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This slot game with high volatility features the Pay Anywhere option that rewards players when they hit 8 or more identical symbols anywhere in the reels. It also comes with an extremely lucrative Free Spins feature with multipliers that can go up to 500x bet. Another example of a trial that is pragmatic is the Home Blood Pressure Management (HBPM) study, which employed different investigators and had participants from different geographic areas. This type of heterogeneity that is crucial for pragmatic trials to be reliable and to reduce bias in the results, is also necessary. However, too much heterogeneity can lead to problems with the design of the trial. Pragmatic Play is also a major player on the live casino market, offering a wide selection of table games like as Blackjack and Roulette in various versions. The live studios of the company in Romania and Malta offer a real-life gaming experience for its customers, as well as a wide range of virtual betting options. 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Legality Pragmatic Play is known for its top-quality games and for offering an exceptional user experience. The software is available on mobile devices and in multiple languages. It has been recognized as one of the leading casino gaming platforms despite its relatively young age. Its latest releases include Wolves 5 reel video slot with a healthful RTP and stunning graphics. Other notable games include Wolf Gold and Chilli Heat. Pragmatic trials seek to replicate real-life settings and achieve maximum external validity. They are usually requested by policy makers and practitioners to guide their decision-making. They can also be used to determine the cause-effect relationship of an intervention and its results. However, they should not be used to replace explanatory studies. The concept of pragmatism is controversial, and there are doubts about whether pragmatic trials should replace or complement them. Schwartz and Lellouch1 proposed the distinction between explanation studies, which confirm the validity of a physiological or clinical hypothesis, as well as pragmatic trials, that inform the practice and policy decision-making. They also suggested a framework dubbed PRECIS for pragmatic trials.2 This tool tried to define the traits of a practical study, including recruitment, design, implementation of the intervention, and follow-up. There is a growing increase in the number pragmatic trials published. A recent Medline search using the words naturalistic and pragmatic, restricted to randomised controlled trials (RCTs), returned 34 articles. They are displayed in red on Figure 2. This indicates that the health sciences community is becoming more aware of the importance of pragmatism. It is important to keep in mind that the majority of these studies were conducted in primary care settings.