Primary Sclerosing Cholangitis from Childhood to Adult Age : Risk Factors, Monitoring and Outcome

BACKGROUND AND AIM This thesis includes two studies conducted in a paediatric and two studies conducted in an adult primary sclerosing cholangitis (PSC) population. The common denominator was endoscopic retrograde cholangiography (ERC) with brush cytology that was performed in all patients. The aims were to: i) identify the possible environmental risk factors (Study I) and report the long-term outcome (Study II) of paediatric-onset PSC, ii) compare ERC and magnetic resonance imaging with cholangiopancreatography (MRI-MRCP) in the evaluation of disease activity and severity of patients with PSC (Study III) and evaluate the role of ERC with brush cytology as screening for cholangiocarcinoma (CC) in patients with PSC (Study IV). MATERIAL AND METHODS PSC was diagnosed, followed-up (or both) in Helsinki University Hospital (HUH). Study I: 71 patients with a new diagnosis of paediatric-onset (age 18 years) between 1 January 2006 and 31 October 2011. All cholangiographic images were scored according to the modified Amsterdam PSC score. RESULTS Study I: In multivariate analysis, children ‘living with a cat in a block of flats’ had a higher risk (OR 3.6; 95% CI: 1.2-10.8) of having AILD than healthy controls, but not IBD controls. Study II: At the end of follow-up (9 years, range 2-20 years) all children were alive and no malignancy occurred. 29/33 (88%) were not transplanted; 26/29 (78%) were not cirrhotic and 3/29 (10%) were cirrhotic. 4/33 (12%) were transplanted after a median of 7.5 years; no PSC recurrence in the graft occurred. Study III: MRCP and ERC scores for IHBD were associated with alkaline phosphatase (p = 0.016 and p = 0.018, respectively) and CA19-9 level (p < 0.001 and p = 0.030, respectively); MRCP score for EHBD was also associated with CA19-9 level (p = 0.021). Finally, peribiliary enhancement detected on MRI correlated with cytology findings for both IHBD (Spearman’s rho = 0.322, SE: 0.095, p = 0.022) and EHBD (Spearman’s rho = 0.319, SE: 0.113, p = 0.025, respectively). Study IV: Most of the patients were asymptomatic (211/261; 80.8%) and had only mild changes on cholangiography (149/261; 57.1%) at time of first ERC. Follow-up was completed in 249/261 (95%). CC developed in 7 patients and biliary dysplasia in 8 patients; brush cytology was suspicious or malignant in 8 patients at time of PSC diagnosis. Advanced EHBD cholangiographic changes (HR: 1.7; 95% CI: 1.2-2.3) and alanine aminotransferase (HR: 14.2; 95% CI: 1.9-106.4) were associated with increased risk of biliary neoplasia. CONCLUSIONS An unidentified environmental risk factor (i.e., microbial) especially associated with cats may increase the risk of PSC in children. The clinical course and outcome of paediatric-onset PSC seems to be good until adulthood with a high survival rate, with no occurrence of malignancy and LT required in only a minority of patients. MRI-MRCP use in PSC follow-up seems to be low. In this respect, ERC with brush cytology is a good screening tool for detection of biliary dysplasia or neoplasia (or both) in patients with PSC. Advanced extrahepatic disease and alanine aminotransferase elevation may predict the occurrence of CC.TITLE IN FINNISH: Primaarinen sklerosoiva kolangiiitti lapsuudesta aikuisuuteen: riskitekijät, seuranta ja selviytyminen