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At least 703 records · Page 39

Fusion of CT Angiography or MR Angiography with Unenhanced CBCT and Fluoroscopy Guidance in Endovascular Treatments of Aorto-Iliac Steno-Occlusion: Technical Note on a Preliminary Experience

AimTo evaluate the feasibility of image fusion (IF) of pre-procedural arterial-phase CT angiography or MR angiography with intra-procedural fluoroscopy for road-mapping in endovascular treatment of aorto-iliac steno-occlusive disease.Materials and MethodsBetween September and November, 2014, we prospectively evaluated 5 patients with chronic aorto-iliac steno-occlusive disease, who underwent endovascular treatment in the angiography suite. Fusion image road-mapping was performed using angiographic phase CT images or MR images acquired before and intra-procedural unenhanced cone-beam CT. Radiation dose of the procedure, volume of intra-procedural iodinated contrast medium, fluoroscopy time, and overall procedural time were recorded. Reasons for potential fusion imaging inaccuracies were also evaluated.ResultsImage co-registration and fusion guidance were feasible in all procedures. Mean radiation dose of the procedure was 60.21 Gycm2 (range 55.02–63.75 Gycm2). The mean total procedure time was 32.2 min (range 27–38 min). The mean fluoroscopy time was 12 min and 3 s. The mean procedural iodinated contrast material dose was 24 mL (range 20–40 mL).ConclusionsIF gives Interventional Radiologists the opportunity to use new technologies in order to improve outcomes with a significant reduction of contrast media administration.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Three-dimensional Image Fusion Guidance for Transjugular Intrahepatic Portosystemic Shunt Placement

IntroductionTo assess the safety, feasibility and effectiveness of image fusion guidance with pre-procedural portal phase computed tomography with intraprocedural fluoroscopy for transjugular intrahepatic portosystemic shunt (TIPS) placement.Materials and methodsAll consecutive cirrhotic patients presenting at our interventional unit for TIPS creation from January 2015 to January 2016 were prospectively enrolled. Procedures were performed under general anesthesia in an interventional suite equipped with flat panel detector, cone-beam computed tomography (CBCT) and image fusion technique. All TIPSs were placed under image fusion guidance. After hepatic vein catheterization, an unenhanced CBCT acquisition was performed and co-registered with the pre-procedural portal phase CT images. A virtual path between hepatic vein and portal branch was made using the virtual needle path trajectory software. Subsequently, the 3D virtual path was overlaid on 2D fluoroscopy for guidance during portal branch cannulation. Safety, feasibility, effectiveness and per-procedural data were evaluated.ResultsSixteen patients (12 males; median age 56 years) were included. Procedures were technically feasible in 15 of the 16 patients (94%). One procedure was aborted due to hepatic vein catheterization failure related to severe liver distortion. No periprocedural complications occurred within 48 h of the procedure. The median dose-area product was 91 Gy cm{sup 2}, fluoroscopy time 15 min, procedure time 40 min and contrast media consumption 65 mL. Clinical benefit of the TIPS placement was observed in nine patients (56%).ConclusionThis study suggests that 3D image fusion guidance for TIPS is feasible, safe and effective. By identifying virtual needle path, CBCT enables real-time multiplanar guidance and may facilitate TIPS placement.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Image Fusion Guidance for In Situ Laser Fenestration of Aortic Stent graft for Endovascular Repair of Complex Aortic Aneurysm: Feasibility, Efficacy and Overall Functional Success

