Version 9.0 has been uploaded! It can be found at the Downloads page of this mod. It's still a WIP, so expect some issues.
Adds to Fallout 3 in the ways that count:
Realistic damage,
able to bottle water,
When you're set on fire you really feel like you are,
shell shock effect for explosives is a excellent addition,
completely fixes the addiction system with one that makes sense (so not around luck but how much you abuse a drug will determine you're chance of getting addicted),
A needs system so you have to eat, drink, sleep and go to the toilet.
robots are harder to kill which makes sense,
cars don't explode anymore when shot up,
and you can kill kids!
I wanted ammunition and stimpacks to be more rare though.
I am not a fan of removing plasma and laser weapons in V8. And I got sick of waiting for compatibility for the 5 DLC so I stopped using the mod after V7...
The newest version 9 has Limited HUD assistance (no rad counter, sneak menu, HP, AP, air menu, or crosshair HUD), as well as the removal of VATS seems rather counter to what the game designers intended but it does add to realism greatly.
It adds sprint, iron sights & the option to disable fast travel... (along with what I wanted ages ago, alot less ammo & chem in loot and compatibility for all DLC's) but I've already been enjoying that with The Wanderers edition for a while now so I'll have to recommend that instead. For New Vegas I would recommend Project Nevada (by the same guys).