Common abstract in Finnish: Primaarinen sklerosoiva kolangiitti (PSC) on etiologialtaan tuntematon sappiteitä ahtauttava sairaus, joka voi johtaa maksakirroosiin tai sappitiesyöpään. Suurimmalla osalla PSC-potilaista on myös tulehduksellinen suolistosairaus (haavainen paksusuolentulehdus tai Crohnin tauti). Sappitiekarsinooman esiasteena pidetään sappitie-epiteelin dysplasiaa. Tässä väitöskirjatyössä tutkittiin sekä lapsi- että aikuispotilaita. Kaikille tutkituille potilaille oli tehty endoskooppinen retrogradinen kolangiografia (ERC) ja otettu harjairtosolunäyte sappiteistä. Väitöskirjatutkimuksen tavoitteina oli etsiä mahdollisia PSC:hen liittyviä ympäristötekijöitä, tutkia lapsipotilaiden selviytymistä pitkäaikaisseurannassa, vertailla ERC:tä ja magneettikolangiografiaa PSC:n aktiivisuuden seurannassa sekä arvioida ERC:n ja harjasolunäytteen merkitystä sappitiekarsinooman seulonnassa aikuisena PSC:hen sairastuneilla. Ensimmäisessä osatyössä selvitettiin kyselytutkimuksella PSC:n ympäristötekijöitä 71:ltä lapsena PSC:hen ja/tai autoimmuunihepatiittiin sairastuneelta. Mukana oli myös kaksi verrokkiryhmää. Tutkimuksessa todettiin, että mm. sisarusten lukumäärä, syntymäpaikka tai ruokailutottumukset eivät olleet yhteydessä sairastumisriskiin. Sen sijaan sairastumisriski oli 3.6-kertainen potilailla, jotka olivat asuneet rivitalossa ja joilla oli ollut kissa lemmikkinä. Toisessa osatyössä tutkittiin vuosina 1993-2011 PSC:hen sairastuneiden lasten selviytymistä pitkäaikaisseurannassa. Mukana oli 41 potilasta, joista 33 oli mukana lopullisessa analyysissä. Yhdeksällä prosentilla oli diagnoosivaiheessa maksakirroosi. Seurannan loppuvaiheessa kellään ei todettu sappitiekarsinoomaa, ja 36%:lla maksansisäisten sappiteiden PSC-muutokset olivat edenneet. Maksansiirto oli tehty 12%:lle. Kolmannessa osatyössä oli mukana 48 aikuispotilasta. Kaikille potilaille tehtiin sekä ERC että magneettikolangiografia ja todettiin, että näiden välinen korrelaatio sappitiemuutosten vaikeuden määrittämisessä oli vain kohtalainen. Kohonnut AFOS ja CA19-9 liittyivät maksan sisäisiin sappitiemuutoksiin sekä ERC:llä että magneettikolangiografialla tutkittuna. Harjasolunäytteen sytologinen löydös korreloi vain magneettikolangiografian löydöksiin. Neljännessä osatyössä tutkittiin 261 PSC:hen sairastunutta aikuispotilasta, joista suurin osa (81%) oli diagnoosivaiheessa oireettomia. ERC:ssä nähtävät sappitiemuutokset olivat lieviä 57%:lla. Seurannassa sappitiekarsinooma todettiin 7:llä potilaalla ja sappitiedysplasia 8:lla. Edenneet maksan ulkoisten sappiteiden muutokset, kohonnut ALAT, epäilyttävä sytologinen löydös ja kohonnut CEA assosioituivat sappitiekarsinooman ja dysplasian riskiin. Väitöskirjatyön johtopäätöksenä todettiin, että tuntematon ympäristötekijä (esim. kissoihin liittyvä mikrobi) voi lisätä PSC:n riskiä lapsilla. Lapsena alkaneella PSC:llä on kuitenkin hyvä ennuste ja maksansiirtoon päädytään harvoin. ERC:n ja magneettikolangiografian korrelaatio sappitiemuutosten arvioinnissa on vain kohtalainen. Magneettikolangiografian löydös korreloi sytologiseen löydökseen. ERC:n yhteydessä otettavaa harjasolunäytettä voidaan käyttää sappitiedysplasian tai karsinooman seulonnassa myös oireettomilla potilailla. Edenneet maksan ulkoisten sappiteiden PSC-muutokset ja kohonnut ALAT diagnoosivaiheessa liittyvät erityisen kohonneeseen sappitiekarsinooman riskiin

