In Minecraft 1.20.1 and below, health boost is bugged and doesn't work properly when given repeatedly.

This is the bug report on Jira relative to this issue: https://bugs.mojang.com/browse/MC-25088
(only fixed in a 1.20.2 snapshot and onwards)

I'm no modder but, a solution to this might be to make Carnage its own effect for a couple of reasons:

• Give Temporary Max HP Attribute instead of bugged health boost
• Tweak twinstrike to work with Carnage effect instead of Health Boost
• Carnage can be assigned the same duration as Exhaustion/Rage to avoid effects lasting longer than intended
• Immobilizing Aura stays as its own effect w/ Carnage