"Puncta extraordinaria (extraordinary points) occur fifty-six times in the Old Testament text: fifty-three times above letters and three times below letters. The electronic edition of the Biblia Hebraica Stuttgartensia text notes that the function of these marks "is not entirely clear ...""
January 1, 1970
https://en.wikiquote.org/wiki/Biblia_Hebraica_Stuttgartensia