Saudi Cultural Missions Theses & Dissertations
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Item Restricted Evaluation of DNA Repair Biomarkers in Epithelial Ovarian and Breast Cancers(Saudi Digital Library, 2025-01-02) (Shoqafi, Ahmed); Madhusudan, SrinivasanDNA damage signalling and repair pathways play a crucial role in the regulation of genomic stability. Impaired DNA repair promotes genomic instability, a key route to the development of cancers. Cells have developed signalling pathways that are activated in response to DNA damage to detect and repair the damage that has occurred. Ataxia-Telangiectasia Mutated (ATM) and Ataxia-Telangiectasia and Rad3-related (ATR) kinases are activated in the presence of DNA damage and initiate a series of phosphorylation events that lead to the activation of downstream effectors. Some of these effectors include p53 and BRCA1, which regulate cell cycle, DNA repair, and apoptosis. The major DNA repair pathways are nucleotide excision repair (NER), which removes bulky DNA adducts; base excision repair (BER), which is involved in repairing small, non-helix-distorting base lesions; mismatch repair (MMR), which corrects replication errors and double-strand break repair which include homologous recombination (HR) and non-homologous end joining (NHEJ). All these pathways are regulated in a manner that is specific to the type of damage that needs to be repaired so that repair is as accurate as possible. Since conventional therapies for advanced epithelial ovarian cancer (EOC) and breast cancers have been found to be less effective, there has been a shift to search for new therapeutic approaches that aim at targeting the DNA repair pathways. The host laboratory, using whole-exome sequencing in platinum-sensitive (PEO1, A2780) and platinum-resistant (PEO4, A2780cis) ovarian cancer cell lines, identified TP73 and POLE as potential predictors of platinum resistance. In the current study, I have investigated the role of TP73 and POLE in EOC and breast cancers in detail. TP73 is a member of the TP53 family of transcription factors that are involved in DNA repair, cell growth, migration, and death. In 331 EOC samples, I observed that high protein expression of TP73 was associated with higher tumour grade, late-stage disease and shorter progression free survival (PFS). In the large publicly available clinical cohort (n=522) and the cancer genome atlas (TCGA) ovarian cohort (n=182), TP73 transcript was upregulated in tumours compared to normal tissues and associated with shorter PFS. Preclinically, I have shown that overexpression of TP73 in A2780 platinum-sensitive ovarian cancer cells enhanced cell proliferation, invasion and increased DNA repair capacity. In clinical breast cancers, analysis of TP73 expression in 1,369 invasive breast cancers and 317 DCIS cases revealed that high cytoplasmic TP73 expression is significantly associated with aggressive disease features, including high tumour grade, ER negativity, triple-negative phenotype, and poor breast cancer-specific survival, particularly in the TP53 mutant subgroup. These findings highlight the prognostic and predictive significance of TP73 in EOC and breast cancers. POLE has roles during DNA replication and repair pathways. I have investigated POLE expression in EOC and breast cancers. Immunohistochemical analysis of 331 EOC samples revealed that 75% exhibited low nuclear POLE expression, while 25% showed high expression. High POLE levels were significantly associated with higher tumour grade, poor progression free survival (PFS) and overall survival (OS). The transcriptomic levels of POLE were analysed in patients with EOC, revealing that high POLE mRNA expression was significantly associated with poor progression free survival (PFS) and overall survival (OS) (All p=<0,05). Functional studies in platinum-resistant OVCAR 4 cells demonstrated that POLE knockdown increased cisplatin sensitivity, which was associated with double-strand break (DSB) accumulation, S-phase cell cycle arrest and increased apoptosis. The data supports the role of POLE in predicting response to platinum chemotherapy in EOC. The study of 1,480 invasive breast cancer cases revealed that exhibited low nuclear POLE expression, which was associated with aggressive tumour features, poorer breast cancer specific survival (BCSS), and reduced response to endocrine therapy in ER+ and luminal subtypes. These findings suggest that POLE may be a predictive factor in ER+ breast cancers. Taken together, the data provides evidence for the role of TP73 and POLE as potential biomarkers in