{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T15:59:32Z","timestamp":1785340772348,"version":"3.55.0"},"publisher-location":"New York, NY, USA","reference-count":21,"publisher":"ACM","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/legalcode"}],"content-domain":{"domain":["dl.acm.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,6,30]]},"DOI":"10.1145\/3807503.3821552","type":"proceedings-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T02:55:27Z","timestamp":1785293727000},"page":"1-10","update-policy":"https:\/\/doi.org\/10.1145\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["When Medical LLMs Eat Their Own Output: The Effects of Recursive Self-Training on German Medical Text"],"prefix":"10.1145","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7353-2542","authenticated-orcid":false,"given":"Aashamsu","family":"Nepal","sequence":"first","affiliation":[{"name":"Heilbronn University of Applied Sciences, Heilbronn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8756-2940","authenticated-orcid":false,"given":"Ruben","family":"Nuredini","sequence":"additional","affiliation":[{"name":"Heilbronn University of Applied Sciences, Heilbronn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9550-7418","authenticated-orcid":false,"given":"Gerrit","family":"Meixner","sequence":"additional","affiliation":[{"name":"Heilbronn University of Applied Sciences, Heilbronn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"320","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"e_1_3_3_1_2_2","volume-title":"Llama 3 Model Card","year":"2024","unstructured":"AI@Meta. 2024. Llama 3 Model Card. Meta. https:\/\/github.com\/meta-llama\/llama3\/blob\/main\/MODEL_CARD.md"},{"key":"e_1_3_3_1_3_2","volume-title":"Self-Consuming Generative Models Go MAD","author":"Alemohammad Sina","year":"2023","unstructured":"Sina Alemohammad, Josue Casco-Rodriguez, Lorenzo Luzi, Ahmed\u00a0Imtiaz Humayun, Hossein Babaei, Daniel LeJeune, Ali Siahkoohi, and Richard\u00a0G. Baraniuk. 2023. Self-Consuming Generative Models Go MAD. arxiv:https:\/\/arXiv.org\/abs\/2307.01850\u00a0[cs.LG]"},{"key":"e_1_3_3_1_4_2","doi-asserted-by":"publisher","unstructured":"M. Barreda D. Cantarero-Prieto D. Coca A. Delgado P. Lanza-Le\u00f3n J. Lera R. Montalb\u00e1n and F. P\u00e9rez. 2025. Transforming healthcare with chatbots: Uses and applications\u2014A scoping review. Digital Health 11 (2025) 20552076251319174. 10.1177\/20552076251319174","DOI":"10.1177\/20552076251319174"},{"key":"e_1_3_3_1_5_2","volume-title":"Language Models are Few-Shot Learners","author":"Brown Tom\u00a0B.","year":"2020","unstructured":"Tom\u00a0B. Brown, Benjamin Mann, Nick Ryder, Melanie Subbiah, Jared Kaplan, Prafulla Dhariwal, Arvind Neelakantan, Pranav Shyam, Girish Sastry, Amanda Askell, Sandhini Agarwal, Ariel Herbert-Voss, Gretchen Krueger, Tom Henighan, Rewon Child, Aditya Ramesh, Daniel\u00a0M. Ziegler, Jeffrey Wu, Clemens Winter, Christopher Hesse, Mark Chen, Eric Sigler, Mateusz Litwin, Scott Gray, Benjamin Chess, Jack Clark, Christopher Berner, Sam McCandlish, Alec Radford, Ilya Sutskever, and Dario Amodei. 2020. Language Models are Few-Shot Learners. arxiv:https:\/\/arXiv.org\/abs\/2005.14165\u00a0[cs.CL] https:\/\/arxiv.org\/abs\/2005.14165"},{"key":"e_1_3_3_1_6_2","unstructured":"Manon den Dunnen. 