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The high-risk slot game features Pay Anywhere option that rewards players when they land 8 or more identical symbols anywhere in the reels. It also includes a lucrative Free Spins feature with multipliers that can be as high as 500x bet. A practical trial that employs different investigators and participants from different geographical areas is the Home Blood Pressure Management study (HBPM). This kind of heterogeneity, which is essential for a pragmatic trial to be valid and lessen the chance of bias, is also necessary. A high degree of heterogeneity, however can result in problems with the trial design. Pragmatic Play is also a major player on the live casino market, providing a wide selection of table games that are classic such as Blackjack and Roulette in various versions. The company's live studios in Romania and Malta offer a real-life gambling experience for customers, as well as an extensive selection of virtual betting options. 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Legality Pragmatic Play is renowned for its top-quality games and for offering an exceptional user experience. Its software is designed to work with mobile devices and supports different languages. Despite its relatively young age, it has already established itself as a leading gaming platform for casinos. Its latest releases include Wolves, a 5-reel video slot that has a healthy RTP and impressive graphics. Other notable games include Wolf Gold and Chilli Heat. The goal of pragmatic trials is to simulate real-life scenarios and gain maximum credibility externally. They are usually commissioned by policy makers and practitioners to guide their decision-making. They are also a good method of determining the causality between an intervention and its outcomes. However, they should not be used as a substitute for explanation trials. The pragmatism idea is controversial, and there are questions about whether pragmatic trials should replace or complement them. Schwartz and Lellouch1 suggested the distinction between explanation studies, which prove the validity of a physiological or clinical hypothesis, as well as pragmatic trials, which inform the practice and policy decision-making. They also suggested the framework for pragmatic trials, dubbed PRECIS.2 This tool attempted to define the characteristics of a pragmatic study, including the recruitment process, the design and implementation of the intervention, and monitoring. The number of pragmatic trials is increasing. A recent Medline search using the keywords pragmatic and naturalistic, restricted to controlled trials randomized to control (RCTs) resulted in 34 articles, shown in red in Figure 2. This indicates that the health sciences community has become more aware of the importance of pragmatism. It is important to keep in mind, however, that the majority of these studies were conducted in primary-care settings.