EOC and breast cancers.37 0Item Restricted Hope, Despair, and Environmental Discourses in Contemporary North American Speculative Fiction(Saudi Digital Library, 2025-06-24) Alotaibi, Hind Mater; Feghalim ZalfaThis thesis examines contemporary North American speculative fiction through an environmental perspective. It explores emotions and environmental discourses portrayed in nine novels, tracing authors’ utilization of hope and despair both as themes and emotional states to envision the future interconnectedness of humanity and the environment. As it connects literature, emotions, and the environment, this study expands the scope of how contemporary environmental speculative fiction is analysed by moving beyond the focus on scientific and economic facts to also include the emotional language and expressions in such texts. It does so through analysing nine novels in which the bonds between humanity and the environment are explored, both emotionally and ecologically: Margaret Atwood's Oryx and Crake (2003), Paolo Bacigalupi's The Water Knife (2015), T. C. Boyle’s A Friend of the Earth (2000), Barbara Kingsolver’s Flight Behavior (2012), Nathaniel Rich’s Odds Against Tomorrow (2013), Kim Stanley Robinson’s New York 2140 (2017), Louise Erdrich’s Future Home of the Living God (2017), Sherri L. Smith’s Orleans (2013), and Cherie Dimaline’s The Marrow Thieves (2017). Across the three broad sections on the consequences of human behaviour on the natural world, climate change, and environmental justice, this thesis asserts the vital role of the expressions of hope and despair as tools for communicating and shaping environmental discourses in contemporary speculative fiction and as fundamental elements of the storytelling, mirroring the ambiguity and uncertainty of future environmental issues. The simultaneous presence of both hope and despair in such narratives is not only determined by human-nonhuman interconnectedness but also aligns with the underlying cultural, historical, societal, and environmental contexts that shape this connection. This alignment, I contend, allows for more broader understanding of the term “Anthropocene” in contemporary texts, one that highlights diverse experiences and voices, especially when applied to literary texts that explore human-nonhuman interactions within various community contexts. Reading contemporary speculative fiction at the intersection of ecocriticism, environmental humanities, and affective ecocriticism, I argue, not only reveals the intricate depiction of human-nonhuman connection in these novels but also the ways in which authors position readers to be part of a wide range of environmental issues.5 0Item Restricted Implementation of a Competency Framework in Saudi Undergraduate Medical Education(Saudi Digital Library, 2025-06-24) Alqarni, Mohammed; Roberts, Trudie; Farnsworth, Valerie; Goddard-Fuler, RikkiIn 2011, a competency-based medical education (CBME) framework called SaudiMEDs was developed in Saudi Arabia to serve the community with medical graduates who can competently fulfil society’s health needs. SaudiMEDs serves as a guide to designing, developing, and evaluating medical school curricula. Despite the widespread implementation of SaudiMEDs, no research has been conducted on how medical education has been shaped as a result of SaudiMEDs. This study’s primary aim is, therefore, to investigate the real-time implementation of SaudiMEDs and its impact on Saudi medical schools. Qualitative case studies with two medical schools across the country were conducted to investigate how SaudiMEDs had been implemented. Documentary analysis of the medical schools’ documents, semi-structured interviews with academic leaders, and focus groups with faculty members and students were carried out for each school. Framework analysis for documents and Reflexive thematic analysis for interviews and focus groups were used to identify patterns and concepts and to conceptualise and construct meaning from the data. Analysis revealed a complex network of mixed perceptions of SaudiMEDs which, based on identified variations in teaching strategies, ways of learning and assessment methods, are considered as a key influence shaping implementation of SaudiMEDs. The perceptions of faculty members and students provide insight into the culture of each medical school and how it mediates implementation. The study also identifies different challenges in the SaudiMEDs implementation, which could provide further explanation for the variation in each medical school context. A key finding was the challenge of translating