Drf1-dependent Kinase Interacts with Claspin through a Conserved Protein Motif

The Dbf4/Drf1-dependent kinase (DDK) is required for the initiation of DNA replication in eukaryotes. Another protein, Claspin, mediates the activation of a cellular checkpoint response to stalled replication forks and is also a regulator of replication. In this study, we found that DDK phosphorylates Claspin in vitro and forms a nuclear complex containing Cdc7, Drf1, and Claspin in Xenopus egg extracts. In addition, purified Claspin and DDK are capable of a direct in vitro interaction. We identified a conserved binding site on Claspin required for its interaction with DDK. This site corresponds to the first of two sequence repeats in the Chk1-binding domain of Claspin. Furthermore, we have established that two amino acids in this motif, Asp^(861) and Gln^(866), are essential for the interaction between Claspin and DDK. We found that mutant forms of Claspin incapable of interacting with DDK are still able to associate with and activate Chk1 in response to DNA replication blockages. However, Claspin-depleted egg extracts that have been reconstituted with these mutants of Claspin undergo DNA replication more slowly. These findings suggest that the interaction of DDK with Claspin mediates a checkpoint-independent function of Claspin related to DNA replication

Using olive mill wastewate to improve performance in producing electricity from domestic wastewater by using single-chamber microbial fuel cell

Improving electricity generation from wastewater (DW) by using olive mill wastewater (OMW) was evaluated using single-chamber microbial fuel cells (MFC). Doing so single-chambers air cathode MFCs with platinum anode were fed with domestic wastewater (DW) alone and mixed with OMW at the ratio of 14:1 (w/w). MFCs fed with DW + OMW gave 0.38 V at 1 kO, while power density from polarization curve was of 124.6mW m 2. The process allowed a total reduction of TCOD and BOD5 of 60% and 69%, respectively, recovering the 29% of the coulombic efficiency. The maximum voltage obtained from MFC fed with DW + OMW was 2.9 times higher than that of cell fed with DW. DNA-fingerprinting showed high bacterial diversity for both experiments and the presence on anodes of exoelectrogenic bacteria, such as Geobacter spp. Electrodes selected peculiar consortia and, in particular, anodes of both experiments showed a similar specialization of microbial communities independently by feeding used

Students’ Voices from the Pandemic. The Use of Modal and Semi-Modal Verbs for Expressing Subjectivity in a Local Academic Learner Corpus

This essay presents the results of a small-scale study on learner output obtained through an asynchronous writing activity completed in a Moodle forum during an English course targeting students of Primary Teacher Education at the University of Modena e Reggio Emilia (Italy) in spring 2020. The activity encouraged learners’ expression about topics relevant to their disciplinary and professional domain, thus enhancing their engagement in the learning process. The analysis focuses on the use of modal and semi-modal verbs, and it aims at contributing to research into modality in learners’ academic writing. Indeed, the insights obtained by examining material created by learners during the pandemic can help develop resources and strategies to be incorporated in a more conscious, organic, and learner-centred manner into the design of future courses. The corpus (27,430 tokens) was investigated using Sketch Engine, and the results show the students’ preference for modals and semi-modals expressing obligation. This may be determined by the topic and by the students’ background, as they integrate their personal perspective as insiders into their contributions, hence demonstrating their strong commitment towards the profession for which they are training

Creating Brand Personality and Engaging Users in Instagram for Marketing Purposes : A Multimodal Discourse Analysis

