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This slot game with high volatility features Pay Anywhere option that rewards players when they hit 8 or more matching symbols on the reels. The game also offers a Free Spins bonus with multipliers up to 500x your bet. A pragmatic study that involves different investigators and participants from diverse geographical locations is the Home Blood Pressure Management study (HBPM). This type of heterogeneity is necessary for practical trials to be valid and also helps to reduce the chance of bias in the results. A high degree of heterogeneity, however could cause issues with the design of the trial. Pragmatic Play Pragmatic Play, one of the major players in the live casino market, provides various classic table games like Blackjack and Roulette. The live studios of the company in Romania and Malta provide customers with an authentic experience in gambling and a wide selection of virtual betting options. 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Schwartz and Lellouch1 made an distinction between explanation-based studies, which confirm the physiological hypothesis or clinical hypothesis, and pragmatic trials, which inform policy and practice decision-making. They also suggested a framework dubbed PRECIS for pragmatic trials.2 This tool attempted to define the elements of a practical study that includes recruitment, design, delivery of the intervention and follow-up. The number of pragmatic trials is increasing. A recent Medline search using the words pragmatic and naturalistic, limited to randomised controlled trials (RCTs), returned 34 articles. These are shown in red on Figure 2. This suggests that the health sciences community has become more aware of the importance of pragmatic thinking. It is important to keep in mind that the majority of these studies were conducted in primary care settings.