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.
Multicellular organisms protect and even sculpt themselves by programmed cell suicide - a process called apoptosis. Of the four principles of multicellular systems, perhaps the least obvious is apoptosis (sometimes spelled aptosis or apotosis, and also known as Programmed Cell Death or PCD).