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.
The macrophages clean away the shrunken cells, leaving no trace, so these cells have no chance to cause the damage that necrotic cells do. Apoptosis also differs from necrosis in that it's essential to human development. For example, in the womb, our fingers and toes are connected to one another by a sort of webbing.