[bobz]

Actually, only a supernova or equivalent energy magnitude event.

Fusion only releases energy up to iron. Creating heavier elements consume energy in the reaction rather than releasing it, therefore cannot sustain a reaction.

[rtkwe]

There are a tiny number of ways but they're all so fantastically expensive it's pointless.

https://en.wikipedia.org/wiki/Synthesis_of_precious_metals#G...

[mtdewcmu]

Fission goes the opposite way. Heavier elements than iron release energy.

I think the inside of a star is not perfectly clear-cut. Various elements get created and cycle, with only the energetically-favorable ones accumulating. It's not altogether unlike chemistry.

What little I know of this comes from wikipedia, but I think there are other ways to synthesize elements apart from fission and fusion. Sometimes they simply catch a neutron, and the decay of a particle produces a different element.