Saudi Cultural Missions Theses & Dissertations
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Item Restricted Long-term use of Probiotics and Bone Mineral Density (BMD), Bone Turnover Markers (BTMs) and Fracture Risk among Postmenopausal Women: A Scoping Review(Saudi Digital Library, 2025) AlShangiti, Dana Firas; Logan, JohnBackground: Bone mineral density (BMD), bone turnover markers (BTMs) and fracture risk are key indicators of bone health, particularly in postmenopausal women who are at increased risk of osteoporosis. Probiotic supplementation has emerged as a potential intervention to improve bone health by modulating gut microbiota and systemic inflammation. Objectives: To identify and describe the types of studies conducted on BMD, BTMs, fracture risk and probiotic supplementation in postmenopausal women. Aim: This review explicitly examines and synthesises available evidence regarding the relationship between BMD, BTMs and fracture risk in postmenopausal women, the impact of probiotic supplementation on these parameters, and the characteristics of populations studied, research concepts, and study contexts. Eligibility criteria: Original research studies investigating the effects of probiotic supplementation on BMD, BTMs and fracture risk in postmenopausal women, with clear reporting of outcomes and relevant intervention details. Sources of evidence: Comprehensive database searches, complemented by manual screening, were used to identify studies that met the inclusion criteria. Charting methods: A narrative synthesis approach was used to collate and analyse study characteristics and findings, with attention to heterogeneity in interventions, eligibility criteria, outcome measurement sites, and co-supplementation regimens. Results: Five studies met the inclusion criteria. Three of these showed significant positive effects of probiotic supplementation on BMD, predominantly in trabecular-rich regions of bones. The included studies were highly heterogeneous regarding co-interventions, eligibility criteria, anatomical sites used for primary outcomes, co-supplementation strategies and findings in BTMs and fracture risk. Conclusions: Despite substantial heterogeneity, probiotic supplementation shows promise in improving bone health in postmenopausal women, particularly in trabecular bone regions. The review provides a comprehensive synthesis of current evidence and highlights the need for more standardised, rigorous long-term research to confirm these preliminary findings.15 0Item Restricted Peer Assessment and Professionalism in Arab Medical Education Settings(المكتبة السعودية الرقمية, 2025) Alotibi, Wafa; Joanne, Hart; Byrne-Davis, LucieBackground: Professionalism is a cornerstone of medical education, integral to fostering ethical practice, accountability, and patient-centred care, as emphasised in recent literature(McMahon et al., 2024; Sattar and Yusoff, 2025). Despite its recognised importance, defining professionalism remains challenging due to its multifaceted and context-dependent nature, with interpretations varying across cultures and institutions (Cruess, Cruess and Steinert, 2010; Tayeb et al., 2023). Traditional assessment methods, such as faculty evaluations and standardised tests, often fall short in capturing the nuanced behaviours and interpersonal skills that constitute professionalism (Tay et al., 2020). In response to these limitations, peer assessment has emerged as a promising approach that could encourage learners to reflect on and evaluate each other’s professional behaviours critically (Stenberg et al., 2021). However, a review of the literature suggests that the application of peer assessment in evaluating professionalism remains underexplored in Arab medical education contexts (Al Gahtani, Jahrami and Silverman, 2021). This thesis aims to investigate how professionalism is conceptualised and assessed within Arab medical education, with a particular focus on the potential of peer assessment as a tool for measuring professional behaviours among medical students. Methods: This research comprises three complementary studies. The first study was a scoping review that mapped the existing literature on peer assessment and professionalism in Arab medical education. The second study utilised semi-structured interviews with medical students and educators to explore their perceptions of professionalism and peer assessment within the cultural context. The third study involved expert focus groups to develop a culturally sensitive peer assessment tool tailored to the needs and values of Arab medical education settings. Results: The findings across the three studies highlight the influence of cultural context on how professionalism is understood, assessed, and potentially developed through peer assessment in Arab medical education. The first study, a scoping review, highlighted the limited use of peer assessment in the region and revealed diverse global approaches to evaluating professionalism, with notable gaps in culturally contextualised frameworks. The second study, based on interviews and a focus group, found that cultural factors such as collectivism, hierarchical structures, family involvement in decision-making, and gender dynamics are strongly influencing the conceptualisation and practice of professionalism. Challenges