Dual-stage feedback network for lightweight color image compression artifact reduction.

Lossy image coding techniques usually result in various undesirable compression artifacts. Recently, deep convolutional neural networks have seen encouraging advances in compression artifact reduction. However, most of them focus on the restoration of the luma channel without considering the chroma components. Besides, most deep convolutional neural networks are hard to deploy in practical applications because of their high model complexity. In this article, we propose a dual-stage feedback network (DSFN) for lightweight color image compression artifact reduction. Specifically, we propose a novel curriculum learning strategy to drive a DSFN to reduce color image compression artifacts in a luma-to-RGB manner. In the first stage, the DSFN is dedicated to reconstructing the luma channel, whose high-level features containing rich structural information are then rerouted to the second stage by a feedback connection to guide the RGB image restoration. Furthermore, we present a novel enhanced feedback block for efficient high-level feature extraction, in which an adaptive iterative self-refinement module is carefully designed to refine the low-level features progressively, and an enhanced separable convolution is advanced to exploit multiscale image information fully. Extensive experiments show the notable advantage of our DSFN over several state-of-the-art methods in both quantitative indices and visual effects with lower model complexity.

Optimal IOFL-based economic model predictive control technique for boiler-turbine system.

The optimal control design of the boiler-turbine system is vital to ensure feasibility and high responsiveness over desired load variations. Using the traditional linear control techniques realization of this task is difficult, as the boiler-turbine mechanism has strong nonlinearities. Besides, environmental and economic concerns have replaced existing tracking control ones as the primary concerns of advanced power plants. Thus, this study proposes an optimal economic model predictive controller (EMPC) scheme for this unit on the basis of the input/output feedback linearization (IOFL) method. By employing the IOFL method, this unit is decoupled into a new linearized model that is utilized for developing the suggested optimal IOFL EMPC technique. The proposed control scheme is formulated in an economic quadratic programming form that considers the input-rate and input limits of the unit for optimal economic performance. In addition, an adaptive iterative algorithm is utilized for constraints mapping with guaranteeing a feasible solution in a finite number of steps without violation of original constraints over the entire predictive horizon. The outcomes of the simulation show that the suggested optimal IOFL EMPC scheme offers an improved dynamic and economic output performance over fuzzy hierarchical MPC, fuzzy EMPC, and nonlinear EMPC techniques during various load variations.

Curative effect of hydrogen peroxide combined with silver ion disinfection on pelvic floor dysfunction.

BACKGROUND: Pelvic floor dysfunction (PFD) is related to muscle fiber tearing during childbirth, negatively impacting postpartum quality of life of parturient. Appropriate and effective intervention is necessary to promote PFD recovery. AIM: To analyze the use of hydrogen peroxide and silver ion disinfection for vaginal electrodes in conjunction with comprehensive rehabilitation therapy for postpartum women with PFD. METHODS: A total of 59 women with PFD who were admitted to the hospital from May 2019 to July 2022 were divided into two groups: Control group (n = 27) received comprehensive rehabilitation therapy and observation group (n = 32) received intervention with pelvic floor biostimulation feedback instrument in addition to comprehensive rehabilitation therapy. The vaginal electrodes were disinfected with hydrogen peroxide and silver ion before treatment. Intervention for both groups was started 6 weeks postpartum, and rehabilitation lasted for 3 months. Pelvic floor muscle voltage, pelvic floor muscle strength, vaginal muscle voltage, vaginal muscle tone, pelvic floor function, quality of life, and incidence of postpartum PFD were compared between the two groups. RESULTS: Before comprehensive rehabilitation treatment, basic data and pelvic floor function were not significantly different between the two groups. After treatment, the observation group showed significant improvements in the maximum voltage and average voltage of pelvic floor muscles, contraction time of type I and type II fibers, pelvic floor muscle strength, vaginal muscle tone, vaginal muscle voltage, and quality of life (GQOLI-74 reports), compared with the control group. The observation group had lower scores on the pelvic floor distress inventory (PFDI-20) and a lower incidence of postpartum PFD, indicating the effectiveness of the pelvic floor biostimulation feedback instrument in promoting the recovery of maternal pelvic floor function. CONCLUSION: The combination of the pelvic floor biostimulation feedback instrument and comprehensive rehabilitation nursing can improve pelvic floor muscle strength, promote the recovery of vaginal muscle tone, and improve pelvic floor function and quality of life. The use of hydrogen peroxide and silver ion disinfectant demonstrated favorable antibacterial efficacy and is worthy of clinical application.