Objective: To evaluate feasibility, efficacy and overall functional success of image fusion guidance during laser-assisted in situ fenestration of aortic stent graft (LISFAS) for endovascular repair of complex aortic aneurysm (complex-EVAR) in a prospective study. Methods: Between September 2016 and July 2018, 20 patients were included and treated with LISFAS for complex-EVAR. Aortic aneurysms were either para-renal (n = 15) or thoraco-abdominal (n = 5) with 57 mm [first quartile: 54; third quartile: 68] median aneurysm diameter in 69 years [68;78] patients. All interventions were performed using the same angiographic system and 3D image fusion software for overlying pre-intervention CTA on per-intervention 2D fluoroscopy with cone-beam CT images to display target vessels ostia. Results: LISFAS for complex-EVAR with image fusion was performed in all patients, and no endovascular intervention required conversion to an open aortic repair. LISFAS of all target vessels was feasible in 18 patients (90%); 48 fenestrations out of 50 were performed successfully. Two fenestrations failed for renal arteries in two patients. Median ischemic times were as follows: 34 min [25;43] for superior mesenteric artery; 69 min [56;83] for left renal artery; 73 min [36;102] for right renal artery; and 93 min [89;96] for the celiac trunk. Median intervention and fluoroscopy times, iodinated contrast volume and X-ray exposure were 180 min [150;180], 74 min [64;87], 80 mL [59;113] and 338 Gy.cm{sup 2} [259;495], respectively. Efficacy was found in 17 patients (85%) on one-week follow-up CTA: Two patients had type 1 and 3 endoleaks, respectively, that were successfully embolized. Overall functional success was 90%. Median hospitalization stay was 9 days [8, 17]. The 30-day safety analysis was 90% (n = 2 deaths) owing to an undetermined cause and to bowel ischemia after low flow in intensive care unit. Conclusions: LISFAS using image fusion was feasible, efficient and overall functionally successful for complex-EVAR in this preliminary study.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Percutaneous Lung Tumor Biopsy Under CBCT Guidance with PET-CT Fusion Imaging: Preliminary Experience

Purpose: The aim of this study is to evaluate the feasibility of percutaneous lung tumor biopsy under cone beam-computed tomography (CBCT) with PET-CT imaging fusion. Materials and Methods: Eleven patients (four women and seven men) underwent C-arm CBCT lung biopsy with PET-CT fusion imaging. A preprocedural PET-CT scan was manually fused with procedural CBCT based on anatomical landmarks; using real-time fluoroscopy, the coregistered PET-CT and CBCT images were overlaid to guide the needle trajectory. Technical success, accuracy, sensibility and specificity were evaluated. Mean total procedure time and time required for image elaboration were recorded. Results: Technical success, diagnostic accuracy, sensitivity and specificity were 100%. The mean procedure time was 38 min. The average time of PET-CT/CBCT image fusion elaboration was 3.53 min for planning and 3.42 min for needle positioning check. Conclusion: CBCT-guided percutaneous lung biopsy with PET-CT fusion imaging is a feasible and effective procedure, with the potential to further improve diagnostic yield by targeting the most metabolically active portion of a lesion, whether it is morphologically altered or normal.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Multi-scale fusion algorithm of intensity and polarization-difference images based on edge information enhancement

To better integrate complementary and redundant information from different source images, improve the edge information, and facilitate the target detection. A multi-scale fusion algorithm of intensity and polarization-difference (PD) images based on edge information enhancement is proposed. Firstly, intensity images are obtained by the polarization information analysis method. PD images are obtained by the adaptive polarization-difference imaging approach based on the principle of minimum mutual information. Secondly, guided filter, affine transformations and Block-Matching and 3D filtering are embedded in visibility enhancement to improve the intensity and PD images. Thirdly, the two images are decomposed into high-frequency and low-frequency images by the dual-tree complex wavelet transform (DT-CWT). The high-frequency and low-frequency images are fused by the fusion rules based on edge detection and the regional variance matching degree respectively. Finally, the fusion image is obtained by the inverse DT-CWT. Experimental results demonstrate that fusion images of the proposed algorithm are significantly improved in information entropy, average gradient, and spatial frequency. Compared with the existing methods, it can achieve a better edge enhancement for images in a turbid medium.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗

Comparative Study of Oxides Formed on Fusion Zone and Base Metal of Laser Welded Zr-1.0Sn-1.0Nb-0.1Fe Alloy

Numerous studies have primarily focused on the corrosion mechanism of zirconium alloy base metal. However, the corrosion resistance of weld beads or seams is of vital importance in the degradation of structural components in the reactor. In the present work, the corrosion resistance of the fusion zone and base metal of laser welded zirconium alloy joints was comparatively investigated. The microstructure morphologies, phase structures and strain fields of oxide films formed on fusion zone and base metal were observed and analyzed. The oxide thickness of the fusion zone was thicker than that of the base metal with prolonged corrosion. Compared to the base metal, the lower density of dislocations and level of strain values in the oxide film of the fusion zone indicated that the stress in the oxide film was lower. The phase transition from the tetragonal ZrO{sub 2} to the monoclinic ZrO{sub 2} could be suppressed due to the high level of stress, resulting in the better corrosion resistance of the base metal. Moreover, the second phase particles and non-βZr phase in the base metal contributed to the better corrosion resistance.

