I guess I don't quite get it. What's so wrong with Win32::API? I mean, I definitely see an argument for developing a custom module as a wrapper around that rather than using Win32::API directly in application code, but why go to the trouble of XS or Inline just to call an external DLL when you don't need to?
Aldo himself suggests that, for heavy duty use (and here I assume he's referring to production code et al), XS should be used in preference to his own Win32::API module ...
At last, a user level that best describes my experience :-))