From Reporting to Improving: How Root Cause Analysis in Teams Shape Patient Safety Culture.

Background: Given the increasing focus on patient safety in healthcare systems worldwide, understanding the impact of Continuous Quality Improvement Programs (QIPs) is crucial. QIPs, including Morbidity and Mortality Conferences (MMCs) and Experience Feedback Committees (EFCs), have been identified as effective strategies for enhancing patient safety culture. These programs engage healthcare professionals in the identification and analysis of adverse events to foster a culture of safety (ie the product of individual and group value, attitudes, and perceptions about quality and safety). This study aimed to determine whether patient safety culture differed regarding care provider participation in MMCs and EFCs activities. Methods: A cross-sectional web-only survey was conducted in 2022 using the Hospital Survey on Patient Safety Culture (HSOPS) among 4780 employees at an 1836-bed, university-affiliated hospital in France. We quantified the mean differences in the 12 HSOPS dimension scores according to MMCs and EFCs participation, using Cohen d effect size. We performed a multivariate analysis of variance to examine differences in dimension scores after adjusting for background characteristics. Results: Of 4780 eligible employees, 1457 (30.5%) participated in the study. Among the respondents, 571 (39.2%) participated in MMCs or EFCs activities. Participants engaged in MMCs or EFCs reported significantly higher scores in six out of twelve HSOPS dimensions, particularly in "Nonpunitive response to error", "Feedback and communication about error", and "Organizational learning" (Overall effect size = 0.14, 95% confidence interval = 0.11 to 0.17, P<0.001). Notably, involvement in both MMCs and EFCs was associated with higher improvements in patient safety culture compared to non-participation or singular involvement in either program. However, certain dimensions such as "Staffing", "Hospital management support", and "Hospital handoffs and transition" showed no significant association with MMCs or EFCs participation, highlighting broader systemic challenges. Conclusion: The study confirms the positive association between participation in MMCs or EFCs and an enhanced culture of patient safety, emphasizing the importance of such programs in fostering an environment conducive to learning, communication, and nonpunitive responses to errors. While MMCs or EFCs are effective in promoting certain aspects of patient safety culture, addressing broader systemic challenges remains crucial for comprehensive improvements in patient safety.

Iron Nanostructure Primes Arbuscular Mycorrhizal Fungi Symbiosis Tightly Connecting Maize Leaf Photosynthesis via a Nanofilm Effect.

It is crucial to clarify how the iron nanostructure activates plant growth, particularly in combination with arbuscular mycorrhizal fungi (AMF). We first identified 1.0 g·kg-1 of nanoscale zerovalent iron (nZVI) as appropriate dosage to maximize maize growth by 12.7-19.7% in non-AMF and 18.9-26.4% in AMF, respectively. Yet, excessive nZVI at 2.0 g·kg-1 exerted inhibitory effects while FeSO4 showed slight effects (p > 0.05). Under an appropriate dose, a nano core-shell structure was formed and the transfer and diffusion of electrons between PS II and PS I were facilitated, significantly promoting the reduction of ferricyanide and NADP (p < 0.05). SEM images showed that excessive nZVI particles can form stacked layers on the surface of roots and hyphae, inhibiting water and nutrient uptake. TEM observations showed that excessive nanoparticles can penetrate into root cortical cells, disrupt cellular homeostasis, and substantially elevate Fe content in roots (p < 0.05). This exacerbated membrane lipid peroxidation and osmotic regulation, accordingly restricting photosynthetic capacity and AMF colonization. Yet, appropriate nZVI can be adhered to a mycelium surface, forming a uniform nanofilm structure. The strength of the mycelium network was evidently enhanced, under an increased root colonization rate and an extramatrical hyphal length (p < 0.05). Enhanced mycorrhizal infection was tightly associated with higher gas exchange and Rubisco and Rubisco enzyme activities. This enabled more photosynthetic carbon to input into AMF symbiont. There existed a positive feedback loop connecting downward transfer of photosynthate and upward transport of water/nutrients. FeSO4 only slightly affected mycorrhizal development. Thus, it was the Fe nanostructure but not its inorganic salt state that primed AMF symbionts for better growth.

Feedback Interventions in Motor Recovery of Lateropulsion after Stroke: A Literature Review and Case Series.