36 MATERIALS SCIENCE↗

Design-informed neutronics assessment of long-lived fission product transmutation in a tokamak fusion reactor blanket

This study presents a neutronics-based assessment of the feasibility and viability of transmuting six major long-lived fission products (LLFPs) from light-water reactors, namely 99 Tc, 129 I, 79 Se, 93 Zr, 126 Sn, and 135 Cs, within the blanket region of a tokamak fusion reactor, using the MIT ARC design as a concrete fusion configuration. Monte Carlo neutronics simulations were performed to evaluate LLFP transmutation and to compare the results with a reference boiling water reactor (BWR). The results indicate that transmutation of all six LLFPs is neutronics-feasible in fusion reactors, with transmutation half-lives significantly shorter than their natural decay half-lives. For elemental targets, transmutation of 135 Cs, 126 Sn, and 93 Zr was found potentially viable, as the net mass transmuted exceeded that achievable in the reference BWR under identical target volume and irradiation time. When isotopically separated targets were considered, transmutation of 126 Sn and 93 Zr appeared potentially viable. A parametric study demonstrated that plasma geometry modifications can enhance local neutron flux, increasing the transmuted 93 Zr mass by approximately 33% and reducing the transmutation half-life from approximately 240 years to 180 years. Repositioning the target and adjusting material layer thickness reduced the transmutation half-life of 93 Zr to 67 years and increased the net mass transmuted by a factor of 50. Furthermore, these results demonstrate that fusion reactors can enable LLFP transmutation beyond the practical limits of thermal fission reactors and highlight the critical role of reactor and blanket design optimization. Engineering and fuel-cycle considerations required for deployment are beyond the scope of this neutronics-focused study.

73 NUCLEAR PHYSICS AND RADIATION PHYSICS↗

Translocation-generated ITK-FER and ITK-SYK fusions induce STAT3 phosphorylation and CD69 expression

Highlights: • The downstream targets of ITK-FER and ITK-SYK were explored and STAT3 is highly phosphorylated by these fusion kinases. • The CD69 T-cell activation marker was significantly elevated. • Upon expression of FER, ITK-FER, SYK, and ITK-SYK, the auto-phosphorylation events in HEK 293T cells were induced, even under serum starvations. Many cancer types carry mutations in protein tyrosine kinase (PTK) and such alterations frequently drive tumor progression. One category is gene translocation of PTKs yielding chimeric proteins with transforming capacity. In this study, we characterized the role of ITK-FER [Interleukin-2-inducible T-cell Kinase (ITK) gene fused with Feline Encephalitis Virus-Related kinase (FER) gene] and ITK-SYK [Interleukin-2-inducible T-cell Kinase (ITK) gene fused with the Spleen Tyrosine Kinase (SYK)] in Peripheral T Cell Lymphoma (PTCL) signaling. We observed an induction of tyrosine phosphorylation events in the presence of both ITK-FER and ITK-SYK. The downstream targets of ITK-FER and ITK-SYK were explored and STAT3 was found to be highly phosphorylated by these fusion kinases. In addition, the CD69 T-cell activation marker was significantly elevated. Apart from tyrosine kinase inhibitors acting directly on the fusions, we believe that drugs acting on downstream targets could serve as alternative cancer therapies for fusion PTKs.

60 APPLIED LIFE SCIENCES↗

Disruption modelling for engineering and physics design of ST-E1 fusion power plant

Plasma disruptions represent a critical challenge for high-performance tokamak operations, as they can compromise machine integrity and reduce operational availability. Although future fusion devices essentially need to incorporate strategies to minimise disruption occurrence, complete avoidance remains unattainable. Consequently, assessing and characterising unmitigated disruption consequences is fundamental for the design and qualification of next-generation fusion power plants. This work supports the pre-conceptual design of ST-E1, a low aspect-ratio Tokamak Fusion Power Plant developed by Tokamak Energy Ltd., by presenting a comprehensive disruption modelling approach applied across different design stages. The methodology integrates both physics and engineering considerations to evaluate the impact of disruptions on machine performance and structural integrity. From an engineering perspective, several ST-E1 layout options were analysed to investigate the electromagnetic response of key components under disruption-induced loads, enabling comparison between alternative design solutions. On the physics side, a broad set of disruption scenarios was explored, scanning operational space parameters, plasma-material interactions, and associated thermal loads. Furthermore, the study examined variations in disruption behaviour arising from different reference equilibria, focusing on a range starting from Double Null to Single Null configurations, reflecting the increasing up-down asymmetry consequences. The results reveal significant contrasts in plasma dynamics and structures electromagnetic behaviour between configurations, highlighting the importance of disruption modelling in guiding design choices. These analyses have proven instrumental in shaping ST-E1 development, offering critical insights for mitigating risks and optimising future fusion power plant designs.

