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.
Apoptosis is so carefully planned out that it is often called programmed cell death. During apoptosis, the cell shrinks and pulls away from its neighbors. Then, the surface of the cell appears to boil, with fragments breaking away and escaping like bubbles from a pot of boiling water.