identified included resistance to critique, implicit biases, and the tension between individual responsibility and group loyalty. The third study, which used a focus group to refine a peer assessment tool, demonstrated consensus around key competencies such as effective communication, ethical conduct, cultural sensitivity, and professional boundaries. Participants emphasised the importance of adapting peer assessment frameworks to reflect these cultural realities while maintaining alignment with international standards. Conclusion: This research contributes a culturally grounded, evidence-informed framework for assessing professionalism in Arab medical education. By integrating insights from a scoping review, interviews, and expert consensus, it demonstrates how professionalism can be evaluated through peer assessment that respects both global standards and regional values. The findings highlight the importance of culturally responsive assessment design, structured peer feedback, and reflective learning environments. The developed tool offers a foundation for institutions to promote professionalism as an educational and ethical competency. Future work should focus on piloting the tool, evaluating its psychometric robustness, and embedding it within professionalism curricula to support formative learning and quality assurance across Arab medical schools.6 0Item Restricted Advertising change: How the Saudi Vision 2030 strategy has influenced gender representation in SAUDIA advertising between 2012 and 2021(Saudi Digital Library, 2024-09) Zehairy, Lujain Ahmed; Wilson, Paul; Stones, CatherineIn 2016 the government of Saudi Arabia announced the Saudi Vision 2030 programme, a blueprint for the country’s economic and social transformation. This research was conducted between 2020 and 2024, during a period of rapid change and the build-up to Vision 2030, situating the research within a key moment of national transformation. While Saudi Arabia was likely known for being culturally and socially conservative - characteristics that were often reflected in its advertising - the programme’s announcement has led to noticeable change in Saudi society, and a growing reliance on soft power strategies to globally communicate the strategic change promised by Vision 2030. Academic research has paid great attention to ways in which advertising and culture influence each other, and to how advertising might work to reflect or shape behaviours and cultural norms across society. From this, the research aims to study the redefinition of gender stereotypes in Saudi advertising, in particular of females, in light of the announcement and application of Saudi Vision 2030 programme and its desire for positive impact on female empowerment. From a sample of advertising images between 2012 to 2021, this research makes use of qualitative content and semiotic analyses to identify ways in which SAUDIA advertising has adjusted or developed methods for visualising females in ways which reflect Vision 2030. A novel framework has been developed which builds upon established scholars of gender representation and social semiotics, such as Goffman, Kress and Van Leeuwen, and integrates Saudi cultural perspectives (e.g. the dress code for women). This framework is utilised both as a model for data analysis and critical lens through which the research results are interpreted. Using a triangulation of methods - integrating semi-structured interviews with professionals in the Saudi advertising industry - allows for a reflection on key research insights, and a perspective from the advertising industry which provides some clarification as to how social change and advertising practices are currently interrelated. The research also makes use of an approach to qualitative trend analysis through the identification of trends within key results, which sheds new light on patterns that can influence future communication strategies. Through analysis and interpretation of the uses of certain visual symbols, the study has identified evidence of significant changes in SAUDIA advertising, which has resulted in four main thematic insights, each one aligning with a specific goal of Saudi Vision 2030. Advertising images analysed in the research exhibited a range of approaches when representing women in non-traditional roles, which aligns to the vision’s objective of creating new opportunities. Within the research, women are shown in a variety of ways in what I term ‘balanced representations’, which reflects notions of equality and the vision’s objective for equal contribution of genders. Images from the analysis also convey a notable balance of strength and softness, which works to highlight a potential for the dual capabilities of social and economic contribution. Lastly, the research reveals an emerging balance in how female appearance is represented, suggesting a need to consider traditions of a moderate society while reflecting the programme’s objective for a tolerant country. The study’s conclusions suggest ways that these results can perhaps be considered as a tool for demonstrating internal soft power applied inwards to demonstrate ways in which advertising can play a dual role in a complex process which both mirrors and promotes social change. Since the Saudi Vision 2030 is an ongoing