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The high-risk slot game features Pay Anywhere option that rewards players when they hit eight or more matching symbols on the reels. It also includes a lucrative Free Spins feature with multipliers that can be as high as 500x bet. Another example of a trial that is pragmatic is the Home Blood Pressure Management (HBPM) study, which utilized a variety of investigators and included participants from different geographic areas. This kind of heterogeneity is required for practical trials to be valid, and it also helps reduce bias in the results. However, too much heterogeneity, can cause problems with the trial design. Pragmatic Play is also a major player in the live casino market, providing an extensive selection of table games that are classic such as Blackjack and Roulette in a variety of versions. The company's live studios in Romania and Malta offer a real-life gaming experience for its customers, as well as an extensive selection of virtual betting options. 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Legality Pragmatic Play is renowned for its top-notch games, and also for providing an outstanding user experience. Its software is designed to work on mobile devices and is compatible with various languages. Despite its relative youth it has established itself as a top gaming platform for casinos. Wolves is one of its latest releases, a 5-reel slot machine with a healthy RTP and stunning graphics. The other notable titles include Wolf Gold and Chilli Heat. Pragmatic trials are designed to replicate real-life settings and achieve maximum external validity. They are usually requested by policy makers and practitioners to inform their decision making. They can be used to determine the cause-effect relationship of an intervention and its effects. However, they should not, be used to replace explanatory studies. The concept 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 alternative to them. Schwartz and Lellouch1 proposed a distinction between explanatory studies, which support the validity of a physiological or clinical hypothesis, as well as pragmatic trials, which inform policy and practice decision-making. They also suggested the framework for pragmatic trials, dubbed PRECIS.2 This tool attempted to define the elements of a pragmatic study that include recruitment, design and delivery of the intervention, and the follow-up. The number of pragmatic trials is growing. A recent Medline search using the terms naturalistic and pragmatic, limited to randomized controlled trials (RCTs) resulted in 34 articles, as shown in red in Figure 2. This suggests that the health sciences community has become more aware of the importance of pragmatism. It is important to remember that the majority of these trials were conducted in primary care settings.