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.
Apoptosis is programmed cell death or cell suicide. It is mainly initiated by the cutting off a portion of the inactive procaspases to make active caspases, which are proteins that speed up chemical reactions that start degrading parts of the cell and are the most important activator of cellular destruction.