curriculum innovation developed in and for Western, specifically North American, contexts to the distinct organisational and institutional culture of Saudi Arabia. One consequence of this was that schools in this study approached implementation as a mapping activity and focused on the short-term accreditation standard requirement rather than a longer-term evaluation. This limited the ability of SaudiMEDs to achieve its stated aims. The research helps to identify what needs to be done to enable the fruitful transformation of SaudiMEDs into robust curricula: a) a rigorous review of SaudiMEDs to contextualise community health needs and b) support for CBME implementation through the enactment of the legislation, training, and establishment of appropriate information technology infrastructure to provide authentic experiences for learners.22 0Item Restricted HOW DISSENTING JUDGMENTS HELP US UNDERSTAND THE ROLE OF FAIRNESS IN THE DEVELOPMENT OF THE COMMON LAW. IN LIGHT OF MABO (NO 2) V QLD (1992) 175 CLR 1 AND CARR V WA (2007) 232 CLR 138.(Saudi Digital Library, 2024-10-09) Almufarriji, Meshari Mohammed M; Bourke, JudyI argue that dissenting judgments have an immense role in developing the law through the lens of fairness and that it is because of how these judgments challenge the majority judgment by presenting the flaws that were not resolved and tested in accordance to legal principles such as fairness which is usually the main principle in dissenting judgments as they highlight the social implications of the majority judgment. The dissenting judgments develop the common law in the long term by making it responsive to social changes in future cases where it can be used as a starting point to create a new law compatible with the current social values, enhancing fairness as a legal principle while maintaining the coherence of the legal system. A great example of the role of fairness is the dissenting judgments in Mabo (No 2) v Qld (1992) 175 CLR 1 and Carr v WA (2007 232 CLR 138 which sets an example of how it can have a vital and crucial role in developing the common law and ensuring its dynamicity. Even though there are some critics about the role of dissent in developing the Common law, such as dissent might affect the certainty of the legal system and doctrine of precedent, which might lead to compromising the credibility before the public, the role of dissent can be balanced to avoid such critiques by ensuring these legal principles are not affected but align with the principle of fairness, and that can be done by accurately testing the precedents to see the ability to be applied before start dissenting.5 0Item Restricted The Impact of Process Mapping Techniques on Emergency Department Efficiency and Quality of Care: A Systematic Review(Saudi Digital Library, 2025-05-28) AL MANSOUR, TAREG MOHAMMED H; Than Win, KhinAbstract Background: Emergency departments worldwide face operational challenges that impact patient care quality and efficiency. Process mapping techniques have emerged as potential quality improvement strategies, yet comprehensive evidence of their effectiveness in emergency department settings remains limited. Objective: To systematically review the impact of process mapping techniques on emergency department efficiency and quality of care. Methods: Article search was conducted at five databases (PubMed, Web of Science, Scopus, MEDLINE, ACM) from August 2024 to January 2025, with no date restrictions. Studies were included if they explicitly applied process mapping techniques in emergency department settings and reported efficiency or quality outcomes. Two reviewers independently screened studies and extracted data. Study quality was assessed using the SQUIRE 2.0 checklist. Due to heterogeneity in study designs and outcome measures, a narrative synthesis was conducted. Results: Twenty-four studies met inclusion criteria, representing diverse settings across 12 countries. All studies reported positive efficiency outcomes, with process mapping techniques demonstrating median reductions of 20% in emergency department length of stay (range: 3-68%) and 54% in door-to-doctor wait times (range: 29-78%). Left without being seen (LWBS) rates decreased by an average of 46% in seven of eight studies, with one study reporting a slight, nonsignificant increase. Quality of care indicators showed improvements in patient satisfaction in all three studies measuring this outcome, with no studies reporting negative impacts on clinical safety measures. Value Stream Mapping, simulation-enhanced approaches, and comprehensive Lean methodologies