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If nothing else, you end up with the people who display the book on their computer screen and do screen captures of each page with an automated process being used most of the time. Some of those people are content with making an ebook from those images while others will use OCR to generate a text based ebook. A couple of years back, one of my grandnieces found that quite a few of her university textbooks were available that way though the pirate sources only discounted the university bookstore's ebook prices by about 50%.
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