Borowiec, Katarzyna [ORNL] (ORCID:0000000335911739↗

A fusion of the Bacteroides fragilis ferrous iron import proteins reveals a role for FeoA in stabilizing GTP-bound FeoB

Iron is an essential element for nearly all organisms, and under anoxic and/or reducing conditions, Fe 2+ is the dominant form of iron available to bacteria. The ferrous iron transport (Feo) system is the primary prokaryotic Fe 2+ import machinery, and two constituent proteins (FeoA and FeoB) are conserved across most bacterial species. However, how FeoA and FeoB function relative to one another remains enigmatic. In this work, we explored the distribution of feoAB operons encoding a fusion of FeoA tethered to the N-terminal, G-protein domain of FeoB via a connecting linker region. We hypothesized that this fusion poises FeoA to interact with FeoB to affect function. To test this hypothesis, we characterized the soluble NFeoAB fusion protein from Bacteroides fragilis, a commensal organism implicated in drug-resistant infections. Using X-ray crystallography, we determined the 1.50-Å resolution structure of BfFeoA, which adopts an SH3-like fold implicated in protein–protein interactions. Using a combination of structural modeling, small-angle X-ray scattering, and hydrogen–deuterium exchange mass spectrometry, we show that FeoA and NFeoB interact in a nucleotide-dependent manner, and we mapped the protein–protein interaction interface. Finally, using guanosine triphosphate (GTP) hydrolysis assays, we demonstrate that BfNFeoAB exhibits one of the slowest known rates of Feo-mediated GTP hydrolysis that is not potassium-stimulated. Importantly, truncation of FeoA from this fusion demonstrates that FeoA–NFeoB interactions function to stabilize the GTP-bound form of FeoB. Taken together, our work reveals a role for FeoA function in the fused FeoAB system and suggests a function for FeoA among prokaryotes.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

Sensitive search for near-symmetric and super-asymmetric fusion-fission of the superheavy element Flerovium (Z=114)

Measurements of mass and angular distributions have been made for fission-like outcomes in reactions forming isotopes of flerovium (Z=114), using 48 Ca, 50 Ti, and 54 Cr projectiles. The dominant fast quasifission process, which masks the presence of fusion-fission, has minimum yield at the most backward angles, where the sensitivity to fusion-fission is thus highest. In fitting the backward angle mass spectra, only weak evidence for a component of super-asymmetric fission was found, but a near-symmetric fission component was consistently required for the 48 Ca + 244 Pu reaction, giving upper limit to the fusion probabilities P CN of ~10 -2 , ~5 times lower than previous results. P CN for the 50 Ti reaction was lower than 48 Ca, whilst no evidence of fusion-fission was found for the 54 Cr reaction.

73 NUCLEAR PHYSICS AND RADIATION PHYSICS↗

Effect of specific amino acid substitutions in the putative fusion peptide of structural glycoprotein E2 on Classical Swine Fever Virus replication

E2, along with E{sup rns} and E1, is an envelope glycoprotein of Classical Swine Fever Virus (CSFV). E2 is involved in several virus functions: cell attachment, host range susceptibility and virulence in natural hosts. Here we evaluate the role of a specific E2 region, {sup 818}CPIGWTGVIEC{sup 828}, containing a putative fusion peptide (FP) sequence. Reverse genetics utilizing a full-length infectious clone of the highly virulent CSFV strain Brescia (BICv) was used to evaluate how individual amino acid substitutions within this region of E2 may affect replication of BICv. A synthetic peptide representing the complete E2 FP amino acid sequence adopted a β-type extended conformation in membrane mimetics, penetrated into model membranes, and perturbed lipid bilayer integrity in vitro. Similar peptides harboring amino acid substitutions adopted comparable conformations but exhibited different membrane activities. Therefore, a preliminary characterization of the putative FP {sup 818}CPIGWTGVIEC{sup 828} indicates a membrane fusion activity and a critical role in virus replication. - Highlights: • A putative fusion peptide (FP) region in CSFV E2 protein was shown to be critical for virus growth. • Synthetic FPs were shown to efficiently penetrate into lipid membranes using an in vitro model. • Individual residues in the FP affecting virus replication were identified by reverse genetics. • The same FP residues are also responsible for mediating membrane fusion.

