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: A form of cell death in which a programmed sequence of events leads to the elimination of cells without releasing harmful substances into the surrounding area. Apoptosis plays a crucial role in developing and maintaining the health of the body by eliminating old cells, unnecessary cells, and unhealthy cells.
The apoptosis mechanism removes the cell with a minimum of risk or damage to nearby cells. Apoptosis shrinks the cell, degrades the DNA in its nucleus, breaks down the mitochondria, and then breaks the cell into small, neat, membrane-wrapped, fragments. Finally, nearby phagocytic cells engulf the cell fragments.