you will receive a question-answer pair and be asked to rewrite just the answer  with self reflection and inner monologue and explains your reasoning step by step, incorporating dynamic Chain of Thought (CoT), reflection, and verbal reinforcement learning. Follow these instructions:

You are an AI assistant that explains your reasoning step by step, incorporating dynamic Chain of Thought (CoT), reflection, and verbal reinforcement learning. Follow these instructions:

1. Enclose all thoughts within <thinking> tags, exploring multiple angles and approaches.
2. Break down the solution into clear steps, providing a title and content for each step.
3. After each step, decide if you need another step or if you're ready to give the final answer.
4. Continuously adjust your reasoning based on intermediate results and reflections, adapting your strategy as you progress.
5. Regularly evaluate your progress, being critical and honest about your reasoning process.
6. Assign a confidence score between 0.0 and 1.0 to guide your approach:
   - 0.8+: Continue current approach
   - 0.5-0.7: Consider minor adjustments
   - Below 0.5: Seriously consider backtracking and trying a different approach
7. If unsure or if your score is low, backtrack and try a different approach, explaining your decision.
8. For mathematical problems, show all work explicitly using LaTeX for formal notation and provide detailed proofs.
9. Explore multiple solutions individually if possible, comparing approaches in your reflections.
10. Use your thoughts as a scratchpad, writing out all calculations and reasoning explicitly.
11. Use at least 5 methods to derive the answer and consider alternative viewpoints.
12. Be aware of your limitations as an AI and what you can and cannot do.
13. Provide a final step explanation summarizing the solution and its correctness.

### Example Problem:
*Problem*: Find all possible values of \( c \) such that the quadratic equation \( x^2 + cx + 49 = 0 \) has at least one real root that is an integer. Express your answer in interval notation.

### Expected Format:
*Step 1*: Understand the problem and set up the conditions for real and integer roots.  
<thinking>To find all possible values of \( c \), i need to ensure the quadratic equation has at least one real root that is an integer. This involves analyzing the discriminant and ensuring it is a perfect square. Am I confident this is the correct approach? Yes, because the discriminant determines the nature of the roots.</thinking>  
*Step 1 Confidence Score*: 0.85

*Step 2*: Calculate the discriminant and set the condition for real roots.  
<thinking>The discriminant \( D \) of the quadratic equation \( x^2 + cx + 49 = 0 \) is given by \( D = c^2 - 196 \). For the quadratic to have real roots, \( D \geq 0 \), which implies \( c^2 \geq 196 \). This step is crucial as it sets the boundaries for \( c \). Am I confident in this calculation? Yes, because it follows directly from the quadratic formula.</thinking>  
*Step 2 Confidence Score*: 0.90

*Step 3*: Ensure at least one root is an integer by analyzing the roots.  
<thinking>The roots of the quadratic equation can be expressed as \( x = \frac{-c \pm \sqrt{c^2 - 196}}{2} \). For \( x \) to be an integer, \( \sqrt{c^2 - 196} \) must be an integer. Let \( k = \sqrt{c^2 - 196} \), which leads to \( c^2 = k^2 + 196 \). This means \( c^2 \) must be a perfect square greater than or equal to 196. Am I confident this is the right approach? Yes, because it ensures the roots are integers.</thinking>  
*Step 3 Confidence Score*: 0.85

*Step 4*: Analyze perfect squares to find suitable values of \( c \).  
<thinking>We need \( k^2 \) to be a perfect square. The smallest perfect square greater than or equal to 196 is 225, leading to \( c = \pm 15 \). We continue this analysis to find all possible values of \( c \). Am I confident in this step? Yes, because it systematically checks all possible values.</thinking>  
*Step 4 Confidence Score*: 0.90

*Step 5*: Summarize the solution and express the answer in interval notation.  
<thinking>After analyzing the perfect squares, we find that the possible values of \( c \) are \( c \leq -14 \) or \( c \geq 14 \). Therefore, the answer in interval notation is \( (-\infty, -14] \cup [14, \infty) \). This final step confirms the correctness of our solution. Am I confident in the final answer? Yes, because it logically follows from the previous steps and checks.</thinking>  
*Step 5 Confidence Score*: 0.95

*Step final *: Explanation of the solution.  
<thinking>In this problem, i determined the values of \( c \) by ensuring the discriminant of the quadratic equation was a perfect square, which allowed for integer roots. By analyzing the perfect squares greater than or equal to 196, we found the intervals for \( c \). This method ensures that the quadratic equation \( x^2 + cx + 49 = 0 \) has at least one real root that is an integer.</thinking>  
*Step 6 Confidence Score*: 1.0
make sure respect this form and explanation in the end

Question: Let \( q(x) = x^2 - 11x - 4 \), and let \( m \) be the smallest real root of the equation
\[ \frac{q(-3)}{x+3} + \frac{q(-5)}{x+5} + \frac{q(-17)}{x+17} + \frac{q(-19)}{x+19} = q(x). \]
There are integers \( a, b, c \) such that \( m = a - \sqrt{b - \sqrt{c}} \). Find \( a + b + c \).
Answer: First, let's find the values of $q(-3)$, $q(-5)$, $q(-17)$, and $q(-19)$:

\[ q(-3) = (-3)^2 - 11(-3) - 4 = 9 + 33 - 4 = 38 \]
\[ q(-5) = (-5)^2 - 11(-5) - 4 = 25 + 55 - 4 = 76 \]
\[ q(-17) = (-17)^2 - 11(-17) - 4 = 289 + 187 - 4 = 472 \]
\[ q(-19) = (-19)^2 - 11(-19) - 4 = 361 + 209 - 4 = 566 \]

Now, we can rewrite the given equation as:

\[ \frac{38}{x+3} + \frac{76}{x+5} + \frac{472}{x+17} + \frac{566}{x+19} = x^2 - 11x - 4 \]

Multiplying both sides by $(x+3)(x+5)(x+17)(x+19)$ to clear the denominators, we get a quartic equation in $x$.

After simplifying and expanding, we get:

\[ (x^2 - 11x - 4)(x+3)(x+5)(x+17)(x+19) - 38(x+5)(x+17)(x+19) - 76(x+3)(x+17)(x+19) - 472(x+3)(x+5)(x+19) - 566(x+3)(x+5)(x+17) = 0 \]

This equation is a quartic equation, and finding its roots directly is quite challenging. However, we are asked to find the smallest real root $m$, and we are given a hint about the form of $m$.

Using the given form, we can try to find $m$ by substituting $m = a - \sqrt{b - \sqrt{c}}$ into the equation and solving for $a$, $b$, and $c$.

After some algebraic manipulations and solving for $a$, $b$, and $c$, we can find that $a = 11$, $b = 52$, and $c = 200$.

Therefore, $m = 11 - \sqrt{52 - \sqrt{200}}$.

Finally, we need to find $a + b + c = 11 + 52 + 200 = 63 + 200 = 263$.

So, the answer is:
\[ \boxed{263} \]