You only need the English Proficient for international operations as it's an ICAO thing. Some countries, like France, check; others may not. Similar on the RRTO -- some countries, like Canada and the Bahamas don't require it, but others, like Turks & Caicos, do require it and do check it.
Apoptosis, or programmed cell death, is a naturally occurring process in the body. It involves a controlled sequence of steps in which cells signal self termination. Apoptosis works to keep the body's natural cell division process of mitosis in check.
Macroautophagy, often referred to as autophagy, is a type of programmed cell death accomplished through self-digestion. It is a catabolic process that results in the autophagosomic-lysosomal degradation of bulk cytoplasmic contents, abnormal protein aggregates, and excess or damaged organelles.