Items spawned from chests in the Death Certificate area can now be picked up safely. Safety and Sourcing Notice

The cost of using Razor Blade or Blood Rights was reduced to a half-heart after the first use in a room.

Instead of a black ring appearing when Isaac takes damage, there is now a luck-based chance for the ring to spawn around enemies Isaac kills.

had its damage per tick increased to 3 (up from 2.5). Quality of Life & Mechanics