Lateropulsion is a post-stroke phenomenon marked by an active push of the body across the midline towards the more affected side and/or a resistance of the weight shift towards the less affected side. Within the mechanisms of treatment, feedback systems have been shown to be effective. The aim of the present study was to create a body of knowledge by performing a literature review on the use of feedback mechanisms in the treatment of lateropulsion and to report two cases of lateropulsion patients who had undergone feedback-based treatment. METHODS: The review was performed across five different databases (Embase, Medline/PubMed, Scopus, Web of Science, and PEDro) up to February 2024, and haptic feedback intervention was incorporated into the case series (with lateropulsion and ambulation capacity as the main variables). RESULTS: In total, 211 records were identified and 6 studies were included after the review of the literature. The most used feedback modality was visual feedback. In the case series, positive results were observed from the intervention, particularly in the recovery of lateropulsion and balance, as well as in the improvement of gait for one patient. Patients demonstrated good adherence to the intervention protocol without adverse effects. CONCLUSIONS: Visual feedback is the most commonly used feedback modality in lateropulsion patients but other mechanisms such as haptic feedback also are feasible and should be taken into account. Larger sample sizes, extended follow-up periods, and the isolation of feedback mechanisms must be established to clarify evidence.

Neurophysiological Oscillatory Mechanisms Underlying the Effect of Mirror Visual Feedback-Induced Illusion of Hand Movements on Nociception and Cortical Activation.

Mirror Visual Feedback (MVF)-induced illusion of hand movements produces beneficial effects in patients with chronic pain. However, neurophysiological mechanisms underlying these effects are poorly known. In this preliminary study, we test the novel hypothesis that such an MVF-induced movement illusion may exert its effects by changing the activity in midline cortical areas associated with pain processing. Electrical stimuli with individually fixed intensity were applied to the left hand of healthy adults to produce painful and non-painful sensations during unilateral right-hand movements with such an MVF illusion and right and bilateral hand movements without MVF. During these events, electroencephalographic (EEG) activity was recorded from 64 scalp electrodes. Event-related desynchronization (ERD) of EEG alpha rhythms (8-12 Hz) indexed the neurophysiological oscillatory mechanisms inducing cortical activation. Compared to the painful sensations, the non-painful sensations were specifically characterized by (1) lower alpha ERD estimated in the cortical midline, angular gyrus, and lateral parietal regions during the experimental condition with MVF and (2) higher alpha ERD estimated in the lateral prefrontal and parietal regions during the control conditions without MVF. These preliminary results suggest that the MVF-induced movement illusion may affect nociception and neurophysiological oscillatory mechanisms, reducing the activation in cortical limbic and default mode regions.

The Impact of the Cost of Travel Time and Feedback Type on Green Travel.

Green travel is a special type of pro-environmental behavior, which requires people to pay a time cost to reduce carbon emissions. This study explored the impact of the cost of travel time and feedback types on green travel. To verify the change of travel choice under different time costs, experiment 1 explored the impact of different costs of travel time on green travel. The results showed that with the increase in time cost, green travel behavior gradually decreased. This suggests that time costs can hinder green travel behavior. To intervene in this negative effect, experiment 2 explored the effects of different types of feedback intervention. The results showed that both environmental and health feedback could only intervene with green travel behavior when the time costs were low. This indicates that health and environmental feedback can intervene in the negative effects of travel time cost, but the cost range of the intervention is limited. This study has implications for promoting green travel behavior.

Efficient multi-stage feedback attention for diverse lesion in cancer image segmentation.

In the domain of Computer-Aided Diagnosis (CAD) systems, the accurate identification of cancer lesions is paramount, given the life-threatening nature of cancer and the complexities inherent in its manifestation. This task is particularly arduous due to the often vague boundaries of cancerous regions, compounded by the presence of noise and the heterogeneity in the appearance of lesions, making precise segmentation a critical yet challenging endeavor. This study introduces an innovative, an iterative feedback mechanism tailored for the nuanced detection of cancer lesions in a variety of medical imaging modalities, offering a refining phase to adjust detection results. The core of our approach is the elimination of the need for an initial segmentation mask, a common limitation in iterative-based segmentation methods. Instead, we utilize a novel system where the feedback for refining segmentation is derived directly from the encoder-decoder architecture of our neural network model. This shift allows for more dynamic and accurate lesion identification. To further enhance the accuracy of our CAD system, we employ a multi-scale feedback attention mechanism to guide and refine predicted mask subsequent iterations. In parallel, we introduce a sophisticated weighted feedback loss function. This function synergistically combines global and iteration-specific loss considerations, thereby refining parameter estimation and improving the overall precision of the segmentation. We conducted comprehensive experiments across three distinct categories of medical imaging: colonoscopy, ultrasonography, and dermoscopic images. The experimental results demonstrate that our method not only competes favorably with but also surpasses current state-of-the-art methods in various scenarios, including both standard and challenging out-of-domain tasks. This evidences the robustness and versatility of our approach in accurately identifying cancer lesions across a spectrum of medical imaging contexts. Our source code can be found at https://github.com/dewamsa/EfficientFeedbackNetwork.

