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Now try clearing all the User levels. There are some tough ones. I beat *all* of them with every trinket EXCEPT for the one trinket in the level that I forget the name of, but it's the one that has a nearly impossible trinket that requires you to go up about 8 screens and come back down to the bottom, similar to the one in the main game. I used invincibility to get that one for the sake of completion, but I think that one is nearly impossible. I would love to see someone actually do it.
Then try to do the time trials. Those are pretty damn hard to get a V rank.