I played quite a bit of Fallout 3 and played around with a few mods. I really liked FOOK 1.6 and later on FWE as my main overhaul. I also always used MMM. I do also miss something along the lines of ACE (amplified cripple effects). I also really liked Fellout but I can't stand the dark nights that it used by default. I had always used the SOTD version which was still a bit darker than the vanilla version but just not as obscene as what some people like.

I am using Project Nevada right now since it contains a few of my favorite FO3 mods like the grenade hotkey. I am also using the radio new vegas extender.

Anyways, I tried Arwen's realism tweaks and it is a really good mod and well maintained it just isn't my style. The weapon damage is just way over the top on both ends. It reminds me of the default settings on the fakefatory mod for Half Life 2. Like I said it's just not my style.

MMM, I doubt that there will be a true replacement sadly. That is just a great mod.

I also tried Nevada Skies and the nights were just way too dark for me. So I have to rule that out right there.

What else should I try? XFO?

There's also nVamp, though development on that is slowed down now.