demonstrated the most substantial improvements across multiple domains. Conclusions: Process mapping techniques consistently improve emergency department efficiency without compromising quality of care across diverse healthcare settings. The evidence strongly supports adopting these techniques as effective quality improvement strategies, particularly for departments facing operational challenges. Future research should focus on comparative effectiveness studies and long-term sustainability evaluations.31 0Item Restricted Improving Sleep Health with Deep Learning: Automated Classification of Sleep Stages and Detection of Sleep Disorders(Saudi Digital Library, 2024-07-07) Almutairi, Haifa; Datta, AmitavaSleep consumes roughly one-third of a person’s lifetime, and it is characterized by distinct stages within sleep cycle. The sequence of these stages at night provides insights into the quality of sleep. Poor sleep quality can have numerous consequences, including drowsiness, reduced concentration, and fatigue. Beyond sleep quality, an analysis of the sequence of sleep stages can uncover the presence of sleep disorders. This thesis aims to focus on three key research problems related to sleep. Firstly, it focuses on the classification of sleep stages using a combination of signals and deep learning models. Sleep stages are categorized into five distinct stages, namely Wake (W), non-rapid eye movement (NREM) stages comprising N1, N2, and N3, and rapid eye movement (REM) stage. Throughout the duration of sleep, individuals experience multiple cycles of sleep stages. Each cycle contains a standard allocation of each stage. An unbalanced distribution of the stages can indicate the presence of sleep disorders. Previous studies primarily classified sleep stages using a single channel of electroencephalography (EEG) signals. However, incorporating a combination of signals from electromyography (EMG) and electrooculogram (EOG) alongside EEG data provides additional features. These features extracted from muscle activity and eye movements during sleep, thereby enhancing classification accuracy. In this thesis, a robust model called SSNet is proposed to accurately classify sleep stages from a fusion of EEG, EMG, and EOG signals. This model combine convolutional neural networks (CNNs) and long short-term memory (LSTM) networks to extract the salient features from various physiological signals. The CNN architecture extracts spatial features from the input signals, while LSTM architecture captures the temporal features present in signals. This study has obtained encouraging outcomes in the classification of sleep stages through the fusion of physiological signals and deep learning techniques. Secondly, this thesis aim to detect obstructive sleep apnoea (OSA) from electrocardiography (ECG) signals using deep learning methods. Sleep disorder breathing (SDB) is categorized into three different types, which are OSA, central sleep apnoea, and mixed sleep apnoea. OSA is the most common form of SDB that is characterized by repeated interruptions in breathing during sleep, leading to fragmented sleep patterns and various health complications. Previous studies developed feature engineering methods and machine learning models for the detection of OSA. Feature engineering methods involve crafting relevant features to feed into machine learning models. However, feature engineering is time-consuming and requires domain expertise. In contrast, deep learning automatically extracts features from ECG signals for OSA detection, eliminating the need for manual feature engineering methods. In this thesis, three deep learning architectures are proposed, including standalone convolutional neural networks (CNN), CNN with long short-term memory (LSTM), and CNN with gated recurrent unit (GRU). Through rigorous experimentation and evaluation, the combination of CNN and LSTM architecture is the best-performing model for OSA detection. To further enhance the architecture’s performance, the hyperparameters of the CNN and LSTM models were tuned and tested over a large dataset to validate their effectiveness. The third research problem addressed in this thesis is detection of periodic leg movements (PLM) and SDB from NREM stage by using a combination of signals and deep learning models. PLM is characterized by involuntary leg movements during sleep. These movements can disrupt sleep and result in daytime sleepiness with reduced quality of life. Detecting PLM and SDB events during NREM stage allows for quantifying the severity of sleep disorders. Previous studies have focused on