basically should it be counted by you using the use for the item or by holding said item(s)

either one should count imo, any interaction would count as a use

both

If I were to let go of an item, and then grab onto it again, say, 3 seconds later, would that count as another item, or would it be the same item? The rules on the leastitems% leaderboard are a tiny bit confusing, given that there are none apparently.

Definetly held. But I feel like re-picking it up should count, after 3 seconds like C1GAMER was saying. Or using can be interpreted as touching

BlankTuber how could you do a run without holding items?. Don't you need to hold at least 1 item? Which one im tlaking about is the explosive in the duplication and ramp rooms.

It's apparently possible to beat the entire game with no items, and you can skip level 2, the wall and duck room, by using t he intended strategy in the first room... but on the celing.