The U.S. still leads the world in biomedical research – but its dominance is being lost to gains by emerging industries such as China, according to a new study.

The analysis of 10 renowned medical journals, and the nationality of the research and authors, spanned the years 2000 to 2015, and was published in the latest issue of JCI Insight.

It found that American-based scientists still led the way in publishing in the Journal of the American Medical Association, the Lancet, the New England Journal of Medicine, Cell, Nature, Science, the British Medical Journal, JAMA Internal Medicine, Journal of Cell Science, and FASEB Journal.

The U.S. share of the papers in the top six of those journals decreased from 44 percent in 2000, to 36.9 percent in 2015. (Great Britain, the consistent number two on the rankings, shrank from 8.9 percent to 3.9 percent over the same time period).

The annual uncertainty in the National Institutes of Health budget, and the proposed cuts like in the latest figures released last month, serve to weaken American biomedical research, said Bishr Omary, senior author of the opinion piece, of the University of Michigan.

“If we continue on the path we’re on, it will be harder to maintain our lead and, even more importantly, we could be disenchanting the next generation of bright and passionate biomedical scientists who see a limited future in pursuing a scientist or physician-investigator career,” said Omary.

Many of the Chinese nationals who come to the U.S. for education are returning to China – and taking their research with them, as opposed to previous decades, the team found.

Another trend is the building of international teams, with more collaboration than ever before. The authorship of papers from more than one country doubled from 25 percent of papers in the top six journals to 50 percent in 2015.

Similarly, massive teams now drive a bigger portion of the big papers. Only two percent of studies in 2000 featured 21 or more authors – a number that grew exponentially to 12.5 percent in 2015.

Funding for the NIH was flat from 2008 until 2015 – but has since been increased for the fiscal year 2017. That is a promising trend to keep the U.S. ahead of its competitors, the authors concluded.

The top 10 remained mostly constant, except for the rise of China. The 2015 ranking was: the U.S., Great Britain, Germany, China, France and Japan (tie), Switzerland, Canada, the Netherlands, and Australia.

China, however, has been implicated in bogus peer review, and some other scientific fraud recently, most notably with a sweeping retraction of 107 papers from Chinese researchers in a Springer tumor journal in April.