This paper presents the findings of a pilot study regarding the ways in which the communicative potential of Instagram can be harnessed for marketing purposes. In particular, by adopting a multi-method approach rooted in Multimodal Discourse Analysis (Iedema 2003; Jewitt 2016), the study explores how an Italian fashion start-up company, D1 Milano, expresses its brand personality (Aaker 1997; Crawford Camiciottoli 2018) and engages its followers. The research objective is pursued by investigating a corpus of 1,137 posts published between 15 August 2015 and 30 September 2019. These are examined focusing on three areas. The most frequent linguistic patterns are analysed using Sketch Engine in order to determine how brand personality is verbalised. The metadata are explored in the light of Zappavigna’s (2015) metafunctional framework, according to which hashtags can fulfil an experiential, a textual, and an interpersonal function. As regards visual representation, the study concentrates on the creation of interpersonal meaning between the image producer, the represented participant, and the viewer through choices in subjectification (Zappavigna 2016). The results indicate that the personality of the brand combines traits belonging to the dimensions of excitement and sophistication, which are conveyed both linguistically and visually. Moreover, since the company frequently reposts pictures taken by its customers/followers, the audience is expected to identify with the brand, especially in the case of those images where the presence of the photographer can be inferred by the inclusion of his/her body parts (almost 25% of the entire corpus). Finally, hashtags mainly serve an experiential and an interpersonal function: one the one hand, they evoke D1 Milano’s personality by foregrounding the features of the brand, while also thematising the followers’ attitude, desires, and ambitions; on the other, they promote engagement by inviting users’ metacomments

GORUĆA GRANICA. Komaprativna studija tršćanskog pitanja i drugih teritorijalnih problema s kojima se Italija suočila nakon poraza u Drugome svjetskom ratu (Sažetak)

The article describes why the Trieste issue is the only one of the territorial disputes Italy had with neighbouring countries at the end of the Second World War that still influences Italian public opinion and policy. The first part of the work briefly describes the problem that Italy had with its former colonies, and with France, Austria and Yugoslavia. While the topic is not discussed in detail for the sake of brevity, emphasis has been placed to the mutual impact each of these territorial issues had on the others during the period when the looming Cold War influenced all of them. The second half of the article explains what made the Trieste issue unique and why it still plays an important role in the Italian national consciousness. The article is based on Italian, Croatian and Slovenian historiography and refers, for specific aspects, to documents from the Office of the Marshal of Yugoslavia (Fond 836 - Arhiv Jugoslavije) and the Political Archives of the Ministry of Foreign Affairs of the Republic of Serbia (PA - DAMSP).U članku se objašnjava zašto je, od svih teritorijalnih pitanja koja je Italija imala sa zemljama u susjedstvu na kraju Drugog svjetskog rata, tršćansko jedino koje još uvijek utječe na talijansko javno mnijenje i politiku. U prvom se dijelu članka ukratko opisuje teritorijalni spor koji je Italija imala s Francuskom, talijanskim bivšim kolonijama, Austrijom i Jugoslavijom. Ta su pitanja promatrana u glavnim crtama radi konciznosti, s fokusom na uzajamni utjecaj koji su međusobno imali jedna na druge u fazi kad je početak hladnog rata utjecao na sve njih. U drugom se dijelu članka objašnjava zašto je tršćansko pitanje tako posebno i zašto još uvijek igra važnu ulogu u talijanskoj nacionalnoj svijesti. Članak se temelji na radovima talijanske, hrvatske i slovenske historiografije, a kako bi se bolje objasnilo određene detalje, korišteno je nekoliko dokumenata iz Kancelarije Maršala Jugoslavije (Fond 836 - Arhiv Jugoslavije) te Političkog arhiva Ministarstva vanjskih poslova Republike Srbije (PA - DAMSP)

The ITALY ELT ARCHIVE: implications for second language awareness research and teacher education