Prospective Audit and Feedback for Antimicrobial Treatment of Patients Receiving Renal Replacement Therapy in Community-Based University Hospitals: A before-and-after Study.

In South Korea, because of manpower and budgetary limitations, antimicrobial stewardship programs have relied on preauthorization. This study analyzed the impact of a prospective audit and feedback (PAF) program targeting inpatients undergoing intermittent hemodialysis or continuous renal replacement therapy, which was implemented at two community-based university hospitals. During three years of PAF, 27,906 antimicrobial prescriptions were reviewed, with 622 (2.2%) interventions. The mean incidence density per 1000 patient days of multidrug-resistant organisms, except for carbapenem-resistant Acinetobacter baumannii, decreased in the study population, whereas it increased among inpatients. Multivariable Poisson regression analysis revealed that after PAF, the incidences of vancomycin-resistant Enterococcus and mortality decreased (incidence risk ratio, 95% confidence interval: 0.53, 0.31-0.93 and 0.70, 0.55-0.90, respectively). Notably, after PAF, incorrect antimicrobial dosing rates significantly decreased (tau -0.244; p = 0.02). However, the incidences of other multidrug-resistant organisms, Clostridioides difficile, length of stay, and readmission did not significantly change. This study shows that in patients undergoing intermittent hemodialysis or continuous renal replacement, targeted PAF can significantly reduce multidrug-resistant organism rates and all-cause hospital mortality, despite limited resources. Furthermore, it can improve antimicrobial dosage accuracy.

Noises on-How the Brain Deals with Acoustic Noise.

What is noise? When does a sound form part of the acoustic background and when might it come to our attention as part of the foreground? Our brain seems to filter out irrelevant sounds in a seemingly effortless process, but how this is achieved remains opaque and, to date, unparalleled by any algorithm. In this review, we discuss how noise can be both background and foreground, depending on what a listener/brain is trying to achieve. We do so by addressing questions concerning the brain's potential bias to interpret certain sounds as part of the background, the extent to which the interpretation of sounds depends on the context in which they are heard, as well as their ethological relevance, task-dependence, and a listener's overall mental state. We explore these questions with specific regard to the implicit, or statistical, learning of sounds and the role of feedback loops between cortical and subcortical auditory structures.

Mathematical analysis of simple behavioral epidemic models.

COVID-19 highlighted the importance of considering human behavior change when modeling disease dynamics. This led to developing various models that incorporate human behavior. Our objective is to contribute to an in-depth, mathematical examination of such models. Here, we consider a simple deterministic compartmental model with endogenous incorporation of human behavior (i.e., behavioral feedback) through transmission in a classic Susceptible-Exposed-Infectious-Recovered (SEIR) structure. Despite its simplicity, the SEIR structure with behavior (SEIRb) was shown to perform well in forecasting, especially compared to more complicated models. We contrast this model with an SEIR model that excludes endogenous incorporation of behavior. Both models assume permanent immunity to COVID-19, so we also consider a modification of the models which include waning immunity (SEIRS and SEIRSb). We perform equilibria, sensitivity, and identifiability analyses on all models and examine the fidelity of the models to replicate COVID-19 data across the United States. Endogenous incorporation of behavior significantly improves a model's ability to produce realistic outbreaks. While the two endogenous models are similar with respect to identifiability and sensitivity, the SEIRSb model, with the more accurate assumption of the waning immunity, strengthens the initial SEIRb model by allowing for the existence of an endemic equilibrium, a realistic feature of COVID-19 dynamics. When fitting the model to data, we further consider the addition of simple seasonality affecting disease transmission to highlight the explanatory power of the models.

Suppressing Thermal Noise to Sub-Millikelvin Level in a Single-Spin Quantum System Using Realtime Frequency Tracking.