the development of signal-based models for detecting PLM or SDB. However, the models lacked the ability to distinguish these events within specific sleep stages. To address this problem, a novel deep learning architecture known as DeepSDBPLM is proposed. This architecture aims to detect PLM and SDB events during the NREM stage. This architecture incorporates novel input features called attention EMDRaw signals and utilizes a Residual Convolutional Neural Network (ResCNN) model. This thesis presents experimental results using publicly available datasets to evaluate the performance of the proposed deep learning models for classification of sleep stages, and detection of sleep disorders. The models were evaluated standard metrics. It includes accuracy, sensitivity, specificity, and F1 score. The empirical results establish the effectiveness of proposed approaches. The models can be a stepping stone towards more advanced techniques.10 0Item Restricted Exploring the High Energy Emission and Luminosity Mechanisms in Binary Black hole Systems Embedded in Active Galactic Nuclie(Saudi Digital Library, 2025) Mahnashi, Laila; Gendre, BruceIn this project, I implement a theoretical astrophysics study to investigate the potential electromagnetic (EM) signatures of binary black hole (BBH) systems embedded within the accretion discs of active galactic nuclei (AGNs). The primary objective is to model the spectral energy distribution (SED) of both the AGN and the BBH system, with the aim of identifying physical conditions under which the BBH-induced emission may become observationally distinguishable from the dominant disc background. To construct realistic SEDs, the model incorporates key radiative processes, including thermal blackbody emission from the AGN disc, synchrotron radiation from relativistic electrons, and inverse Compton scattering of seed photons. Systematic variations in viscosity, accretion rate, density, and optical depth are explored to assess their influence on the spectral properties. Special emphasis is also placed on transient flare events associated with BBH activity and on scenarios where the AGN disc is intrinsically dimmed. These conditions may enhance the visibility of BBH-driven high-energy emission, partic ularly in the hard X-ray and gamma-ray regimes. The results suggest that during low-luminosity phases of AGNs and BBH flaring episodes, the BBH emission can dominate at high photon energies, providing a promising opportunity for detection. This approach offers a complementary perspective to conventional methods, align ing with emerging observational efforts to connect gravitational-wave detections with electromagnetic counterparts. Although the model adopts several simplifying assumptions, it provides valuable theoretical insights into the EM observability of BBHsystems in AGN environments and contributes to the broader understanding of multimessenger astrophysics.6 0Item Restricted Exploring Female Preschool Teachers’ Perspectives on Conceptualising and Implementing Play and Play-Based Learning in the Kingdom of Saudi Arabia(Saudi Digital Library, 2024-09-12) Aljohani, Asma Hulayyil; Jo Bird, Associate; Sims, Margaret; Eliott, Sue; Zheng, HaoranThis study explored how Saudi female preschool teachers conceptualise and implement play and Play-Based Learning (PBL) within their unique cultural, social, and religious contexts. While Saudi Arabia’s early childhood curriculum has implmeneted Western models of PBL, the significant cultural differences challenge direct application. Through a qualitative, socially constructivist approach and indigenous methodology, the study involved 23 teachers from public, private, and charity-based preschools. Data were collected via interviews, lesson plans, and focus groups and analysed thematically. Findings revealed that teachers’ understanding of play is shaped by local values and religious practices. Three main types of play were identified:(Outdoor play)routines aligned with school, social, religious, and cultural contexts; (Interest area activities) as scripted play informed by the curriculum and society’s cultural norms and contexts; and (Refreshment play) for when children had a little spare time at the end of a group activity. Teachers also adopted varied pedagogical roles such as planner, co-player, facilitating leader, observer, and supporter based on their perspectives, understanding, curriculum goals, and children's needs. Challenges included societal expectations, gender norms, and administrative pressures. To bridge this gap, I have proposed a practical model to meld the