Il ruolo centrale degli archivi e delle collezioni speciali nell’educazione, in particolare nelle scienze umane, è stato studiato per molti anni. Tuttavia, l’uso degli archivi digitali per la formazione degli insegnanti di seconda lingua sembra essere stato trascurato. Inoltre, mentre la ricerca sulla storia dell’insegnamento delle seconde lingue è un campo in espansione in Europa, la storia dell’insegnamento della lingua inglese (ELT) in Italia è ancora poco sviluppata. Per colmare queste lacune, presso l’Università degli Studi di Milano è in corso un progetto per la creazione di un archivio online, ad accesso libero, di materiali ELT pubblicati nel XX secolo e destinati agli studenti italiani di inglese, l’Italy ELT Archive (IELTA). Lo scopo è quello di promuovere la ricerca e di fornire agli insegnanti in servizio e pre-servizio gli strumenti per comprendere i principi alla base dei materiali ELT e sviluppare la loro consapevolezza dei metodi di insegnamento della seconda lingua. Nella prima parte di questo articolo, descriviamo come IELTA è stato progettato e sviluppato per soddisfare sia gli scopi di ricerca che quelli educativi. Nella seconda parte, forniamo esempi di come IELTA possa essere utilizzato per la ricerca sulle variazioni linguistiche e sugli atteggiamenti linguistici, al fine di migliorare la consapevolezza degli insegnanti su questi fenomeni linguistici. Una questione critica nella formazione degli insegnanti è quella di colmare il divario tra la conoscenza teorica dei metodi di insegnamento delle seconde lingue e la loro applicazione pratica. Nell’ultima parte, forniamo esempi di come l’IELTA sia stato utilizzato per migliorare la consapevolezza degli studenti insegnanti sui metodi di insegnamento attraverso l’analisi e la valutazione dei materiali ELT.The pivotal role of archives and special collections in education, particularly in the humanities, has been researched for many years. However, the use of digital archives for second language teacher education appears to have been overlooked. Moreover, while research into the history of second language teaching is an expanding field in Europe, the history of English Language Teaching (ELT) in Italy is still undeveloped. To fill these gaps, a project is underway at the University of Milan to create an online, open-access archive of ELT materials published in the twentieth century targeting Italian learners of English, the Italy ELT Archive (IELTA). The purpose is to promote research and provide in-service and pre-service teachers with tools to understand the principles underpinning ELT materials and develop their awareness of second language teaching methods. In thefirst part of this article, we describe how IELTA was designed and developed to fulfil both research and education purposes. In the second part, we provide examples of how IELTA can be used to research language variation and language attitudes to enhance teachers’ awareness of these linguistic phenomena. One critical issue in teacher education is bridging the gap between theoretical knowledge of second language teaching methods and their practical implementation. In the last part, we provide examples of how IELTA was used to enhance student teachers’ awareness of teaching methods through the analysis and evaluation of ELT materials

