BackgroundThrombocytopenia, bleeding and plasma leakage are cardinal features of severe dengue. Endothelial cell activation with exocytosis of Weibel-Palade bodies (WPBs) may play an etiological role in this condition.Methods and Principal FindingsIn a cohort of 73 Indonesian children with dengue hemorrhagic fever (DHF), of which 30 with dengue shock syndrome (DSS), we measured plasma levels of the WPB constituents von Willebrand factor antigen (VWF:Ag), VWF propeptide and osteoprotegerin (OPG), together with activity levels of the VWF-cleaving enzyme ADAMTS-13 and the amount of VWF in a platelet binding conformation (VWF activation factor). Compared with healthy controls (n = 17), children with DHF/DSS had significantly higher levels of VWF:Ag, VWF propeptide and OPG and decreased ADAMTS-13 activity. The VWF activation factor was also significantly higher in DHF/DSS and highest in children who died. There were significant differences in the kinetics of the various WPB constituents: VWF propeptide and OPG levels decreased toward discharge, while VWF:Ag levels were lower than expected at enrollment with plasma levels increasing toward discharge. Moreover, VWF propeptide levels correlated better with markers of disease severity (platelet count, liver enzymes, serum albumin and pleural effusion index) than corresponding VWF levels. Together, these findings suggest that there is consumption of VWF in DHF/DSS. In 4 out of 15 selected children with low ADAMTS-13 levels on admission, we found a remarkable reduction in the large and intermediate VWF multimers in the discharge blood samples, consistent with an acquired von Willebrand disease.ConclusionThese findings suggest that severe dengue is associated with exocytosis of WPBs with increased circulating levels of VWF:Ag, VWF propeptide and OPG. High circulating levels of VWF in its active conformation, together with low ADAMTS-13 activity levels, are likely to contribute to the thrombocytopenia and complications of dengue. During the convalescence phase, qualitative defects in VWF with loss of larger VWF multimers may develop.

Semarang city has two canals which was developed to decrease the flood risk happened since 19th century, those are known as Banjir Kanal Timur (BKT) and Banjir Kanal Barat (BKB). Both canals which are made connected to Sungai Garang are served as primary drainages that flow directly to the sea. The weak regulation of limitation zone (e.g. riverfront) caused many violations done by people around the area by built houses or places for working along BKT riverfront. Many buildings are made as houses (i.e. commonly used by the poor) drives domestic waste dumped in the river. This is one of many driving forces caused flooding in Semarang City (i.e. the nature factor is erosion happen in BKT river upstream). Those problems caused sedimentation in BKT downstream and indirectly caused the water spilled to the settlement around the river. The development by Eco-Riverwalk Village Concept are implemanted as an effort to improve the ecology aspect in riverfront area by build a linear park as a new identity of Kelurahan Mlatiharjo Riverfront. Linear park is the implemantation of ‘riverwalk’ concept (i.e. the walkable zone along the river) and improve the aesthetic value in case study area.

The existence of Undip and Unika in Semarang become the main attraction for students who are outside Semarang. It can increase the activity around Undip and Unika areas. Nevertheless, there are some new things happening around the campus area, in September 2017, there were reports of loss of 34 motorcycles, 133 helmets and 1 rearview mirror in Undip. Meanwhile, Unika has a case of murder that killed a man outside the exit gate of Unika in 2014. Therefore to minimize the crime case it is necessary to "Crime Prevention through Environmental Design (CPTED)" in campus area, can improve students' sense of security on the two campuses. In this research, to achieve the result of design quality, the method of analysis used is descriptive quantitative method. Analytical technique used is Analytical Hierarchy Process (AHP) and scoring using categorical given in the form of descriptive quantitative. Results of research that determine in Undip are in the sufficient category with 2,079 and the Unika category is in good category with a score of 2,378. These differences can be influenced by factors such as land area, contour, building density, area, number of students, and number of activities, which can cause facilities and policies to reduce crime and improve security at Undip and Unika.