A single nitrogen-vacancy (NV) center in a diamond can be used as a nanoscale sensor for magnetic field, electric field or nuclear spins. Due to its low photon detection efficiency, such sensing processes often take a long time, suffering from an electron spin resonance (ESR) frequency fluctuation induced by the time-varying thermal perturbations noise. Thus, suppressing the thermal noise is the fundamental way to enhance single-sensor performance, which is typically achieved by utilizing a thermal control protocol with a complicated and highly costly apparatus if a millikelvin-level stabilization is required. Here, we analyze the real-time thermal drift and utilize an active way to alternately track the single-spin ESR frequency drift in the experiment. Using this method, we achieve a temperature stabilization effect equivalent to sub-millikelvin (0.8 mK) level with no extra environmental thermal control, and the spin-state readout contrast is significantly improved in long-lasting experiments. This method holds broad applicability for NV-based single-spin experiments and harbors the potential for prospective expansion into diverse nanoscale quantum sensing domains.

A Latent Dirichlet Allocation approach to understanding students' perceptions of Automated Writing Evaluation.

Automated writing evaluation (AWE) has shown promise in enhancing students' writing outcomes. However, further research is needed to understand how AWE is perceived by middle school students in the United States, as they have received less attention in this field. This study investigated U.S. middle school students' perceptions of the MI Write AWE system. Students reported their perceptions of MI Write's usefulness using Likert-scale items and an open-ended survey question. We used Latent Dirichlet Allocation (LDA) to identify latent topics in students' comments, followed by qualitative analysis to interpret the themes related to those topics. We then examined whether these themes differed among students who agreed or disagreed that MI Write was a useful learning tool. The LDA analysis revealed four latent topics: (1) students desire more in-depth feedback, (2) students desire an enhanced user experience, (3) students value MI Write as a learning tool but desire greater personalization, and (4) students desire increased fairness in automated scoring. The distribution of these topics varied based on students' ratings of MI Write's usefulness, with Topic 1 more prevalent among students who generally did not find MI Write useful and Topic 3 more prominent among those who found MI Write useful. Our findings contribute to the enhancement and implementation of AWE systems, guide future AWE technology development, and highlight the efficacy of LDA in uncovering latent topics and patterns within textual data to explore students' perspectives of AWE.

Three Birds with One Stone: Copper Ions Assisted Synergistic Cuproptosis/Chemodynamic/Photothermal Therapy by a Three-Pronged Approach.

Copper is indispensable to organisms, while its homeostatic imbalance may interference normal cellular physiological processes and even induce cell death. Artificially regulating cellular copper content provides a viable strategy to activate antineoplastic effect. In light of this, a copper ions homeostasis perturbator (CuP-CL) with cinnamaldehyde (Cin) packaging and thermosensitive liposome coating is reported. Following laser exposure, the doping of Cu2+ in polydopamine initiates enhanced photothermal therapy (PTT) and unlocks the outer layer of liposome, leading to the release of copper ions and Cin in tumor microenvironment with mild acidity and high glutathione (GSH) levels. The liberative Cu2+ can evoke cuproptosis and chemodynamic therapy (CDT). Meanwhile, leveraging the merits of H2O2 supply and GSH consumption, Cin serves as a tumor microenvironment regulator to amplify Cu2+ mediated cuproptosis and CDT. Additionally, the positive feedback effects of "laser-triggered PTT, PTT accelerates reactive oxygen species (ROS) generation, ROS amplifies lipid peroxide (LPO) accumulation, LPO mediates heat shock proteins (HSPs) clearance, down-regulated HSPs promote PTT" entailed the overall benefit to therapeutic outcomes. Both in vitro and in vivo results corroborate the remarkable antineoplastic performance of CuP-CL by the synergy of cuproptosis/CDT/PTT. Collectively, based on the three-pronged approach, this work plots a viable multimodal regimen for cancer therapy.

Re-Purposing the Ordering of Routine Laboratory Tests in Hospitalized Medical Patients (RePORT): protocol for a multicenter stepped-wedge cluster randomised trial to evaluate the impact of a multicomponent intervention bundle to reduce laboratory test over-utilization.

