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I've been dying for the inverse of lilypond;an app that would allow you to take a picture and turn it into text notation/MIDI would be awesome.

That said, I used lilypond a couple of years ago and loved it.

There is an open source Audiveris http://audiveris.kenai.com/ (link currently down, cache at http://bit.ly/99yvbm) and commercial SmartScore http://www.musitek.com/smartscre.html (400$)