Tried to run something similar to this in KSync using a SLX OLEDB connection:

select top 1 firstname, left(firstname,2) from sysdba.contact order by firstname desc

Rather than yielding something like "Smith", "Sm" I get "Smith", "0". Tried to test it in the SLX admin and get the same results. I'm on v7.2.1

Is it possible this really doesn't work and I've simply never tried before?

I ran the same code on 7.5.3 and 7.5.2 and it works fine, so it could be just a bug on that specific version.

What hot fixes?

I can honestly say that we  have no one deployed with 7.2.1......7.2.2 definitely.