The SAS difference before and after the treatment of STEC (upper panels) and EC alone (the lower panels). A and C: The pre- and post-SAS. B and D: the pre-post difference of SAS score. STEC treatment reduced SAS in both years (A). However, EC alone did not improve SAS in 2020, instead the SAS was increased significantly in the 2nd assessment (C). Correspondingly, STEC produced a slightly better improvement in SAS in 2019 than in 2020, but improvement by EC alone was much better in 2019 than in 2020, in which SAS was deteriorated. The number of symbols (*, $ or #) represents the level of significance, with 1, 2 or 3 symbols for ρ < 0.05, 0.01, or 0.001 respectively. STEC: sound therapy + educational counseling, EC: educational counseling.