```xml
<?xml version="1.0" encoding="UTF-8" standalone="yes"?>
<ns4:query_definition xmlns:ns2="http://www.i2b2.org/xsd/cell/crc/psm/1.1/" xmlns:ns4="http://www.i2b2.org/xsd/cell/crc/psm/querydefinition/1.1/" xmlns:ns3="http://www.i2b2.org/xsd/cell/crc/psm/analysisdefinition/1.1/">
    <query_name>Patient Instruc@20:32:38</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>6</hlevel>
            <item_name>Maxair 0.2 mg/inh aerosol with adapter 3 M Pharmaceuticals</item_name>
            <item_key>\\i2b2_MEDS\i2b2\Medications\MUL\(LME219) respiratory agents\(LME223) bronchodilators\(LME224) adrenergic bronchodilators\pirbuterol\00089079021\</item_key>
            <item_icon>FA</item_icon>
            <tooltip>medications \ respiratory agents \ bronchodilators \ adrenergic bronchodilators \ pirbuterol \ maxair 0.2 mg/inh aerosol with adapter 3 m pharmaceuticals</tooltip>
            <class>ENC</class>
            <constrain_by_modifier>
                <modifier_name>Patient Instructions</modifier_name>
                <modifier_key>\\i2b2_MEDS\Medication\Instructions\</modifier_key>
                <applied_path>\i2b2\Medications\%</applied_path>
                <constrain_by_value>
                    <value_operator>CONTAINS[database]</value_operator>
                    <value_constraint>breath</value_constraint>
                    <value_type>LARGETEXT</value_type>
                </constrain_by_value>
            </constrain_by_modifier>
            <item_is_synonym>false</item_is_synonym>
        </item>
    </panel>
</ns4:query_definition>

```

I want to find all instances where the medication "Maxair 0.2 mg/inh aerosol with adapter 3 Pharmaceuticals" was prescribed to patients, and the patient instructions for this medication contain the word "breath" in the database. The query will be applied to the "Medications" panel, and the specificity scale is set to 0, meaning that all occurrences of the medication will be considered regardless of the specificity of the information provided. The accuracy scale is set to 100, indicating that the query should return highly accurate results. The query timing is set to "ANY," meaning it will search for instances regardless of when the medication was prescribed. The panel timing is also set to "ANY," meaning it will consider all panels regardless of when they were created. The invert value is set to 0, meaning the query will return positive results only. There is only one item in the panel, and the hierarchy level is set to 6. The class is set to "ENC," which stands for "Encounter." The tooltip provides additional information about the medication and its classification.