Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There has been no significant interval change . Left chest wall pacing device is again seen . The lungs are well expanded and clear without effusion or vascular congestion . The cardiomediastinal silhouette is stable and atherosclerotic calcifications are again noted at the aortic arch . No acute osseous abnormality is identified .
    OUTPUT:
    
No acute cardiopulmonary process .