &#40;5 RCTs&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#10753;&#9711;&#9711;&#9711; Very low<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">MD <span class="elsevierStyleBold">2&#46;02&#160;&#181;m more</span> &#40;0&#46;85 fewer to 4&#46;88 more&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&#42;<span class="elsevierStyleBold">The risk in the intervention group</span> &#40;and its 95&#37; confidence interval&#41; is based on the assumed risk in the comparison group and the <span class="elsevierStyleBold">relative effect</span> of the intervention &#40;and its 95&#37; CI&#41;&#46; <span class="elsevierStyleBold">CI&#58;</span> confidence interval&#59; <span class="elsevierStyleBold">MD&#58;</span> mean difference</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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Article information
ISSN: 03650596
Original language: English
DOI:10.1016/j.abd.2024.01.002
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