That does does mean that be other hidden 'tweaks' on the system. Make sure Pinballx isn't set to run in any compatibility mode too. Also check visual pinball etc.
The issue when it occurs is still a game doesn't launch and pinballx hangs, so for the above you exited a game and and tried to launch another?
The compatibility issues were resolved in a later version so you should be good to go to 64bit, you can install to a fresh directory so you leave your current 32bit install if you want - then just copy over your database files and ini to test (so copy databases and config folders, no need to copy media)
Going back to the procmon errors, an nvidia profile file is shown, and i did find this link https://answers.microsoft.com/en-us/windows/forum/all/program-startup-very-slow-auroradll/b9437ddd-1600-49d3-849d-70bfd5cf3131 re aurora.dll which is also shown in the image... so i suspect the problems there lie with nvidia drivers. Don't know if they relate to your main issue or not. but it may be worth checking if pinballx has it's own program settings in nvidia control panel rather than using global settings) and/or updating/reinstalling nvidia drivers if you're confident with that kind of thing.
Cool, make sure the log is after a failed launch.