The line graph (Panel A) shows the temporal trends in SCRs. The boxplots (Panel B) show the annual SCRs. SCR was highest in 2013, then decreased and stabilized after 2015. Difference in SCRs over 5 years were significant (P = 0.002). SCRs were significantly different among the years 2013, 2014, and 2015 (P = 0.002), but not among the years 2015, 2016, and 2017. (P = 0.926).