BACKGROUND: Laboratory test overuse in hospitals is a form of healthcare waste that also harms patients. Developing and evaluating interventions to reduce this form of healthcare waste is critical. We detail the protocol for our study which aims to implement and evaluate the impact of an evidence-based, multicomponent intervention bundle on repetitive use of routine laboratory testing in hospitalized medical patients across adult hospitals in the province of British Columbia, Canada. METHODS: We have designed a stepped-wedge cluster randomized trial to assess the impact of a multicomponent intervention bundle across 16 hospitals in the province of British Columbia in Canada. We will use the Knowledge to Action cycle to guide implementation and the RE-AIM framework to guide evaluation of the intervention bundle. The primary outcome will be the number of routine laboratory tests ordered per patient-day in the intervention versus control periods. Secondary outcome measures will assess implementation fidelity, number of all common laboratory tests used, impact on healthcare costs, and safety outcomes. The study will include patients admitted to adult medical wards (internal medicine or family medicine) and healthcare providers working in these wards within the participating hospitals. After a baseline period of 24 weeks, we will conduct a 16-week pilot at one hospital site. A new cluster (containing approximately 2-3 hospitals) will receive the intervention every 12 weeks. We will evaluate the sustainability of implementation at 24 weeks post implementation of the final cluster. Using intention to treat, we will use generalized linear mixed models for analysis to evaluate the impact of the intervention on outcomes. DISCUSSION: The study builds upon a multicomponent intervention bundle that has previously demonstrated effectiveness. The elements of the intervention bundle are easily adaptable to other settings, facilitating future adoption in wider contexts. The study outputs are expected to have a positive impact as they will reduce usage of repetitive laboratory tests and provide empirically supported measures and tools for accomplishing this work. TRIAL REGISTRATION: This study was prospectively registered on April 8, 2024, via ClinicalTrials.gov Protocols Registration and Results System (NCT06359587). https://classic. CLINICALTRIALS: gov/ct2/show/NCT06359587?term=NCT06359587&recrs=ab&draw=2&rank=1.

Goal-directed vocal planning in a songbird.

Songbirds' vocal mastery is impressive, but to what extent is it a result of practice? Can they, based on experienced mismatch with a known target, plan the necessary changes to recover the target in a practice-free manner without intermittently singing? In adult zebra finches, we drive the pitch of a song syllable away from its stable (baseline) variant acquired from a tutor, then we withdraw reinforcement and subsequently deprive them of singing experience by muting or deafening. In this deprived state, birds do not recover their baseline song. However, they revert their songs toward the target by about 1 standard deviation of their recent practice, provided the sensory feedback during the latter signaled a pitch mismatch with the target. Thus, targeted vocal plasticity does not require immediate sensory experience, showing that zebra finches are capable of goal-directed vocal planning.

Online reach adjustments induced by real-time movement sonification.

Movement sonification can improve motor control in both healthy subjects (e.g., learning or refining a sport skill) and those with sensorimotor deficits (e.g., stroke patients and deafferented individuals). It is not known whether improved motor control and learning from movement sonification are driven by feedback-based real-time ("online") trajectory adjustments, adjustments to internal models over multiple trials, or both. We searched for evidence of online trajectory adjustments (muscle twitches) in response to movement sonification feedback by comparing the kinematics and error of reaches made with online (i.e., real-time) and terminal sonification feedback. We found that reaches made with online feedback were significantly more jerky than reaches made with terminal feedback, indicating increased muscle twitching (i.e., online trajectory adjustment). Using a between-subject design, we found that online feedback was associated with improved motor learning of a reach path and target over terminal feedback; however, using a within-subjects design, we found that switching participants who had learned with online sonification feedback to terminal feedback was associated with a decrease in error. Thus, our results suggest that, with our task and sonification, movement sonification leads to online trajectory adjustments which improve internal models over multiple trials, but which themselves are not helpful online corrections.

Prophylactic antibodies inhibit spike-specific T and B cell responses after COVID-19 vaccination.

Active and passive immunization is used in high-risk patients to prevent severe courses of COVID-19, but the impact of prophylactic neutralizing antibodies on the immune reaction to the mRNA vaccines has remained enigmatic. Here we show that CD4 T and B cell responses to Spikevax booster immunization are suppressed by the therapeutic antibodies Casirivimab and Imdevimab. B cell and T cell responses were significantly induced in controls but not in antibody-treated patients. The data indicates that humoral immunity, i. e. high levels of antibodies, negatively impacts reactive immunity, resulting in blunted cellular responses upon boosting. This argues for temporal separation of vaccination efforts; with active vaccination preferably applied before prophylactic therapeutic antibody treatment.