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Place a fine-mesh strainer over a medium bowl and set it near the stove. Pour milk into a small heavy saucepan. If using vanilla bean, halve lengthwise and, using the tip of a small sharp knife, scrape the seeds from the pod into the saucepan. (Or add vanilla extract.) Whisk until well combined. Heat the milk over medium heat, stirring often, until steaming, but not bubbling.
Meanwhile, whisk egg yolks and sugar in a medium bowl.
Gradually whisk half the hot milk into the eggs until combined. Slowly whisk the egg-milk mixture into the remaining milk in the pan. Cook over medium-low heat, stirring constantly with a wooden spoon in a figure-eight motion, until the custard thickens enough to coat the back of the spoon, 4 to 6 minutes. The temperature should reach 160°F on an instant-read thermometer—watch carefully to prevent the custard from boiling. Working quickly, strain the custard into the bowl. Serve warm or at room temperature.