Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left chest wall pacing device is again seen with leads in stable position . Calcific density projecting over the posterior right fourth rib compatible with bone island is unchanged . The lungs are clear without focal consolidation , effusion , or edema . The cardiomediastinal silhouette is stable . Atherosclerotic calcifications are noted at the aortic arch . No acute osseous abnormalities .
    OUTPUT:
    
No acute cardiopulmonary process .