```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>(t) DiagnosesCirculatory sysDigestive systeEvents of pregnInjury and pois@11:27:33</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>Diagnoses</item_name>
            <item_key>\\i2b2_DIAG\i2b2\Diagnoses\</item_key>
            <item_icon>FA</item_icon>
            <tooltip>Diagnoses</tooltip>
            <class>ENC</class>
            <item_is_synonym>false</item_is_synonym>
        </item>
    </panel>
    <subquery_constraint>
        <first_query>
            <query_id>Event 1</query_id>
            <join_column>STARTDATE</join_column>
            <aggregate_operator>FIRST</aggregate_operator>
        </first_query>
        <operator>LESS</operator>
        <second_query>
            <query_id>Event 2</query_id>
            <join_column>STARTDATE</join_column>
            <aggregate_operator>FIRST</aggregate_operator>
        </second_query>
    </subquery_constraint>
    <subquery_constraint>
        <first_query>
            <query_id>Event 2</query_id>
            <join_column>STARTDATE</join_column>
            <aggregate_operator>FIRST</aggregate_operator>
        </first_query>
        <operator>LESS</operator>
        <second_query>
            <query_id>Event 3</query_id>
            <join_column>STARTDATE</join_column>
            <aggregate_operator>FIRST</aggregate_operator>
        </second_query>
    </subquery_constraint>
    <subquery_constraint>
        <first_query>
            <query_id>Event 2</query_id>
            <join_column>STARTDATE</join_column>
            <aggregate_operator>FIRST</aggregate_operator>
        </first_query>
        <operator>LESS</operator>
        <second_query>
            <query_id>Event 4</query_id>
            <join_column>STARTDATE</join_column>
            <aggregate_operator>FIRST</aggregate_operator>
        </second_query>
    </subquery_constraint>
    <subquery>
        <query_id>Event 1</query_id>
        <query_type>EVENT</query_type>
        <query_name>Event 1</query_name>
        <query_timing>SAMEINSTANCENUM</query_timing>
        <specificity_scale>0</specificity_scale>
        <panel>
            <panel_number>1</panel_number>
            <panel_timing>SAMEINSTANCENUM</panel_timing>
            <panel_accuracy_scale>100</panel_accuracy_scale>
            <invert>0</invert>
            <total_item_occurrences>1</total_item_occurrences>
            <item>
                <hlevel>2</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>
                <item_is_synonym>false</item_is_synonym>
            </item>
        </panel>
    </subquery>
    <subquery>
        <query_id>Event 2</query_id>
        <query_type>EVENT</query_type>
        <query_name>Event 2</query_name>
        <query_timing>SAMEINSTANCENUM</query_timing>
        <specificity_scale>0</specificity_scale>
        <panel>
            <panel_number>1</panel_number>
            <panel_timing>SAMEINSTANCENUM</panel_timing>
            <panel_accuracy_scale>100</panel_accuracy_scale>
            <invert>0</invert>
            <total_item_occurrences>1</total_item_occurrences>
            <item>
                <hlevel>2</hlevel>
                <item_name>Digestive system</item_name>
                <item_key>\\i2b2_DIAG\i2b2\Diagnoses\Digestive system (520-579)\</item_key>
                <item_icon>FA</item_icon>
                <tooltip>Diagnoses \ Digestive system</tooltip>
                <class>ENC</class>
                <item_is_synonym>false</item_is_synonym>
            </item>
        </panel>
    </subquery>
    <subquery>
        <query_id>Event 3</query_id>
        <query_type>EVENT</query_type>
        <query_name>Event 3</query_name>
        <query_timing>SAMEINSTANCENUM</query_timing>
        <specificity_scale>0</specificity_scale>
        <panel>
            <panel_number>1</panel_number>
            <panel_timing>SAMEINSTANCENUM</panel_timing>
            <panel_accuracy_scale>100</panel_accuracy_scale>
            <invert>0</invert>
            <total_item_occurrences>1</total_item_occurrences>
            <item>
                <hlevel>2</hlevel>
                <item_name>Events of pregnancy</item_name>
                <item_key>\\i2b2_DIAG\i2b2\Diagnoses\Events of pregnancy (630-677)\</item_key>
                <item_icon>FA</item_icon>
                <tooltip>Diagnoses \ Events of pregnancy</tooltip>
                <class>ENC</class>
                <item_is_synonym>false</item_is_synonym>
            </item>
        </panel>
    </subquery>
    <subquery>
        <query_id>Event 4</query_id>
        <query_type>EVENT</query_type>
        <query_name>Event 4</query_name>
        <query_timing>SAMEINSTANCENUM</query_timing>
        <specificity_scale>0</specificity_scale>
        <panel>
            <panel_number>1</panel_number>
            <panel_timing>SAMEINSTANCENUM</panel_timing>
            <panel_accuracy_scale>100</panel_accuracy_scale>
            <invert>0</invert>
            <total_item_occurrences>1</total_item_occurrences>
            <item>
                <hlevel>2</hlevel>
                <item_name>Injury and poisoning</item_name>
                <item_key>\\i2b2_DIAG\i2b2\Diagnoses\Injury and poisoning (800-999)\</item_key>
                <item_icon>FA</item_icon>
                <tooltip>Diagnoses \ Injury and poisoning</tooltip>
                <class>ENC</class>
                <item_is_synonym>false</item_is_synonym>
            </item>
        </panel>
    </subquery>
</ns3:query_definition>

```

I want to find patients who have an encounter with a diagnosis related to the circulatory system (Circulatory system) and do not have any encounters with diagnoses related to the digestive system (Digestive system), events of pregnancy (Events of pregnancy), or injury and poisoning (Injury and poisoning) within the same instance number (SAMEINSTANCENUM) and whose encounter dates for the circulatory system diagnosis are earlier than the encounter dates for the other three categories.