60 APPLIED LIFE SCIENCES↗

Structural and functional characterization of EIAV gp45 fusion peptide proximal region and asparagine-rich layer

Equine infectious anaemia virus (EIAV) and human immunodeficiency virus (HIV) are members of the lentiviral genus. Similar to HIV gp41, EIAV gp45 is a fusogenic protein that mediates fusion between the viral particle and the host cell membrane. The crystal structure of gp45 reported reveals a different conformation in the here that includes the fusion peptide proximal region (FPPR) and neighboring asparagine-rich layer compared with previous HIV-1 gp41 structures. A complicated hydrogen-bond network containing a cluster of solvent molecules appears to be critical for the stability of the gp45 helical bundle. Interestingly, viral replication was relatively unaffected by site-directed mutagenesis of EIAV, in striking contrast to that of HIV-1. Based on these observations, we speculate that EIAV is more adaptable to emergent mutations, which might be important for the evolution of EIAV as a quasi-species, and could potentially contribute to the success of the EIAV vaccine. - Highlights: • The crystal structure of EIAV gp45 was determined. • The fusion peptide proximal region adopts a novel conformation different to HIV-1. • The asparagine-rich layer includes an extensive hydrogen-bond network. • These regions of EIAV are highly tolerant to mutations. • The results provide insight into the mechanism of gp41/gp45-mediated membrane fusion.

60 APPLIED LIFE SCIENCES↗

Myosin heavy chain-like localizes at cell contact sites during Drosophila myoblast fusion and interacts in vitro with Rolling pebbles 7

Besides representing the sarcomeric thick filaments, myosins are involved in many cellular transport and motility processes. Myosin heavy chains are grouped into 18 classes. Here we show that in Drosophila, the unconventional group XVIII myosin heavy chain-like (Mhcl) is transcribed in the mesoderm of embryos, most prominently in founder cells (FCs). An ectopically expressed GFP-tagged Mhcl localizes in the growing muscle at cell–cell contacts towards the attached fusion competent myoblast (FCM). We further show that Mhcl interacts in vitro with the essential fusion protein Rolling pebbles 7 (Rols7), which is part of a protein complex established at cell contact sites (Fusion-restricted Myogenic-Adhesive Structure or FuRMAS). Here, branched F-actin is likely needed to widen the fusion pore and to integrate the myoblast into the growing muscle. We show that the localization of Mhcl is dependent on the presence of Rols7, and we postulate that Mhcl acts at the FuRMAS as an actin motor protein. We further show that Mhcl deficient embryos develop a wild-type musculature. We thus propose that Mhcl functions redundantly to other myosin heavy chains in myoblasts. Lastly, we found that the protein is detectable adjacent to the sarcomeric Z-discs, suggesting an additional function in mature muscles. - Highlights: ► The class XVIII myosin encoding gene Mhcl is transcribed in the mesoderm. ► Mhcl localization at contact sites of fusing myoblasts depends on Rols7. ► Mhcl interacts in vitro with Rols7 which is essential for myogenesis. ► Functional redundancy with other myosins is likely as mutants show no muscle defects. ► Mhcl localizes adjacent to Z-discs of sarcomeres and might support muscle integrity.

