The policy to accelerate the design of the Detailed Spatial Plan regulation document (RDTR) is a strategic step to enhance ease of doing business and promote sustainable development in Indonesia. Targeting 2036 RDTR sites nationwide, the initiative relies on various policy interventions and technical approaches. However, as of 8 January 2024, only 399 RDTRs (19.59%) were enacted after four years of implementation. This underperformance suggests the need to examine factors influencing the process, including issues at each stage of the RDTR design business process. While often overlooked due to its perceived irrelevance to the core substance of planning, analyzing the process is crucial to addressing operational and procedural challenges. This research identifies critical issues arising from the preparation to the enactment stage of RDTR regulations and proposes necessary policy changes. Using an explanatory approach, the study employs methods such as Analytic Hierarchy Process (AHP), post-review analysis, stakeholder analysis, business process evaluation, and scenario planning. Results show several impediments, including challenges related to commitment, technical and substantive issues, managerial coordination, policy frameworks, ICT support, and data availability. These findings serve as inputs for the development of business process improvement scenarios and reengineering schemes based on Business Process Management principles.

In today's competitive and complex business environment, achieving business excellence requires a combination of effective methodologies and strong leadership to drive and sustain organizational transformation. Lean Six Sigma (LSS), a proven methodology for improving operational efficiency, relies on effective leadership for successful implementation and lasting impact. This study examines how the integration of Lean, Six Sigma, and Total Quality Management (TQM) shapes leadership strategies that enhance organizational agility, resilience, and responsiveness to market dynamics. It highlights the crucial role of leadership in fostering collaboration, optimizing resource utilization, and cultivating a culture of continuous improvement. The study introduces the Structured Lean Leadership Framework as a strategic tool to develop the leadership capabilities essential for LSS success, addressing challenges such as weak leadership commitment, resistance to change, and communication barriers. Through the application of the DMAIC framework, Key Performance Indicators (KPIs), and Voice of Customer (VOC) analysis, the research aligns LSS with business objectives, customer needs, and sustainability goals. Additionally, it explores how combining LSS with Agile methodologies can improve operational efficiency, governance, and innovation, helping organizations better navigate future challenges. This research offers valuable insights for executives, practitioners, and researchers, supporting leadership development, data-driven decision-making, and long-term value creation. Future studies should focus on validating the Structured Lean Leadership Framework, exploring Agile-LSS integration in regulated industries, and examining the impact of Industry 4.0 technologies on LSS and leadership.

Instant and accurate evaluation of drug resistance in tumors before and during chemotherapy is important for patients with advanced colon cancer and is beneficial for prolonging their progression-free survival time. Here, the possible biomarkers that reflect the drug resistance of colon cancer were investigated using proton magnetic resonance spectroscopy (1H-MRS) in vivo. SW480[5-fluorouracil(5-FU)-responsive] and SW480/5-FU (5-FU-resistant) xenograft models were generated and subjected to in vivo 1H-MRS examinations when the maximum tumor diameter reached 1–1.5 cm. The areas under the peaks for metabolites, including choline (Cho), lactate (Lac), glutamine/glutamate (Glx), and myoinositol (Ins)/creatine (Cr) in the tumors, were analyzed between two groups. The resistancerelated protein expression, cell morphology, necrosis, apoptosis, and cell survival of these tumor specimens were assessed. The content for tCho, Lac, Glx, and Ins/Cr in the tumors of the SW480 group was significantly lower than that of the SW480/5-FU group (p < 0.05). While there was no significant difference in the degree of necrosis and apoptosis rate of tumor cells between the two groups (p > 0.05), the tumor cells of the SW480/5-FU showed a higher cell density and larger nuclei. The expression levels of resistance-related proteins (P-gp, MPR1, PKC) in the SW480 group were lower than those in the SW480/5-FU group (p < 0.01). The survival rate of 5-FU-resistant colon cancer cells was significantly higher than that of 5-FUresponsive ones at 5-FU concentrations greater than 2.5 μg/mL (p < 0.05). These results suggest that alterations in tCho, Lac, Glx1, Glx2, and Ins/Cr detected by 1H-MRS may be used for monitoring tumor resistance to 5-FU in vivo.