BIOHYDROGEN PRODUCTION FROM AGRICULTURAL AND LIVESTOCK RESIDUES WITHIN AN INTEGRATED BIOENERGY CONCEPT

Concerns about energy security, fossil fuel prices, and climate change issues, are leading to increasing renewable energy demand. Hydrogen is considered as one of the main possible energy carriers in future, due to its environmental (it can be converted to energy with the solely emission of water) and energetic (energy content of 120 MJ/kg, three times higher of the gasoline content of 44 MJ/kg) unique properties. If hydrogen is currently being produced mainly by fossil sources, its production from renewable sources answers to the demand of more environment-friendly exploiting alternatives, possibly leading to a renewable-based hydrogen economy. Biomasses are an important renewable source ranging from energy-dedicated crops to livestock waste effluents, agro-industrial wastewaters, food-processing industry residues and organic fractions of the municipal solid waste (OFMSW). Thus the agricultural sector may acquire a renewed importance in the mid-term as a producer of energy sources for renewable biohydrogen production. Among the biological ways to exploit biomasses for hydrogen production, this thesis focused its interest on anaerobic dark fermentation, which can simultaneously guarantee the production of an high-value product (H2) at high evolution rates and the treatment of wastes, thus transformed from an environmental pollution and greenhouse gases emissions source into a valuable resource. If on the one hand this process has lots in common with anaerobic digestion, which already is a well-established technology for treating different biomass types in real-scale plants, on the other hand it is a relatively new approach, which needs to be further studied for improving its performances and being concretely applicable. As a matter of fact, the main disadvantage of dark fermentation is its relatively low yield, compared to other bio-hydrogen production methods, which typically are between 2.4 and 3 mol H2/mol glucose. This represents just the 20-25% of the 12 mol of H2 theoretically obtainable by glucose fermentation. Therefore, generally two different (but not mutually exclusive) options could be chosen for improving the process and making it ready for full-scale applications: the optimization of the biological, biochemical, chemical-physical operative parameters that regulate process; or the coupling of this bioprocess with other technologies capable of exploiting the organic matter not fully used by the dark fermentative approach. For example, Microbial Electrolysis Cells (MECs) are able to biologically oxidize the organic matter (from simple substrates like volatile fatty acids, lactic acid, glucose, cellulose, to actual wastewaters) releasing electrons from an anode to a cathode where potentially pure hydrogen can be formed from protons in the water. Papers I and II basically belong to the first strategy. In Paper I indeed, two waste biomasses were co-digested: in consideration that in the Po Valley area (Italy) swine manures (SM) are yearly produced at high waste density levels and could be a cause of environmental problems, this waste was used as a co-substrate for biohydrogen production by the thermophilic fermentation of easily degradable and carbohydrate-rich materials, such as fruit and vegetable market waste (FVMW). Biohydrogen production rates and process stability were thus simultaneously maximized, thanks to the endogenous buffer capacity of manure, through the combination of a suitable composition (as FVMW/SM) of the feeding material and the hydraulic retention time (HRT) of the process. Thus, livestock manure represented not only a renewable source for supplying the production of biohydrogen, but also a source of alkali to be used for avoiding the addition of exogenous chemicals (alkali) to maintain the pH, and so the metabolic pathways and bacterial communities, into an optimal domain for biohydrogen production. To further study and optimize the bio-H2 production in laboratory-scale processes, but also to find applicable tools for favoring dark fermentation application in full-scale biogas plants, Paper II succeeded in obtaining mixed microbial cultures from natural sources (soil-inocula and anaerobically digested materials) which reached high hydrogen yields with glucose and were used to explore the potential of bio-hydrogen production from four organic substrates of possible interest for full-scale plants (market bio-wastes, maize silage, swine manure, OFMSW). In direct prosecution of the positive co-digestion results shown in Paper I and looking for future transfer of this bioprocess technical solutions to full-scale systems, Paper II used the enriched mixed microflora for evaluating the co-fermentation of a mixture of OFMSW and swine manure in a lab-scale continuously-fed CSTR (continuously stirred tank reactor) digester. Despite the good results obtained, our study suggested that further efforts are needed for future applications of effective biohydrogen fermentation in full-scale plants. Paper III and IV are more focused on the second scientific strategy. Paper III joins the interest toward implementation of bio-H2 in full-scale plants and the strategy of improving the overall recovery of the energy contained in the biomass associating hydrogen production to other bioprocesses. Many authors report that the two-stage anaerobic digestion (AD) process, if compared to traditional and extensively real-scale applied single-stage AD, has also other advantages, such as differentiating the biofuel production (bio-hydrogen and bio-methane), potentially reducing the plant dimensions and costs, improving the overall biogas production yields and allowing higher CH4 concentrations in the biogas produced in the second stage, thus decreasing the biogas purification costs. Therefore, a two-stage laboratory-scale CSTR anaerobic digester, fed with a mixture of agricultural and livestock residues, was monitored for a long run (approximately 700 hours) and compared to a similar one-stage reactor. This study obtained a good hydrogen yield per kg of biomass treated and partially confirmed the advantages previously illustrated, even if it reached almost the same overall energy recovery of the single stage process. Aiming at other possible biological strategies to improve the energy and hydrogen recovery efficiency with the use of effluents from a first dark fermentative stage, a relatively new electrohydrogenesis device (MEC) was studied. Paper IV explores the rate and the yield of biogas (a mixture of H2, CH4 and CO2) produced by MEC exploiting an actual industrial wastewater with high methanol content, a compound never before reported to be used in a MEC device. The energetic recovery and treatment performance of the process was evaluated and also compared with a simulation of anaerobic digestion of the same wastewater, revealing the economical competitiveness of the MEC technology with the AD process. This leads to future research perspectives aiming to realize a laboratory-scale two-stage reactor with a MEC using the volatile-rich effluent of a first dark fermentative stage

