I recently opened a large modded server with the mod blood and madness, the problem is that the server lag a lot, between 8 and 13 tps.
I did an analysis with Spark and apparently blood and madness consumes between 35 and 40% of performance.
I have more than 300 mods and blood and madness is a server killer.

Update, the mod take more than 70% of perf

Link the spark report itself or expand down the tree to the very bottom, they can't do anything with screenshots that are that general.