2021. Synthetic Reality & Deep Fakes: Impact on Police Work. ENLETS report. Retrieved February 2 2026 from https:\/\/enlets.eu\/wp-content\/uploads\/2021\/11\/Final-Synthetic-Reality-Deep-fakes-Impact-on-Police-Work-04.11.21.pdf"},{"key":"e_1_3_3_1_7_2","volume-title":"Beyond Model Collapse: Scaling Up with Synthesized Data Requires Verification","author":"Feng Yunzhen","year":"2024","unstructured":"Yunzhen Feng, Elvis Dohmatob, Pu Yang, Francois Charton, and Julia Kempe. 2024. Beyond Model Collapse: Scaling Up with Synthesized Data Requires Verification. arxiv:https:\/\/arXiv.org\/abs\/2406.07515\u00a0[cs.LG]"},{"key":"e_1_3_3_1_8_2","volume-title":"Characterizing Model Collapse in Large Language Models Using Semantic Networks and Next-Token Probability","author":"Gambetta Daniele","year":"2025","unstructured":"Daniele Gambetta, Gizem Gezici, Fosca Giannotti, Dino Pedreschi, Alistair Knott, and Luca Pappalardo. 2025. Characterizing Model Collapse in Large Language Models Using Semantic Networks and Next-Token Probability. arxiv:https:\/\/arXiv.org\/abs\/2410.12341\u00a0[cs.CL]"},{"key":"e_1_3_3_1_9_2","doi-asserted-by":"publisher","unstructured":"Shuangyan Guo Yang Song Guanyun Chen Hongxin Han Hong Wu and Jingdong Ma. 2025. Promoting trust and intention to adopt health information generated by ChatGPT among healthcare customers: An empirical study. DIGITAL HEALTH 11 (2025) 20552076251374121. arXiv: 10.1177\/20552076251374121","DOI":"10.1177\/20552076251374121"},{"key":"e_1_3_3_1_10_2","volume-title":"Unsloth","author":"Han Daniel","year":"2023","unstructured":"Daniel Han, Michael Han, and Unsloth Team. 2023. Unsloth. Unsloth AI. https:\/\/github.com\/unslothai\/unsloth"},{"key":"e_1_3_3_1_11_2","volume-title":"State Examination","author":"University Heidelberg","year":"2026","unstructured":"Heidelberg University. 2026. State Examination. Retrieved February 24, 2026 from https:\/\/www.uni-heidelberg.de\/en\/study\/fields-of-study\/state-examination Medicine and other regulated professions in Germany conclude with the Staatsexamen.."},{"key":"e_1_3_3_1_12_2","volume-title":"Collapse of Self-trained Language Models","author":"Herel David","year":"2024","unstructured":"David Herel and Tomas Mikolov. 2024. Collapse of Self-trained Language Models. arxiv:https:\/\/arXiv.org\/abs\/2404.02305\u00a0[cs.CL]"},{"key":"e_1_3_3_1_13_2","volume-title":"LoRA: Low-Rank Adaptation of Large Language Models","author":"Hu Edward\u00a0J.","year":"2021","unstructured":"Edward\u00a0J. Hu, Yelong Shen, Phillip Wallis, Zeyuan Allen-Zhu, Yuanzhi Li, Shean Wang, Lu Wang, and Weizhu Chen. 2021. LoRA: Low-Rank Adaptation of Large Language Models. arxiv:https:\/\/arXiv.org\/abs\/2106.09685\u00a0[cs.CL] https:\/\/arxiv.org\/abs\/2106.09685"},{"key":"e_1_3_3_1_14_2","volume-title":"Collapse or Thrive? Perils and Promises of Synthetic Data in a Self-Generating World","author":"Kazdan Joshua","year":"2025","unstructured":"Joshua Kazdan, Rylan Schaeffer, Apratim Dey, Matthias Gerstgrasser, Rafael Rafailov, David\u00a0L. Donoho, and Sanmi Koyejo. 2025. Collapse or Thrive? Perils and Promises of Synthetic Data in a Self-Generating World. arxiv:https:\/\/arXiv.org\/abs\/2410.16713\u00a0[cs.LG]"},{"key":"e_1_3_3_1_15_2","doi-asserted-by":"publisher","unstructured":"Dmitry Kobak Rita Gonz\u00e1lez-M\u00e1rquez Em\u0151ke-\u00c1gnes Horv\u00e1t and Jan Lause. 