project, this thesis sets a foundation for future studies to explore ways in which contemporary advertising can effectively capture and communicate social change.12 0Item Restricted Assessing the Impact of AI on Operational and Supply-Chain Decision-Making: Evidence from Companies in the Kingdom of Saudi Arabia (KSA)(Saudi Digital Library, 2025) Shalhoob, Huda Shafiq; Tahirov, NailThis study investigates the impact of Artificial Intelligence (AI) on flexible and responsive supply chain decision-making within Saudi Arabian enterprises. Using a mixed-methods approach, the research incorporates qualitative insights from seven semi-structured interviews and quantitative data from 96 survey respondents. The findings show that AI enhances supply chain flexibility and responsiveness; however, challenges remain related to strategic integration, cultural readiness, and financial accountability. Although AI adoption in Saudi enterprises is still at an early stage, it has significant potential to transform decision-making, improve agility, and strengthen competitiveness in global markets. The study highlights that current AI integration is fragmented and uneven, suggesting that further research is needed to explore sector-specific adoption patterns and long-term financial impacts, as well as the cultural and leadership barriers influencing AI-enabled supply chain transformation.27 0Item Restricted The Emotional Edge: Investigating the Role of Trait Emotional Intelligence in Emotional Language Use among Saudi EFL Learners(Saudi Digital Library, 2025) Alaofi, Amani Khaled Hamed; Mavrou, IriniEmotional expression is a central dimension of second language learning, yet little is known about how learners encode emotions lexically in L2 writing or how individual traits contribute to this process. This study examined the relationship between trait emotional intelligence (EI), narrative theme, and English proficiency in shaping the emotional vocabulary used by Saudi university students when recounting autobiographical experiences of guilt and loneliness. Ninety-three participants completed the TEIQue-SF and produced two 20-minute narratives in English, which were analysed for emotional language using SEANCE, a natural language processing tool, alongside thematic coding. By exploring how EI and narrative content intersect with language use, this research highlights the role of personal dispositions and memory focus in the development of learners’ expressive capacity in L2 writing.7 0Item Restricted Exploring Contemporary Trends in Simulation Modalities within Emergency Medical Services Education: A Scoping Review(Saudi Digital Library, 2025) Raffah, Abdulaziz Emad; Haq, Muhammad AinulBackground: With the rapid evolution of simulation modalities, such as the COVID-19 pandemic and various technological advancements, such as computer-based modalities and head-mounted display (HMD)-based technologies, a coatic simulation-based educational environment has been produced, where it has become challenging for Emergency Medical Services (EMS) educational agencies to adapt the proper simulation tool for the best cohort of learners. Consequently, curricular coherence suffers, faculty expertise is diluted, and the calibre of graduates declines, ultimately jeopardizing patient safety and outcomes. Therefore, the demand to map the existing literature on contemporary simulation modalities within the last five years is non-negotiable, ensuring the graduation of high-quality EMS professionals. Methods: Following PRISMA-ScR and JBI guidance, we searched PubMed, Web of Science, and Scopus (January 2020 – June 2025) and supplemented the results with grey literature, hand-searching, and citation chaining. From 979 records, 540 titles/abstracts were screened, 132 full texts were assessed, and 33 studies were included. Descriptive statistics and reflexive thematic analysis (inductive and deductive) were applied to the data on simulation types, barriers, facilitators, and fidelity practices. Results: Most studies originated from the Americas and Europe (36.5 % each); the remainder came from the Eastern Mediterranean, Western Pacific, and Southeast Asia. The methodologies were mainly quantitative (70 %), with mixed methods (21 %) and qualitative designs (9 %). Six modalities dominated: high-fidelity manikins, HMD-based virtual or augmented reality, screen-based simulation, cadaver training, actor-based scenarios, and hybrid design. Barriers and facilitators were clustered into five themes: resource, realism, human, facilitator, and operational or regulatory-related factors. Fidelity reporting was inconsistent; only two studies used an explicit framework, while most misapplied or omitted the concept. Conclusions: EMS practitioners play a pivotal role in life-saving care; therefore, there is no time to lose in preparing competent, knowledgeable, and professional clinicians. Simulation provides a diversified toolbox for cultivating both cognitive and psychomotor skills; however, its educational value depends on aligning each modality and simulation’s appropriate level of fidelity with clearly defined learning outcomes. This review offers a practical decision map that enables stakeholders to understand the benefits and limitations of contemporary simulation options and decide when, how, and