60 APPLIED LIFE SCIENCES↗

Effect of myonuclear number and mitochondrial fusion on Drosophila indirect flight muscle organization and size

Mechanisms involved in establishing the organization and numbers of fibres in a muscle are not completely understood. During Drosophila indirect flight muscle (IFM) formation, muscle growth is achieved by both incorporating hundreds of nuclei, and hypertrophy. As a result, IFMs provide a good model with which to understand the mechanisms that govern overall muscle organization and growth. We present a detailed analysis of the organization of dorsal longitudinal muscles (DLMs), a subset of the IFMs. We show that each DLM is similar to a vertebrate fascicle and consists of multiple muscle fibres. However, increased fascicle size does not necessarily change the number of constituent fibres, but does increase the number of myofibrils packed within the fibres. We also find that altering the number of myoblasts available for fusion changes DLM fascicle size and fibres are loosely packed with myofibrils. Additionally, we show that knock down of genes required for mitochondrial fusion causes a severe reduction in the size of DLM fascicles and fibres. Our results establish the organization levels of DLMs and highlight the importance of the appropriate number of nuclei and mitochondrial fusion in determining the overall organization, growth and size of DLMs. - Highlights: • Drosophila dorsal longitudinal muscles are similar to vertebrate skeletal muscles. • A threshold number of myoblasts governs the organization of a fibre and its size. • Mitochondrial fusion defect leads to abnormal fibre growth and organization.

60 APPLIED LIFE SCIENCES↗

Marf-mediated mitochondrial fusion is imperative for the development and functioning of indirect flight muscles (IFMs) in drosophila

Highlights: • Mitochondrial fusion is essential during development of Drosophila IFM. • Marf expression is required during early muscle development. • Marf knock down during IFM development affects mitochondrial shape and function. • Marf deficiency alters myofibril size and decreases muscle function. Dynamic changes in mitochondrial shape and size are vital for mitochondrial health and for tissue development and function. Adult Drosophila indirect flight muscles contain densely packed mitochondria. We show here that mitochondrial fusion is critical during early muscle development (in pupa) and that silencing of the outer mitochondrial membrane fusion gene, Marf, in muscles results in smaller mitochondria that are functionally defective. This leads to abnormal muscle development resulting in muscle dysfunction in adult flies. However, post-developmental silencing of Marf has no obvious effects on mitochondrial and muscle phenotype in adult flies, indicating the importance of mitochondrial fusion during early muscle development.

60 APPLIED LIFE SCIENCES↗

Improving Data and Prediction Quality of High-Throughput Perovskite Synthesis with Model Fusion

Combinatorial fusion analysis (CFA) is an approach for combining multiple scoring systems using the rank-score characteristic function and cognitive diversity measure. One example is to combine diverse machine learning models to achieve better prediction quality. In this work, we apply CFA to the synthesis of metal halide perovskites containing organic ammonium cations via inverse temperature crystallization. Using a data set generated by high-throughput experimentation, four individual models (support vector machines, random forests, weighted logistic classifier, and gradient boosted trees) were developed. We characterize each of these scoring systems and explore 66 possible combinations of the models. When measured by the precision on predicting crystal formation, the majority of the combination models improves the individual model results. The best combination models outperform the best individual models by 3.9 percentage points in precision. In addition to improving prediction quality, we demonstrate how the fusion models can be used to identify mislabeled input data and address issues of data quality. In particular, we identify example cases where all single models and all fusion models do not give the correct prediction. Experimental replication of these syntheses reveals that these compositions are sensitive to modest temperature variations across the different locations of the heating element that can hinder or enhance the crystallization process. In summary, we demonstrate that model fusion using CFA can not only identify a previously unconsidered influence on reaction outcome but also be used as a form of quality control for high-throughput experimentation.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

Molecular mechanism of respiratory syncytial virus fusion inhibitors

Respiratory syncytial virus (RSV) is a leading cause of pneumonia and bronchiolitis in young children and the elderly. Therapeutic small molecules have been developed that bind the RSV F glycoprotein and inhibit membrane fusion, yet their binding sites and molecular mechanisms of action remain largely unknown. In this paper, we show that these inhibitors bind to a three-fold-symmetric pocket within the central cavity of the metastable prefusion conformation of RSV F. Inhibitor binding stabilizes this conformation by tethering two regions that must undergo a structural rearrangement to facilitate membrane fusion. Inhibitor-escape mutations occur in residues that directly contact the inhibitors or are involved in the conformational rearrangements required to accommodate inhibitor binding. Resistant viruses do not propagate as well as wild-type RSV in vitro, indicating a fitness cost for inhibitor escape. Finally and collectively, these findings provide new insight into class I viral fusion proteins and should facilitate development of optimal RSV fusion inhibitors.

59 BASIC BIOLOGICAL SCIENCES↗