2025. Delving into LLM-assisted writing in biomedical publications through excess vocabulary. Science Advances 11 27 (July 2025). 10.1126\/sciadv.adt3813","DOI":"10.1126\/sciadv.adt3813"},{"key":"e_1_3_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.18653\/v1\/N16-1014"},{"key":"e_1_3_3_1_17_2","volume-title":"OpenBioLLMs: Advancing Open-Source Large Language Models for Healthcare and Life Sciences","author":"Pal Ankit","year":"2024","unstructured":"Ankit Pal and Malaikannan Sankarasubbu. 2024. OpenBioLLMs: Advancing Open-Source Large Language Models for Healthcare and Life Sciences. Hugging Face. https:\/\/huggingface.co\/aaditya\/OpenBioLLM-Llama3-70B"},{"key":"e_1_3_3_1_18_2","volume-title":"Medical-Llama3-8B","year":"2024","unstructured":"ruslanmv. 2024. Medical-Llama3-8B. Hugging Face. https:\/\/huggingface.co\/ruslanmv\/Medical-Llama3-8B"},{"key":"e_1_3_3_1_19_2","unstructured":"Trivikram Satharasi and S\u00a0Sitharama Iyengar. 2025. Future of AI Models: A Computational perspective on Model collapse. arxiv:https:\/\/arXiv.org\/abs\/2511.05535\u00a0[cs.CL] https:\/\/arxiv.org\/abs\/2511.05535"},{"key":"e_1_3_3_1_20_2","doi-asserted-by":"publisher","unstructured":"Ilia Shumailov Zakhar Shumaylov Yiren Zhao Yarin Gal Nicolas Papernot and Ross Anderson. 2024. The Curse of Recursion: Training on Generated Data Makes Models Forget. Nature 631 8021 Article 755 (2024). 10.1038\/s41586-024-07548-x","DOI":"10.1038\/s41586-024-07548-x"},{"key":"e_1_3_3_1_21_2","volume-title":"Will we run out of data? Limits of LLM scaling based on human-generated data","author":"Villalobos Pablo","year":"2024","unstructured":"Pablo Villalobos, Anson Ho, Jaime Sevilla, Tamay Besiroglu, Lennart Heim, and Marius Hobbhahn. 2024. Will we run out of data? Limits of LLM scaling based on human-generated data. arxiv:https:\/\/arXiv.org\/abs\/2211.04325\u00a0[cs.LG]"},{"key":"e_1_3_3_1_22_2","volume-title":"German Wikipedia dumps","author":"Foundation Wikimedia","year":"2026","unstructured":"Wikimedia Foundation. 2026. German Wikipedia dumps. Retrieved February 24, 2026 from https:\/\/dumps.wikimedia.org\/dewiki\/ Publicly available dumps of the German-language Wikipedia.."}],"event":{"name":"BCB '26: 17th ACM International Conference on Bioinformatics, Computational Biology and Health Informatics","location":"Rende (CS) Italy","acronym":"BCB '26","sponsor":["SIGBio ACM Special Interest Group on Bioinformatics"]},"container-title":["Proceedings of the 17th ACM International Conference on Bioinformatics, Computational Biology and Health Informatics"],"original-title":[],"link":[{"URL":"https:\/\/dl.acm.org\/doi\/pdf\/10.1145\/3807503.3821552","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T15:14:26Z","timestamp":1785338066000},"score":1,"resource":{"primary":{"URL":"https:\/\/dl.acm.org\/doi\/10.1145\/3807503.3821552"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":21,"alternative-id":["10.1145\/3807503.3821552","10.1145\/3807503"],"URL":"https:\/\/doi.org\/10.1145\/3807503.3821552","relation":{},"subject":[],"published":{"date-parts":[[2026,6,30]]},"assertion":[{"value":"2026-07-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}