Violence against women in politics: Reflections on its international conceptualization in dialogue with decolonial feminist thinking

International treaties on Violence Against Women in Politics (VAWP) have given visibility to a long-overlooked issue (Restrepo Sanín, 2018; Krook, 2020). While influential in shaping national reform processes and normative responses in Abya Yala, these frameworks remain Eurocentric, failing to address the colonial, patriarchal, racist, and heteronormative structures which have shaped the violence that affect women holding elected offices or exercising political power in the region (Curiel, 2014). As a result, prevention strategies can be inadequate or insufficient, reinforcing exclusions in political spaces. This paper, drawing on decolonial feminist perspectives, explored how VAWP is conceptualized in the global normative framework, examining six international agreements that address the issue directly or indirectly and that are relevant to Abya Yala. In particular, it focuses on the way the configuration of VAWP relates to the overshadowing of a gendered modern/ colonial system of oppression on which globalized predatory capitalist order lies upon. For doing that, we adopt the lens of the imbrication of oppression and the fourfold coloniality framework as key methodological tools, grounded in a decolonial feminist standpoint. The paper approach allows for the disclosure and questioning of the dominant modern/colonial rationality that continues to perpetuate exclusion practices and hinder substantial equality. In this process, it is key to unveil the imbrication of race, sexuality, gender and class that simultaneously affect embodied experiences of oppression and exploitation, both in relation to geographical and corporal territories. It is then argued in favour of a more contextualized approach to VAWP that considers dissident-in-many-ways bodies and their geo-political location, highlighting the differentiated impact of violence.Los tratados internacionales sobre violencia contra las mujeres en la política (VAWP, por su sigla en inglés) han visibilizado un problema largamente ignorado. Aunque han influido en los diseños de reformas nacionales y respuestas normativas en Abya Yala, este andamiaje institucional sigue siendo eurocéntrico y no cuestiona las estructuras coloniales, patriarcales, racistas y heteronormativas que moldean la violencia contra las mujeres en cargos políticos en la región. Por eso, las estrategias de prevención siguen siendo insuficientes y hasta excluyentes. Este artículo, en diálogo con el feminismo decolonial, analiza cómo se conceptualiza la VAWP en los acuerdos internacionales relevantes para Abya Yala, examinando seis instrumentos globales que abordan la problemática directa o indirectamente. En particular, nos enfocamos en cómo la definición de esta violencia oculta un sistema moderno/colonial de opresión de género, sobre el que se sustenta el orden capitalista depredador globalizado. Para eso, en nuestro análisis documental exploratorio, empleamos el modelo de la colonialidad en cuatro dimensiones y la imbricación de opresiones como herramientas analítico metodológicas claves, en diálogo con la perspectiva feminista decolonial. El enfoque propuesto contribuye a revelar y cuestionar la racionalidad moderna/colonial dominante que reproduce exclusiones y frena la igualdad sustantiva. Además, permite destacar cómo se entrelazan raza, sexualidad, género y clase en las experiencias de opresión y explotación, tanto en territorios geográficos como corporales. Así, se plantea la necesidad de abordar la VAWP desde una mirada contextualizada que considere los cuerpos disidentes en todas sus formas y su ubicación geopolítica, visibilizando el impacto diferenciado de la violencia