To simplify the expression, we first need to rationalize the denominators of the fractions.

Starting with the first fraction:
5 / (4 + √11)

We multiply both the numerator and denominator by the conjugate of the denominator, which is 4 - √11:
5 / (4 + √11) * (4 - √11) / (4 - √11)
= 5(4 - √11) / (16 - 11)
= (20 - 5√11) / 5
= 4 - √11

Next, simplify the second fraction:
8 / (√19 - √11)

We multiply both the numerator and denominator by the conjugate of the denominator, which is √19 + √11:
8 / (√19 - √11) * (√19 + √11) / (√19 + √11)
= 8(√19 + √11) / (19 - 11)
= 8(√19 + √11) / 8
= √19 + √11

Finally, simplify the third fraction:
-10 / (√19 + 3)

There's no need to rationalize the denominator in this fraction since there are no square roots added or subtracted to the denominator.

Now we can rewrite the expression with the simplified fractions:
4 - √11 + √19 - √11 - 10 / (√19 + 3)

= 4 + √19 - 2√11 - 10 / (√19 + 3)

Therefore, the simplified expression is:
4 + √19 - 2√11 - 10 / (√19 + 3)