Mechanical Ventilation (MV) is a critical life-support intervention in intensive care units (ICUs). However, optimal ventilator settings are challenging to determine because of the complexity of balancing patient-specific physiological needs with the risks of adverse outcomes that impact morbidity, mortality, and healthcare costs. This study introduces ConformalDQN, a novel distribution-free conformal deep Q-learning approach for optimizing mechanical ventilation in intensive care units. By integrating conformal prediction with deep reinforcement learning, our method provides reliable uncertainty quantification, addressing the challenges of Q-value overestimation and out-of-distribution actions in offline settings. We trained and evaluated our model using ICU patient records from the MIMIC-IV database. ConformalDQN extends the Double DQN architecture with a conformal predictor and employs a composite loss function that balances Q-learning with well-calibrated probability estimation. This enables uncertainty-aware action selection, allowing the model to avoid potentially harmful actions in unfamiliar states and handle distribution shifts by being more conservative in out-of-distribution scenarios. Evaluation against baseline models, including physician policies, policy constraint methods, and behavior cloning, demonstrates that ConformalDQN consistently makes recommendations within clinically safe and relevant ranges, outperforming other methods by increasing the 90-day survival rate. Notably, our approach provides an interpretable measure of confidence in its decisions, which is crucial for clinical adoption and potential human-in-the-loop implementations.

Vision Transformers (ViTs) have shown promise in medical image semantic segmentation (MISS) by capturing longrange correlations. However, ViTs often struggle to model local spatial information effectively, which is essential for accurately segmenting fine anatomical details, particularly when applied to small datasets without extensive pre-training. We introduce Gabor and Laplacian of Gaussian Convolutional Swin Network (GLoG-CSUnet), a novel architecture enhancing Transformer-based models by incorporating learnable radiomic features. This approach integrates dynamically adaptive Gabor and Laplacian of Gaussian (LoG) filters to capture texture, edge, and boundary information, enhancing the feature representation processed by the Transformer model. Our method uniquely combines the longrange dependency modeling of Transformers with the texture analysis capabilities of Gabor and LoG features. Evaluated on the Synapse multi-organ and ACDC cardiac segmentation datasets, GLoG-CSUnet demonstrates significant improvements over stateof-the-art models, achieving a 1.14% increase in Dice score for Synapse and 0.99% for ACDC, with minimal computational overhead (only 15 and 30 additional parameters, respectively). GLoG-CSUnet’s flexible design allows integration with various base models, offering a promising approach for incorporating radiomics-inspired feature extraction in Transformer architectures for medical image analysis. The code implementation is available on GitHub at: https://github.com/HAAIL/GLoGCSUnet.