for whom each modality should be deployed.14 0Item Restricted Deep Learning-Based White Blood Cell Classification Through a Free and Accessible Application(Saudi Digital Library, 2025) Alluwaim, Yaseer; Campbell, NeillBackground Microscopy of peripheral blood smears (PBS) continues to play a fundamental role in hematology diagnostics, offering detailed morphological insights that complement automated blood counts. Examination of a stained blood film by a trained technician is among the most frequently performed tests in clinical hematology laboratories. Nevertheless, manual smear analysis is labor-intensive, time-consuming, and prone to considerable variability between observers. These challenges have spurred interest in automated, deep learning-based approaches to enhance efficiency and consistency in blood cell assessment. Methods We designed a convolutional neural network (CNN) using a ResNet-50 backbone, applying standard transfer-learning techniques for white blood cell (WBC) classification. The model was trained on a publicly available dataset of approximately 4,000 annotated peripheral smear images representing eight WBC types. The image processing workflow included automated nucleus detection, normalization, and extensive augmentation (rotation, scaling, etc.) to improve model generalization. Training was performed with the PyTorch Lightning framework for efficient development. Application The final model was integrated into a lightweight web application and deployed on Hugging Face Spaces, allowing accessible browser-based inference. The application provides an easy-to-use interface to upload images, which are then automatically cropped and analyzed in real-time. This open and free tool is intended to provide immediate classification results. It is also a useful tool for laboratory technologists without requiring specialized hardware or software. Results Testing on an independent set revealed that the ResNet-50 network reached 98.67% overall accuracy. Performance was consistently high across all eight WBC categories. Precision, recall, and specificity closely matched the overall accuracy, indicating well-balanced classification. However, for the assessment of real-world generalization, the model was tested on an external heterogeneous dataset from different sources. It performed with 86.33% accuracy, reflecting strong performance outside of its main training data. The confusion matrix showed negligible misclassifications. This suggested consistent distinction between leukocyte types. Conclusion This study indicates that a lightweight AI tool can support peripheral smear analysis by offering rapid and consistent WBC identification via a web interface. Such a system may reduce laboratory workload and observer variability, particularly in resource-limited or remote settings where expert microscopists are scarce, and serve as a practical training aid for personnel learning cell morphology. Limitations include reliance on a single dataset, which may not encompass all staining or imaging variations, and evaluation performed offline. Future work will aim to expand dataset diversity, enable real-time integration with digital microscopes, and conduct clinical validation to broaden applicability and adoption. Application link: https://huggingface.co/spaces/xDyas/wbc-classifier6 0Item Restricted In-situ Environmental Transmission Electron Microscopy on Nickel-Based Nanostructures(Arej Eid, 2025) Eid, Arej; Lazarov, Vlado; Lari, LeonardoThis thesis explores the synthesis, phase transformations, and structural development of nickel-based nanoparticles (Ni-based NPs) using ex-situ and in-situ environmental transmission electron microscopy (ETEM). The study starts with exploring the transformation of carbamide and ammonia into NiO nanoparticles (NPs). We focus on the mechanism of this transformation via nickel hydroxide intermediates, β-Ni(OH)2 and Ni3(OH)4(NO3)2, which are achieved through thermal annealing. The ex-situ thermal decomposition of these intermediates resulted in NiO NPs with distinct shapes, sizes, and surface properties. NiO obtained by the carbamide route forms nanorods with polar {111} facets with a bandgap of 3.7 eV. NiO obtained by the ammonia route forms flower-like 3D nanostructures with neutral {002} facets and a lower bandgap of 3.2 eV, associated with an increased number of surface states due to their three times smaller size compared to NiO obtained by the carbamide route. Both sets of NPs are Ni-deficient. Next, we study these phase transformation mechanisms by utilising the electron beam as a driving force. In-situ (E)TEM was employed to observe the real-time transformation of the intermediates, β-Ni(OH)2 and Ni3(OH)4(NO3)2, under electron beam irradiation, as well as in an annealing and O₂ environment. In both cases, the transformation proceeded via β-NiOOH intermediates to NiO, with 3D flower-like morphology preserved in both cases. In-situ annealing at 350–400 °C formed <3 nm NiO particles retained the original structure, in comparison to ex-situ treatments that led to distinct NiO NPs morphologies. Next, we focused on NiO NPs obtained by physical ultra-high vacuum methods. MBE-grown Ni ultrathin films were transformed to Ni NPs under annealing in H2 atmosphere and vacuum, resulting in Ni NPs with varied