The D|AX fourth P|AO|R|TH F|U|R|TH P|U|R|TH F|AO|R|T P|AO|R|T F|U|R|T P|U|R|T and AX|N|JH most M|U|S|T M|O|SH|T M|U|SH|T specific SH|P|AX|SH|IH|F|IH|K S|P|AX|S|I|F|I|K SH|P|AX|SH|I|F|I|K S|P|AX|S|IH|P|IH|K SH|P|AX|SH|IH|P|IH|K S|P|AX|S|I|P|I|K SH|P|AX|SH|I|P|I|K level L|I|V|AX|L L|EH|B|AX|L L|I|B|AX|L is I|Z IH|S I|S made M|A|D M|E + I|JH M|A|JH up O|P of O|V AH|B O|B clusters K|L|O|S|T|ER|Z K|L|AH|SH|T|ER|Z K|L|O|SH|T|ER|Z K|L|AH|S|T|I R|Z K|L|O|S|T|I R|Z K|L|AH|SH|T|I R|Z K|L|O|SH|T|I R|Z K|L|AH|S|T|ER|S K|L|O|S|T|ER|S K|L|AH|SH|T|ER|S K|L|O|SH|T|ER|S K|L|AH|S|T|I R|S K|L|O|S|T|I R|S K|L|AH|SH|T|I R|S K|L|O|SH|T|I R|S of O|V AH|B O|B signs SH|A + I|N|Z S|IH|N|Z SH|IH|N|Z S|A + I|N|S SH|A + I|N|S S|IH|N|S SH|IH|N|S and AX|N|JH symptoms SH|IH|M|P|T|AX|M|Z S|I|M|P|T|AX|M|Z SH|I|M|P|T|AX|M|Z S|IH|M|P|T|AX|M|S SH|IH|M|P|T|AX|M|S S|I|M|P|T|AX|M|S SH|I|M|P|T|AX|M|S that D|AE|T DH|A|T D|A|T describe JH|IH|S|K|R|A + I|B D|I|S|K|R|A + I|B JH|I|S|K|R|A + I|B D|IH|SH|K|R|A + I|B JH|IH|SH|K|R|A + I|B D|I|SH|K|R|A + I|B JH|I|SH|K|R|A + I|B D|IH|S|K|R|IH|B JH|IH|S|K|R|IH|B D|I|S|K|R|IH|B JH|I|S|K|R|IH|B D|IH|SH|K|R|IH|B JH|IH|SH|K|R|IH|B D|I|SH|K|R|IH|B JH|I|SH|K|R|IH|B actual A|K|CH|AX|W|AX|L AE|K|SH|AX|W|AX|L A|K|SH|AX|W|AX|L problems P|R|U|B|L|AX|M|Z P|R|AA|B|L|AX|M|S P|R|U|B|L|AX|M|S