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What the margin difference looks like in practice: Community sources describe the room-temperature-stored punctured vial as more likely to reach the boundary of preservative efficacy within the 28-day window still technically within the documented period, but with less safety margin

Am J Clin Nutr 2014;100(6):1578-86

PMID: 2739055 Loeys BL, Dietz HC, Braverman AC, Callewaert BL, De Backer J, Devereux RB, Hilhorst-Hofstee Y, Jondeau G, Faivre L, Milewicz DM, Pyeritz RE, Sponseller PD, Wordsworth P, De Paepe AM

Stirring the paint before you test it lets you see if it really needs thickening

Concurrent Review Applies during ongoing inpatient stays