Western and Saudi Arabia notions of play and PBL by creating a metaphorical model entitled, “Using a Date Palm Tree Metaphor for Play-Based Learning in the KSA”. ’The aim of this model and other recommendations arising from the study is to improve the cross-cultural transferability of the Western concept of PBL and to offer a suitable and consistent framework for supporting children’s learning and development in ways relevant and applicable to the Saudi educational setting.19 0Item Restricted Susceptibility Analysis of Flash Flood in Jeddah City, Saudi Arabia, Using a GIS-Based Analytical Hierarchy Process(Saudi Digital Library, 2025-05) Alnasser, Nasser; Aly, MohamedFloods rank among the most devastating natural hazards on Earth, posing significant threats to human society across various geographies, including arid regions such as Saudi Arabia. In Saudi Arabia, Jeddah is the second largest city in terms of population with more than 4.5 million residents. The city experiences long and arid summers and short, dry, and windy winters. As the severity and frequency of floods continue to increase, there is a growing demand for improved flood risk assessment to mitigate damage to lives and properties. Given the complex nature of flood evaluation and prediction, a systematic criteria-based methodology, such as the Analytical Hierarchy Process (AHP), offers a robust solution. This study integrates the AHP with a Geographic Information System (GIS) to model flash flood risk hazards in Jeddah, Saudi Arabia. Key parameters for this evaluation included precipitation, elevation, slope, proximity to drainage networks, land cover, and lithology. A pairwise comparison was conducted to rank these criteria by order of magnitude in flood contribution. Four susceptibility grades – ranging from Low to Very High – were identified to represent flood hazard likelihood. The findings show that the eastern and central parts of Jeddah, particularly areas leading to the coast, are identified as the most vulnerable areas to flash flooding due to their proximity to natural water channels and their low-lying, intermittent topography, which creates valleys. Obviously, the rapid urbanization of Jeddah contributes also to flash flooding caused by seasonal downpours. Local authority should develop coping strategies, such as widening drainage systems and reducing paved surface areas in highly susceptible zones, to mitigate future flood risks effectively.23 0Item Restricted Developing a system to study proteins clustering at membranes(Saudi Digital Library, 2025) Hasanin, Mohamed; Bowen, Mark ESynaptic transmission relies on a dense network of proteins at the postsynaptic density (PSD), where scaffold proteins like PSD‑95 organize neurotransmitter receptors and adhesion molecules into functional complexes. Understanding how these proteins cluster on membranes is key to deciphering synaptic strength and plasticity, yet it remains challenging to study. In living cells, cytoplasmic crowding and limited resolution obscure nanoscale assembly, and past work on PSD‑95 palmitoylation has relied on static, non‑specific interventions or trafficking‑deficient mutants, leaving the real‑time role of membrane anchoring unclear. This work set out to supply the purified, assay‑ready proteins needed for a two‑dimensional membrane reconstitution system that can reveal the step‑by‑step assembly of PSD complexes, laying the groundwork for clearer mechanistic insights and, for strategies to correct synaptic‑organization disorders. To that end, we produced PSD‑95, GluN2B CTD2, and neuroligin CTD with assay‑ready tags. PSD‑95 was made His‑tag‑free after purification; anion‑exchange removed DNA contamination, although low solubility persisted, indicating that future plasmid redesign (for example, adding a solubility tag) may be needed. For GluN2B CTD2, expression in Rosetta2 E. coli and the inclusion of 2 M urea throughout purification increased the soluble yield and markedly reduced aggregation at pH 7.4. Neuroligin CTD experienced a greater than 90 % loss somewhere in the fluorescent‑labeling workflow; it’s extremely low 280 nm absorbance makes this difficult to track. To enable precise monitoring, additional His‑tagged batches were prepared in BL21(DE3), and future expression in Rosetta2 is proposed to offset rare‑codon limitations and improve output. Despite remaining hurdles, these optimized protein preparations provide the essential building blocks for forthcoming membrane‑based clustering assays, bringing us closer to observing how PSD proteins self‑assemble and remodel in real time.31 0