```xml
<?xml version="1.0" encoding="UTF-8" standalone="yes"?>
<ns3:query_definition xmlns:ns2="http://www.i2b2.org/xsd/cell/crc/psm/1.1/" xmlns:ns4="http://www.i2b2.org/xsd/cell/crc/psm/analysisdefinition/1.1/" xmlns:ns3="http://www.i2b2.org/xsd/cell/crc/psm/querydefinition/1.1/">
    <query_name>Circulatory system-Acute Rheumatic fever@14:33:52</query_name>
    <query_timing>ANY</query_timing>
    <specificity_scale>0</specificity_scale>
    <panel>
        <panel_number>1</panel_number>
        <panel_timing>ANY</panel_timing>
        <panel_accuracy_scale>100</panel_accuracy_scale>
        <invert>0</invert>
        <total_item_occurrences>1</total_item_occurrences>
        <item>
            <hlevel>1</hlevel>
            <item_name>Circulatory system</item_name>
            <item_key>\\i2b2_DIAG\i2b2\Diagnoses\Circulatory system (390-459)\</item_key>
            <item_icon>FA</item_icon>
            <tooltip>Diagnoses \ Circulatory system</tooltip>
            <class>ENC</class>
            <constrain_by_modifier>
                <modifier_name>Admit Diagnosis</modifier_name>
                <modifier_key>\\i2b2_DIAG\Admit Diagnosis\</modifier_key>
                <applied_path>\i2b2\Diagnoses\Circulatory system (390-459)\%</applied_path>
            </constrain_by_modifier>
            <item_is_synonym>false</item_is_synonym>
        </item>
    </panel>
    <panel>
        <panel_number>2</panel_number>
        <panel_timing>ANY</panel_timing>
        <panel_accuracy_scale>100</panel_accuracy_scale>
        <invert>0</invert>
        <total_item_occurrences>1</total_item_occurrences>
        <item>
            <hlevel>3</hlevel>
            <item_name>Acute Rheumatic fever</item_name>
            <item_key>\\i2b2_DIAG\i2b2\Diagnoses\Circulatory system (390-459)\Acute Rheumatic fever (390-392)\</item_key>
            <item_icon>FA</item_icon>
            <tooltip>Diagnoses \ Circulatory system \ Acute Rheumatic fever</tooltip>
            <class>ENC</class>
            <item_is_synonym>false</item_is_synonym>
        </item>
    </panel>
</ns3:query_definition>

```

I want to find all instances where a patient has been diagnosed with Acute Rheumatic fever within the Circulatory system category in the i2b2 database. This query looks for any occurrences of this diagnosis, regardless of the timing, and is set to have a high specificity scale and accuracy. The query includes two panels, one for the Circulatory system category and another for Acute Rheumatic fever as a subcategory within it. The query does not invert the results, meaning it will return only positive matches. The query is not a synonym and is constrained by the "Admit Diagnosis" modifier, meaning it will only return results where the diagnosis was made during admission.