morphologies. Ni NPs oxidation was performed in a 1 Pa background of O2, H2O, and H2O + CO2. O2 background resulted in the formation of spherical NiO NPs; H2O background yielded single-crystal NiO NPs, faceted predominantly by {111} surfaces, while CO2 + H2O mixtures produced polycrystalline NiO NPs, with irregular shape. Finally, we studied the reduction and oxidation of core-shell Ni/NiO NPs. We follow this process dynamically using in-situ ETEM, which includes shell grains coalescence and changes in crystallinity. The oxidation of pristine Ni NPs results in core-shell formation of Ni/NiO, which follows the Cabrera-Mott and logistic models of self-limited oxide formation. The findings in this work support the rational design of Ni-based nanostuctures with potential use in catalysis.3 0Item Restricted Enforcement and Power Dynamics in Saudi Arabia’s Transition to International Financial Reporting Standards(Saudi Digital Library, 2024) Aldarsi, Basmah; Chandler, RoyOver the past two decades, Saudi Arabia has transitioned from a closed, oil-based economy to a more open, international, and modernized private economy. This shift has influenced institutions across the country, particularly in transitioning from Saudi GAAP to IFRS. The adoption of IFRS changed the basis for auditing and disclosure practices among listed firms. While previous studies have explored resistance, challenges, and mixed outcomes of this transition, they have overlooked how power dynamics within regulatory bodies and the Public Auditing and Accounting Field (PAAF) have evolved to enforce and sustain these changes. This research explores how and why the power balance among actors in the auditing and accounting field shifted following the 2017 reforms. Using Strategic Action Field (SAF) theory, the study examines how various stakeholders including regulatory body members, local auditors, Big 4 firms, mid-tier international firms, and CFOs strategically acted within two key fields: the regulatory field and the PAAF. Based on 37 interviews, the study develops four models and one integrative framework that illustrate the restructuring of governance, resource allocation, and power relations. The findings show that the strategic objectives of the state disrupted existing power structures in regulatory bodies, allowing IFRS supporters to gain dominance. These actors aligned with Big 4 firms and international players, leveraged state backing, and strategically managed resistance to enforce IFRS. In the PAAF, local firms, previously dominant, were unprepared for the technical demands of IFRS. Big 4 firms seized this opportunity, expanding market control and raising prices. In response, local auditors formed partnerships with mid-tier firms. Today, the PAAF includes 15 regulated auditors: 3 local firms (20%), 4 Big 4 (26.67%), 1 regional Arabic firm, 4 partnerships with mid-tier firms (26.67%), and 3 independent mid-tier firms (20%). Before IFRS, any SOCPA-authorized auditor could audit listed firms. Post-IFRS, the Capital Market Authority (CMA) restricted this through a regulated list, reshaping access and oversight in the audit market. The study highlights the central role of the “Big 10” (Big 4 and international mid-tier firms) in enabling IFRS adoption and implementation. Their expertise and resources made the current 100% IFRS compliance among listed firms possible. However, their dominance threatens local firms, which must quickly adapt or risk marginalization. To counter this, state actors could support local capacity through IFRS training, encourage accessible partnerships with international firms, and embed IFRS education in university curricula to ensure sustainable market participation.4 0Item Restricted Cold chain logistics: analyse how Almarai company in Saudi Arabia manages temperature-sensitive logistics for dairy and food products(Saudi Digital Library, 2025) Aljuaid, Muhannad; Agca, AhmetBackground: This research aims to critically assess cold chain logistics for Almarai Company in managing their temperature-sensitive logistics for transporting food and dairy products in Saudi Arabia. Method: The research adopts a systematic literature review (SLR) guided by specific inclusion and exclusion criteria. Data from 33 relevant studies were analysed through thematic analysis to identify patterns, themes, and gaps, ensuring transparency, validity, and reliability throughout. Findings: Findings reveal cold chain logistics as essential for food safety and quality, influenced by infrastructure, workforce skills, technology adoption, climate, and regulations. Almarai faces high costs, infrastructural gaps, and technological limitations. Effective improvement measures include adopting IoT and RFID systems, workforce training, regulatory support, and infrastructure investment, ensuring sustainability and resilience. Recommendations: The study recommends Almarai enhance technological integration, particularly IoT-enabled monitoring, strengthen workforce training programs, and collaborate with government bodies to improve infrastructure and regulations. Strategic investment in sustainable and energy-efficient cold logistics is vital. Partnerships with logistics firms and adoption of green practices will strengthen operational resilience, compliance, and long-term competitiveness.8 0