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This high-volatility slot game has the Pay Anywhere option that pays players when they hit 8 or more matching symbols anywhere in the reels. It also has an extremely lucrative Free Spins feature with multipliers that can go up to 500x the bet. A practical trial that employs a variety investigators and includes participants from diverse geographical locations is the Home Blood Pressure Management study (HBPM). This type of heterogeneity is required for pragmatic trials to be valid and also helps reduce the chance of bias in the results. Too much heterogeneity, however could cause issues with the trial design. Pragmatic Play Pragmatic Play, one of the major players in the live casino market offers various classic table games like Blackjack and Roulette. The live studios of the company in Romania and Malta provide a genuine gambling experience for players and offer an extensive selection of virtual betting options. 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Legality Pragmatic Play has earned a name for itself by providing top-quality games and an outstanding user experience. Its software is designed to work with mobile devices and supports various languages. Despite its relatively young age, it has already established itself as a premier casino gaming platform. Its latest releases include Wolves, a 5-reel video slot with a healthy RTP and stunning graphics. Other notable titles include Wolf Gold and Chilli Heat. The aim of pragmatic trials is to replicate real-life situations and achieve maximum validity externally. They are usually commissioned by practitioners and policy makers to aid in their decision-making. They are also a good method to determine the causality between an intervention and its results. They should not, however be used to replace explanation studies. The idea of pragmatism is controversial and there are doubts about whether pragmatic trials can be used to replace explanation tests or if they should serve as an addition to them. Schwartz and Lellouch1 proposed an distinction between explanation-based studies, which support the physiological hypothesis or clinical hypothesis, as well as pragmatic trials that aid in the practice and policy decision-making. They also suggested a framework dubbed PRECIS for pragmatic trials.2 This tool tried to define the elements of a pragmatic research study which includes the recruitment, design, and delivery of the intervention and follow-up. There is an encouraging trend in the number of pragmatic trials published. A recent Medline query that used the words pragmatic and naturalistic, which was restricted to randomised controlled trials (RCTs) returned 34 articles. These are shown in red on Figure 2. This is an indication that the health sciences community is becoming increasingly sensitized to the issue of pragmatic thinking. It is important to keep in mind that the majority of these trials were conducted in primary care settings.