I agree, this has to be THE most complicated dialog of the whole app. It makes little sense that opening a project should ever be allowed to overwrite an exiting profile (at that stage anyways). Opening a profile with a different set of parameters (but from an existing profile) should just append its profile to the profiles list TEMPORARILY (and only while that project is in use) rather than creating a new permanent profile. Then add a mechanism to allow the user to copy/save that temporary profile onto an existing profile.
As it stands now, I'm presented with 2 choices, and I have not a clue which one to select every time it appears.