Tinker's Construct, Upgraded Core and (not in screenshot) Useful Backpacks mods
Health is realistic, and now you are way more vulnerable
Apart from sleeping and using bandages, xp now also heals you
The journey to The End is a whole lot more difficult but exciting now
You always spawn in a mob-overrun village
Start the game with a sword, boots and a shield
The game progressively gets worse as time goes on (0.3 after roughly 20 minutes)
An example of how crazy night time can get