A lot of mods to look through
-Up to you if you want to change any of the notes that go into the HP Bar, as Shiirn mentioned that shouldn't ever be compared with a custom skin but they don't look too nice with the default skin either in my opinion
-I am fine with the slider tick rate being 1 on every difficulty instead of 2 and the 5.0 SB load isn't too bad as doesn't last for long
-Although it really doesn't matter...0% timing sections are apprently not meant to be used anymore, so change them all to 5%
Keine:-Both the HP/AR would be nice being 1-2 lower for the easiest difficulty
01:05:618 (1,2,3,4) - I agree with Sapphire, the spacing here looks odd...even if that is how DS shows it, you could fix it manually
Shirasawa:-Although a stack leniency of 3 is not unrankable "all of the time" in this case it acts like stacking is disabled at certain points (as is explained above) so stuff like 01:25:390 (8,9,1,2) is harder to read. Changing it to 4 should fix all of those problems
-I would lower the AR slightly more to balance between the difficulties
KUMA's Insane:-Needs the storyboard displays in front of the combo fire like the other difficulties as mentioned earlier
00:08:345 (2,3,1,2,1,2,3) - spacing like this doesn't really flow well with the song
00:55:731 (1,2) - jump doesn't fit
Anyway I only posted on some of the more major things that people have commented on while going through. I suggest you also take a look at all of the other comments that have been left here as well
I would try and get a few more mods before getting a rebubble on this if possible~